What is DBT?, by Dr. Monya Cohen, Psy.D., MSW, RYT-200, Certified PRYT Yoga Therapist
The past eighteen months have been rough for everyone, including teenagers. In-person school, virtual school, or a hybrid. It’s easy to fall behind with these disruptions. There has been so much change, unpredictability, and loss. Learning DBT Skills helps teens develop positive coping skills, learn to respond rather than react, and improve their relationships.
DBT or Dialectical Behavioral Therapy was developed by Marcia Linehan, Ph.D. in the 1980’s to help women diagnosed with borderline personality disorder. It was so successful that a skills manual (Rathus & Miller, 2015) was developed to work with teens and families. I use the DBT Skills Manual by Rathus and Miller (2015) as a foundation for the DBT skills group and share an electronic copy of the skills handouts with the students.
Dialectical is not a word that is part of our everyday vocabulary. Dialectical means that there are two ideas that are opposite and considered together, can create a new truth and a new way of viewing the situation. There is more than one way to see a situation. DBT incorporates CBT (cognitive behavioral therapy) and Zen mindfulness.
There are five DBT problem areas or problems to decrease: Reduced awareness and focus; emotional dysregulation, impulsivity, interpersonal problems, and teenager and family challenges.
DBT offers five modules or behaviors to increase: Core mindfulness skills, emotion regulation skills, distress tolerance skills, interpersonal effectiveness and walking the middle path. Mindfulness skills or ways to be in the present moment are learned and practiced throughout every session. The group members learn and practice coping skills, create a coping kit, learn to validate themselves and others, recognize and reframe thinking errors and learn skills to be more effective interpersonally.
I’ve been working with teens for many years and as you may recall, being a teenager has never been easy. As a teenager, you are struggling with the developmental stage of individuation and separation. Your peer group is the most important thing and yet you still need your parents – however not too much! You may feel left out, awkward, isolated, and afraid of being rejected. Electronic media has brought a whole new element of communicating as well as bullying to the world of teens. The DBT skills group lets them know they are not alone. In other words, other teens feel the same way and go through the same difficulties with peers, school and with families. The skills group provides them with a community and a safe place to practice and learn their skills. During the skills group, group members have an opportunity to lead one or more mindfulness exercises, share their experiences, as well as positive coping skills and resources with their peers.
Due to the long history of teenager and parent challenges, the Walking the Middle Path module addresses many of the difficulties that teens and their families face. In my experience of working with teens and their families, it is important for one or both parents to familiarize themselves with what the teens are learning in the skills group. I have learned that everyone, including myself have room to improve our thinking, learn how to be more present and less reactive, and be more open to perspectives that are different from our own. We can all learn to recognize when we are being judgmental and validate ourselves and others more often. I encourage parents to join me once a month to review and familiarize themselves with the current skills module. It helps to reinforce the teens when using their DBT Skills. In addition, parents can remind themselves and model for their teens positive ways of responding during a crisis.
A new virtual DBT Skills Group is starting on Wednesday, November 10 from 5:00 -6:30 pm. The group is limited to 8 teens. Register by October 10 and received a reduced rate and participate in the monthly parent DBT skills group free of charge. Be sure to reach out if you have any questions or concerns at firstname.lastname@example.org.
Lets face it, over the last year or so, we have all been made to live with a higher level of stress than we are used to. Everyone has had to deal with some degree of change. There are many different things to turn to when looking to treat this stress or cope with the intense changes life and indeed, humanity, has been going through. For thousands of years, people have looked to acupuncture as an incredible resource and modality to treat stress and for the effects it can have on mental health. As an ancient form of holistic medicine, acupuncture exists as a powerful method of healing to promote the body's own innate system of vitality. The philosophical concepts that act as a foundation of acupuncture explore a universal notion of balance in all things. Everything from the macrocosmic to the microcosmic. From the structure of a galaxy to a human cell, the relationship between night and day, or an ecosystem in nature. All things that exist in this reality have a harmony and equilibrium to them. When integrating these metaphor based, esoteric concepts of Chinese medicine with modern science we can come to see how there are countless overlaps.
The balance of "Qi" or ones vitality, can be paralleled to homeostasis just as using different acupuncture points to "calm the mind" can be illustrated to effect the nervous system in a way to activate the parasympathetic (rest and digest) nervous system. There is a myriad of scientific literature that supports acupuncture's efficacy for therapeutic stress reduction and in turn, supportive modality for mental health. Acupuncture and its relationship with mental health can be understood in a scientific context by observing the changes in neurotransmitters and endorphin release, such as serotonin and beta-endorphin ("feel good chemicals"). Similarly, one could look to the rich history of literally thousands of years of empirical and anecdotal acupuncture evidence that makes up the backbone of Chinese medicine. Some of us are more comfortable thinking of the science and some folks are happy to look at the philosophy. It is equally valid, important, and profound as a form of medicine either way. However we choose to view and understand the mechanisms, in times like these we could certainly all benefit from some self care.
So how does this relate to everything happening in the world now, and your level of stress? Well, acupuncture can help to maintain your individual level of internal harmony and balance in both your physical and mental well-being. It is a wonderful method of healing and can help to relieve both conscious and even unconscious levels of stress and tension. Everyone's personal level of stress relates directly to their unique state of mental health. No two individuals are exactly alike, just as are our states of mental health and emotional well-being. Acupuncture fits perfectly to treat these issues, because treatments themselves are individualized and specific to the unique needs and patterns of each and every person. Acupuncture is also helpful in that the practitioner truly takes the time to figure out how to help you in the best way they can. It's not just about listing symptoms and throwing pharmaceuticals at them. It is a whole and comprehensive approach to treating the root causes of the problem at hand. Please let us know if you have any questions about how acupuncture can help you. We are happy to help in any way we can and confident that can make a significant impact on the quality of your life.
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