What The Heck Is DBT and Why Will It Help My Teen?

Dialectical Behavior Therapy (DBT) is a comprehensive treatment model that offers hope for teens who have not seen improvement in other therapies. It is based on actionable skills and focuses on problem solving and acceptance-based strategies. DBT is led by a DBT-Certified therapist who is intensively trained by Behavior Tech.

At Mindful Healing, LLC our DBT program for adolescents involves group skills training. These actionable skills focus on helping teens learn to feel in control of their emotions rather than their emotions being in control of them. To transfer skills to the home and school environment, many teens also participate in individual DBT and parent coaching.

DBT is used to treat teens with anything from school avoidance to suicidality. It is the gold standard of evidence based treatment for emotion regulation in teens.

What Skills Does DBT Teach?

DBT skills group is a co-ed open-enrollment group. It runs for 26 weeks.   Group has a maximum of 8 clients to ensure that everyone has the opportunity to fully engage. We ask that you make the commitment to attend for a minimum of 12-weeks to give your teen ample time to develop skills and begin to see progress.

DBT skills training is very structured and consists of five modules.

Mindfulness skills: Teaches teens how to focus the mind and to observe and describe what they are feeling and thinking in the moment without judgement. These skills can help teens reduce reactivity to painful thoughts and emotions.

Distress Tolerance: Learning how to accept yourself and the situation. More specifically, learning to tolerate a crisis and being able to recognize urges to do things that would be ineffective, such self-harm, without acting on them.

Emotion Regulation: Addresses emotional sensitivity, mood changes such as depression, anxiety, or anger. In addition, recognizing and coping with negative emotions, and reducing one’s emotional vulnerability by increasing positive life experiences.

Interpersonal Effectiveness: It’s often relationships with others that are the triggers for self-destructive behaviors in teens. Interpersonal effectiveness skills teach adolescents how to engage more effectively with others. In addition, it enables them to feel more supported by others.

Middle Path: Teaches teens how to shift perspectives and see more than one viewpoint rather than only extreme thinking and behaviors. These skills involve learning about how to compromise and negotiate, as well as methods of behavior change, validation and acceptance.

Additional DBT Supports Available At Mindful Healing:

Individual DBT psychotherapy: This is the main way of developing and refining the ability to apply skills taught in DBT skills group to daily life. Individual DBT focuses on helping teens identify personal triggers for behaviors and explore skill based solutions.

Parent Tele-Coaching: Many parents feel unsure of how to approach a particular situation, when or how to set limits, if setting limits will make things better or worse, how to encourage skills use, etc. Parents can contact our intake corrdinator to arrange an individual parent coaching session for assistance in developing their own skills!

Commitment Strategies: “Commitment strategies” are a cornerstone of DBT treatment. Not all adolescents choose to come to therapy. Some are encouraged by parents or friends to seek treatment, and may not be “motivated” initially to attend therapy. Special commitment strategies are used to help adolescents gain a better understanding of their behaviors, and how DBT skills will help them meet their own unique individual goals!

In a nutshell, DBT teaches teens actionable skills to help them learn to live a life they can love! DBT targets the issues that cause distress. It teaches teens skills to deal with them without having to resort to self-defeating behaviors.

GROUP THERAPY: IT’S NOT JUST “SOCIAL HOUR”

Sometimes I hear from parents that they don’t think group is right for their teen because they don’t believe that a “social hour” will help their depression or anxiety. Or that “social hour” would create too much anxiety or comparison for their teen.

But Here’s The Deal:

Support has been scientifically proven to be the #1 indicator of overall wellbeing. It leads to improved symptoms of anxiety and depression, and better physical health.

3 REASONS GROUP CAN BE THE BEST FOR YOUR TEEN:

Group helps your teen experience and learn that they are not alone

Being in a group with others who have similar struggles lets your teen know they are not the only one who feels this way and that they aren’t broken, bad, wrong or different for having the feelings that they do. It allows them to feel heard and understood and this experience is the first step towards healing.

Group hold your teen accountable their goals

Group members support each other in making healthy decisions and actionable changes. I’ve had group members commit to end toxic relationships, finish school work on time, work on angry outburst, and more… and they actually follow through because they have PEERS holding them accountable weekly and cheering them on. Peers accountability is more effective adults checking in on teens!

Group helps your teen learn to love and accept themselves the way they are

The experience of showing up week after week, sharing with teens who have similar struggles allows them to start to feel emotionally safe and be their authentic self. They begin to stop hiding behind emotional walls and allow themselves to be seen, known, and accepted for who they really are. This is a priceless experience and will rocket their self-esteem!

There are other ways to find social support for your teen. Whether you decide on group as a way to help your teen find support, or you seek connection for your teen elsewhere, our mission is to help your teen understand that they are not alone.

If you think group might be right for your teen contact us here for your free consultation.

What Teens Really Want!

It is hard to be the parent of a teenager. It is even harder to be the parent of a teenager that is struggling with depression, anxiety, anger, or suicidal thoughts. The worry, the desire to take their pain away, the sleepless nights and more…

Parents of teens that are struggling often say that they don’t know how to help them and feel that their teen is often isolating, angry, or pulling away. However, teens have a different perspective.

Watch this video to learn what teens really want and what you can do?

To learn more about how to connect with your teen click here to schedule your free consultation!

UNDERSTANDING NORMAL VS. ADNORMAL TEENAGER BEHAVIOR

With the school year starting I have been getting a lot of calls from parents worried about their teens. School anxiety is spiking, teens are beginning to feel overwhelmed and their dread of the new year is sinking in.

Parents ask me: “Lianna, how do I know if what my daughter’s is doing is a ‘normal teenager thing’ or if it’s something more serious? How do I know when I’m at the point where I should get my teenager some help?”

One of the hardest aspects for parents raising teenagers is understanding the difference between normal teenager behavior and unhealthy, abnormal teenage behavior. It’s normal for teens to become cranky, withdrawn, and — let’s be honest — irritating at times. But how can you tell if a teen is being moody or showing the warning signs of anxiety and depression? How can you distinguish typical teenage behavior from dangerous red flags?

WHAT’S NORMAL AND WHAT’S REASON FOR CONCERN?

I put together this list to help you get an idea of some of the differences to keep an eye out for. This is not an exhaustive list by any means but hopefully will help give you an idea of the basics.

WHAT CAN PARENT’S DO TO HELP?

Teen’s are always communicating with us, verbally and non-verbally. Sometimes we are just too distracted to notice all the signs. Listen to what they are saying and what concerns are on the minds. Ask questions for clarification, if you are a nag. Just own up to it, admit to being annoying and ask what they mean. Pay attention to their body language or any changes in behavior.

If you think your teen is in need of additional support contact me today!

3 Tips To Help Your Teen Cope With Back To School Anxiety

As you know school is starting and you know what happens next feelings of overwhelm, stress, and anxiety. I am going to address some of things you can do as a parent to help your kids be successful this year despite feeling anxious.

Many of us believe that by the time our kids reach high school they have back-to-school anxiety under control. Nope. Many of the teens I work with talk consistently about worrying about returning to school. They worry about a number of issues including classes, being liked, fitting in, finding their way around, what to say, managing their schedule and work load, etc.

Something I see a lot of with the teens I work with and I am sure many of you parents are familiar with too as that when teens get this anxious and uncomfortable they beg and plead to stay home. They actually can make themselves sick.

WHAT CAN YOU DO TO HELP…

So bearing in mind that your teens are nervous not only about the first day, but the first few weeks or months here are some tips you can use to help your teen adjust to returning to school:

  1. Look At the Basics

Have a routine. Start about 1-2 weeks before school starts. Get their sleeping back on track for a school schedule. Eat breakfast! No one copes well when they are hungry. Pack your book bag the night before, decide on your outfit, etc.

  1. Avoid reassuring instead focus on problem solving

Parents this doesn’t mean solve the problem for them. However, try to avoid statements like everything will be fine. Your teen doesn’t believe this and it can feel invalidating. Instead try to ask them problem solving questions, such as, If (worst thing) happened what would you do? Use things they identified as being anxious about (try not to come up with your own things, this may increase fears).

3. Encourage them to breathe

Practicing their coping skills will help them feel more confident when school starts. Try making this part of your house-hold routine. Role model using this as a skill or practice it as a family before or after dinner.

If your teen needs support with coping skills for returning to school contact me here  to learn more.

RAISING A CONFIDENT DAUGHTER IN TODAY’S WORLD

According to researchers this is the unhappiest, loneliest and most stressed out generation on record — and its girls who are struggling the most. By adolescence girls are twice as likely as boys to develop a mood disorder. Depressive symptoms in teen girls increased by 50% between 2012 and 2015, at more than twice the rate of boys. The results of one study in 2017 showed the number of girls who described themselves as “confident” declines more than 25% throughout middle school.

Despite girls excelling academically, they still don’t believe they are smart enough. 30% of girls with the highest grade point averages don’t believe they are intelligent enough to get into a good college.

WHY IS THERE SUCH A DISPARITY?

We know from looking at brain scans that there are differences in the way girls and boys process emotional stimuli. Girls mature, in terms of their emotional recognition, faster than boys—and that sensitivity could make them more vulnerable to depression, anxiety, and social acceptance.

WE KNOW THAT THE WORLD IS COMPLICATED FOR GIRLS

Fitting in, body image, pressure, academics, friendships and relationships are all challenging to navigate. Add to this, the potential challenges of technology and social media, and it is not surprising that girls are reporting high levels of pressure alongside declining levels of self-confidence. Girls

For too many girls today, motivation to be successful is fueled by intense self-criticism and fear that they will fail. Our girls may look exceptional on paper but they are often anxious and overwhelmed in life. Many feel that no matter how hard they try, they will never be smart enough, successful enough, pretty enough, thin enough, well liked enough, etc.  And it starts young.

AVOID FAT TALK

Between 40% and 60% of elementary school girls monitor their weight. This is partially responsible for the gender disparity of depression.

Many parents believe that their girls in elementary school are too young to have body image issues. Nope. Body acceptance starts early. Kids are sponges and absorb everything around them. Your daughters are influenced by media and by family socialization, this can begin as early as preschool.

Monitor your “Fat Talk” at home. negative comments about your body, how much you’ve eaten or exercised, or comments about others’ bodies. This is body bashing, a kind of ritual self-hatred girls begin practicing early, and many of them learn it from adult women.

Focus your body comments on the ways her body serves her, not others. When your daughter achieves a physical goal, point out how her strong or agile body helped her do it. Talk about eating to be healthy so we can do the things we love with our bodies.

PRAISE THE PROCESS NOT THE RESULT

Well intended efforts to praise your daughter can often backfire. As a parent when you focus on the result this can be heard by your daughter as pressure or an expectation. For example, one study showed that praising intelligence could undermine a child’s confidence.  Two groups of fifth graders received two different kinds of praise after taking an IQ test. Kids in one group were told, “Wow, that’s a good score. You must be really smart at this.” Kids in the other group were told, “Wow, that’s a good score. You must have worked really hard.”

Kids in both groups then had the opportunity to try a challenging task, with the promise they could learn from it. The kids in the “smart” group weren’t interested. The kids praised for their effort took it on. Not only that, the kids in the second group performed better over time, outpacing their “smart” peers on follow-up IQ tests. It appears that seeing intelligence as a fixed trait instills fear of failure that makes kids less able to handle setbacks.

DON’T BE A PERFECT PARENT

Role model messing up and making mistakes! Girls learn from media, adults, and peers to please others in order to remain likeable. The desire to please has a large impact on the loss of confidence for girls in the first place. Not surprisingly, many girls grow to fear failure. They think the more they succeed, the more liked they will be.

Whenever you can, show her that you can fail, mess up, make mistakes and still be okay; The world doesn’t end. Your worth didn’t change; your relationships didn’t change. The ability to handle disappointment and failure is the cornerstone for building confidence. She will learn from watching you.

USE SELF-COMPASSION NOT SELF-CRITISCM

This means that when you do make a mistake, feel bad, or embarrassed you role model saying “I feel really bad about this. It is okay to feel this way.” Rather than “I can’t believe this happened. I really messed up.”

Self-compassion is about being kinder to yourself when you are stressed or upset. Research shows that people who practice self-compassion have lower rates of depression and anxiety.

Next time you are running late and your daughter is with you rather than beating yourself up for being late try verbalizing kindness to yourself. Say out loud “I feel nervous because I am running late. It makes sense that I am late because I am busy and get behind. Lots of people run late. It won’t be the end of the world.”

Just remember to be in it for the long haul. Raising confident daughter’s is a process. Some days will seem easier than others. If your daughter needs help learning to fully accept herself, I am now enrolling for my fall Teen Girls Confidence Group. Contact Me  to apply.

YOU DON’T HAVE TO BE AFRAID OF YOUR EMOTIONS

Does your teen feel overwhelmed by emotions, hide from them or shove them down? Facing distress is difficult and a common reaction for teenagers is to shove those feelings away. Sometimes the emotions we are having feel so overwhelming we don’t want to feel them or deal with them so we shove them away, we are not even interest in going close to them because we are afraid to of what might happen if we connect to them.

It’s normal to have a range of emotions and every day is not going to be perfect. It’s okay to experience them.

How To Face Difficult Emotions

We have discovered that if you acknowledge them and label them the intensity with decrease and you will get through it quicker. In DBT we use the skill “riding the wave” to help teenagers learn to experience their emotions in the moment without their emotions being in control.

A surfer doesn’t fight the powerful ocean wave; he moves with the wave riding its natural tide. “Riding the wave” is also a practice of surfing your own powerful and negative emotions. Rather than fighting sadness, anger and other negative emotions, it’s about allowing your emotions to wash over you like a tidal wave, riding them out until they pass so that you can make wise decisions from a place of calm rather than a place of emotional turmoil that can often lead to destructive or ineffective behavior that doesn’t serve your goals.

When your teen is in distress it can be challenging to control or manage intense emotions. They may be flooded and inundated with negative emotions and harmful urges. There may be a feeling of hopelessness as the emotions are too overwhelming to deal with.  This is when riding the wave comes in handy.

Also known as Urge surfing, riding the wave involves observing and coping with the experience without trying to change it. As the more frequent tendency is to avoid, escape, or shove the feeling away, so riding the wave may seem unnatural. Riding the wave will give your teen a sense of personal control over uncomfortable feelings. Riding the wave allows one to sit with his or her discomfort, sorrow, and pain, instead of fighting the feeling by acting impulsively and engaging in harmful and self-destructive behaviors.  Although it can seem counterintuitive, accepting painful emotions allows for freedom from suffering.

It’s challenging to accept our thoughts and manage our emotions, but if we can learn how to “ride the wave” of our feelings we can prevent our urges from dictating our behavior. Your Teen will be more secure in knowing they have more control over their behavior and be able to respond rather than react!

This can be a difficult skill to learn. If you think your teen might benefit from riding the wave or other coping skills contact me here to learn more about Teen DBT Skills Group!

SHIFT OUT OF NEGATIVE THOUGHTS (GOAL IS NOT TO CHANGE THEM)

If your teen struggles with negative self-talk the DBT mindfulness skill “Fact or Judgement” may be the solution. They can enjoy the moment without negative thinking.

Thoughts and Feelings aren’t Facts

Anybody who has worked with teens or has teens know that negative self-talk teens are very hard on themselves and this impacts their behavior. Using “Fact or Judgement” can help teens notice what’s happening in their mind and have more control over their emotions and reactions.

For example, if a teen fails a test in school they may think “I’m not good enough. I’m a failure. I’m never going to succeed in school.” Thoughts like this just keeps going and going in their head and by the time they get home they may not be willing to talk or have an angry outburst and as the parent you have no idea why. They may even not want to do their homework, or not want to go to school anymore.

When using “Fact or Judgment” helps teens observe their negative self-talk and ask themselves is this a fact, or is this a judgment? This will help to give emotional distance from the thought.

Teens can say: “I’m having the that I am stupid because I failed this test and this is a judgement. The fact is that I didn’t study. I am passing the class.”

This will in turn impact their behavior: If your teen is no longer feeling like a failure or stupid and has stopped the negative-self talk wheel, they may be more open to studying, going to school, talking to you, etc.

Don’t Let Your Thoughts Drive You

Remember don’t let your thoughts take control. Thoughts are not facts. Practice noticing your thoughts and letting them go. Remind yourself of what the facts of the situation are. Ask yourself what is true here? What amI reacting to?

Some teens have even mentioned that it is helpful gain distance from their thoughts by saying them out loud or talking to them in third person (ex. Lianna this negative thought is just a thought, your facts are…).

This doesn’t mean to invalidate our feelings, just to acknowledge that the thought is just a thought and a fact is fact.

Need more support or tricks for your teen? Book your free parent consultation here.

YOUR TEEN CAN ACCEPT THE WORD “NO” (AND HERE IS HOW)

Does your teen get angry when told no or things don’t go their way? Accepting things that are uncomfortable is difficult for anyone, especially for teenagers. Teenagers are still developing their frontal lobes where decision making and patience reside.

Life can be messy. We experience pain, we are wronged, and sometimes life is simply unfair. When faced with a problem we can start by asking ourselves these questions:

1) Is there anything I can do about this? If so, do it. Change your situation.

2) Can I change how I feel about this situation? If so, change your feelings.

3) Can I tolerate this situation? This is where today’s blog comes in.

Many of the teens I work with at Mindful Healing struggle with accepting when things aren’t the they want them to be. This leads to anger, frustration, resentment, which in turn result in outburst at school or arguments at home. This can be related to parents having to set limits or it can be related to facing challenging situations in their life such as being justifiable wronged.

Teens often feel more in control when trying to change things they actually cannot control. There is an illusion of control for them. They are often trying to change their parents’ minds, trying to change the past, trying to change or control what other people think about them. This leads to increased suffering.

ACCEPTANCE

One skill I teach to help teens manage being told no, not getting their way or dealing with a painful experience from their past is Radical acceptance. We all have those moments we wish would could change but can’t. The first step to acceptance is realizing what it is not. Teens often feel like if they accept a situation they are giving up or saying that something wrong or unfair was okay.

ACCEPTANCE IS NOT AN ENDORSEMENT OF PAIN

Acceptance is about accepting the moment as it is and a willingness to be present in our lives without attachment to the past or future. In DBT we often use the mantra “I don’t like, I Can’t Change it, but I Can Accept it” to help shift us to an open state of mind.

If you have a teen who is struggling is experiencing anger, frustration, sadness or low self-esteem over things out of their control go ahead and reach out to me at hereand I will connect with you help explore the next best steps to helping your teen find happiness.

FIND YOUR TRUE SELF

If your teen struggles with not knowing who they are or feeling lost negative core beliefs may be part of the problem.

Many teens are filled with these negative core belief systems. Core beliefs are belief systems that impact how we see ourselves, others, our future, and the world. They develop over time, usually from childhood and from significant life events and circumstances. They are strongly-held and ridged belief systems that are reinforced by the tendency to focus on facts that support the belief and ignore evidence that contradicts the belief system.

Many of the teenagers I work with at Mindful Healing believe that “They will never get better,” “They aren’t worth helping,” “They are hurting the people around them,” or “They don’t deserve to be loved.”

These beliefs are distress intolerant and can be activated by certain circumstances. When they are triggered they create such a pain response and such large emotional reactions teens cannot tolerate distress.

Core-Beliefs Are Attached to Values

One of the skills I teach at Mindful Healing is the DBT skill: Finding Meaning

This skill helps teens take a look at their distress intolerant beliefs and identify the value and meaning that it is triggering. If they say “I hurt the people around me,” they may value relationships. If they say “I will never get better,” they may value hope.

When teens are able to identify their values and begin to stripe away their self-doubt they are better able to tolerate distress. Adding meaning to life can help create a sense of purpose, life, and hope for the future.

It can help them begin to change their distress intolerant beliefs and find their authentic self!