DBT for Children (DBT-C)
Approximately 5% of children struggle with emotional dysregulation and challenges coping.
With only a handful of clinicians in the United States trained in this specialized treatment, DBT-C is an effective approach for treating children ages 7-12 years old.
Is DBT-C effective for Children?
As parents, you are not alone in navigating uncertainty around your child’s emotions. What we have come to learn through DBT research is that some children are born as highly emotionally sensitive. We call them supersensers. The advantages to having a child who is a supersensor is that they feel positive emotions very strongly, can easily read other people’s emotions, have increased empathy and caring, and are creative. Some of the challenges that you may be noticing that your child is facing are that they get upset very easily or suddenly, have really strong feelings, and it takes a longer time to calm down.
Dialectical Behavior Therapy specifically helps children to recognize and understand emotions, better control behavior, learn ways to effectively cope with problems, and learn how to problem-solve difficulties. DBT-C is a behavioral approach that focuses on specific strategies around thinking and acting patterns in your child to help them better regulate emotions through a dialectical framework. Specifically, we consider behavioral changes by appreciating that everything has at least two sides and therefore searching for a synthesis of these polar opposites.
How does DBT-C support Emotional Regulation in Children?
Emotion dysregulation means blindly following whatever emotions are telling us to do. This can be both uneasy for children to experience and unsettling for parents to observe. The goal of DBT-C is to work towards an awareness of emotion regulation. Emotion regulation requires learning skills and practicing them to decrease reactive responding. It is important to note that learning how to regulate emotions can be very difficult especially for supersensers. There is a high chance that the child’s problematic or shut down behaviors will get worse at the beginning of treatment before it gets better.
Three steps to behavior change that are the cornerstone of DBT-C are: awareness and being mindfulness of thoughts, sensations, and action urges; a willingness and motivation to learn effectiveness and consider what works; and engage in adaptive skills and effective problem solving to cultivate behavior capabilities of what to do that works. Individual therapy provides an opportunity for your child to talk about their problems, learn about their emotions, help them understand what gets them in trouble, and how to communicate their needs. The focus deepens to helping your child be a better problem solver and apply learned skills to everyday problems.
How do parents support their children in DBT-C treatment?
As parents, you play a role in the therapy! Parents are given the opportunity to learn about what it means to parent a supersensor and practice their own emotion regulation. This is a crucial aspect of DBT-C. We ask for your commitment to both understanding and modeling the skills that your child is learning to create a common language that facilitates trust and connection between you and your child. The focus is on two aspects: validation skills that support acceptance techniques, and behavior modification that focuses on change techniques.
Could DBT help your child?
Which specific skills are most relevant?
DBT-C focuses on the 4 components of DBT: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
Mindfulness: Learn how to be truly present.
Mindfulness skills teach you how to be grounded to the present moment, and focus on your current situations. Regular mindfulness practice can help keep you grounded and increase your focus. By being grounded in the present, you are better able to recognize your impulsive behaviors, vacillating emotions, and cope ahead for future stressors.
Emotion Regulation: Learn to manage, change, and accept the different emotions, so that your emotions don’t control you.
DBT teaches Emotion Regulation skills to stop unwanted emotions from starting in the first place, regulate or change such emotions once they start, and learn to accept and become comfortable with unavoidable emotions. Many of the skills meant to regulate emotions also prioritize balanced sleep, eating, and exercise that support emotional regulation.
Distress Tolerance: Learn to tolerate painful emotions and situations that seem unbearable, and avoid behavior that can make things worse.
Emotions often seem unbearable or intolerable, which can lead you to make hasty decisions. Distress Tolerance offers tangible skills to use in place of ineffective, impulsive behaviors that can make things worse. These techniques range from guided self-soothing skills, to easy to use methods that activate the parasympathetic nervous system, using your own body’s chemistry to reduce distress. Distress Tolerance skills like Self-Soothe and Wise Mind ACCEPTS can help you tolerate the moment and give you space from the emotion so you can choose more balanced behavior.
Interpersonal Effectiveness: Learn to communicate with others in respectful ways while maintaining healthy boundaries and upholding positive self-respect.
Interpersonal effectiveness skills provide clear instruction on how to maintain relationships with others, ask for what you want, and uphold your self-respect. Interpersonal Effectiveness skills also provide tools to head off problems and better resolve conflicts before they become overwhelming.
Research References that demonstrate Treatment Efficacy for DBT-C
Perepletchikova, F., Nathanson, D., Axelrod, S.R., Merrill, C., Walker, A., Grossman, M., Rebeta, J., Scahill, L., Kaufman, J., Flye, B., Mauer, E., & Walkup, J. (2017). Dialectical Behavior Therapy for pre-adolescent children with Disruptive Mood Dysregulation Disorder: Feasibility and primary outcomes. Journal of the American Academy of Child and Adolescent Psychiatry, 56, 832-840.
Additional Resources can be found at Child DBT.