What in the World is DBT?
The following describes many of the challenges facing the youth who come to PATCH: Drama, isolation, chaos, loneliness, depression, poor grades, very poor family relationships, sexualized behavior, experimentation with drugs and self-harm such as cutting. Over the years the Ranch staff has observed five key areas that need to be addressed to help kids stabilize:
1. Confusion about self - who they are and what they want
2. Impulsivity - not considering cause and effect of their actions
3. Emotional instability - constant drama and negative attention-seeking behavior
4. Interpersonal problems - attracted to negative, destructive relationships
5. Parent-teen problems, - constant family power struggles
We have implemented Dialectical Behavior Therapy (DBT), which is a comprehensive treatment approach for people whose emotions create major problems in their lives (and perhaps in the lives of people around them). These emotions may be expressed in a destructive way (as in angry outbursts, or depression and immobility), or avoided by behaviors such as suicide attempts, substance abuse, eating disorders, or impulsive actions.
DBT clients are taught more skillful ways to regulate their emotions, deal with the distressing situations in their lives, and improve relationships. These skills are taught in caring treatment relationships that appreciate the clients' strengths, acknowledge their emotional sensitivity, and offer powerful, pragmatic methods for creating a "life worth living".
The staff coaches the clients on how to be responsible for their emotions. For example, often when a client receives a distressing phone call, the client becomes angry and perhaps yells at either staff or other clients. Using DBT coaching techniques, the staff helps the client find a healthy alternative such as journaling, listening to music, or a hot shower to bring the emotional level down. Once emotions aren’t creating havoc, the staff and client then focus on the source of the problems of why the phone call was so upsetting.
The parent component to DBT focuses on helping the parent coach their teenager on self-care and regulating their emotions, which improves communication and lessens power struggles.
DBT is not a fix all; however, it does empower young people with skills that they can take home. DBT is a treatment approach which has been shown to be effective in residential settings and has wide therapist recognition and support. Most importantly, we have watched as kids use the skills to avoid negative behaviors and build strong, positive relationships.