Understanding Dialectical Behaviour Therapy (DBT) for Young People in Geelong

DBT is based on the concept of "dialectics" – the idea that two seemingly opposite things can both be true. For example:

• "I'm doing my best AND I need to try harder"
• "My emotions are valid AND I need to change my behaviour"
• "I accept myself as I am AND I want to grow and change"

Adolescence is naturally a time of intense emotions and identity development. DBT provides practical tools for:

• Managing overwhelming feelings
• Improving relationships with family and peers
• Building distress tolerance
• Developing a stronger sense of self

Key Skills:

• Observe: Notice what's happening without getting caught up in it
• Describe: Put words to experiences without interpretation
• Participate: Engage fully in the current moment
• Non-judgmentally: Avoid labeling experiences as good or bad
• One-mindfully: Do one thing at a time with full attention
• Effectively: Focus on what works rather than what's "right"

TIPP Skills (for intense distress):

• Temperature: Change your body temperature quickly
• Intense Exercise: Get your heart rate up rapidly
• Paced Breathing: Slow your breathing to calm your system
• Paired Muscle Relaxation: Tense and release muscle groups

ACCEPTS (for distracting from distress):

• Activities: Engage in enjoyable or meaningful activities
• Contributing: Help others or contribute to something bigger
• Comparisons: Think of others who are coping with similar struggles
• Emotions: Create different emotions through music, movies, or books
• Pushing away: Mentally push away the situation temporarily
• Thoughts: Use puzzles, counting, or other mental activities
• Sensations: Use intense sensations like ice or spicy food

Core Components:

• Understanding emotions and their functions
• Reducing vulnerability to emotional overwhelm
• Increasing positive emotional experiences
• Changing unwanted emotions when appropriate

Key Skills:

• PLEASE: Treat physical illness, balance eating, avoid mood-altering substances, balance sleep, get exercise
• Mastery activities: Engage in activities that create feelings of accomplishment
• Pleasant activities: Schedule enjoyable experiences
• Opposite action: Act opposite to emotional urges when emotions don't fit the facts

DEAR MAN (for getting what you want):

• Describe the situation
• Express feelings
• Assert needs clearly
• Reinforce benefits
• Mindful: Stay focused on goals
• Appear confident
• Negotiate when possible

GIVE (for maintaining relationships):

• Gentle: Be kind and respectful
• Interested: Show genuine interest in others
• Validate: Acknowledge others' perspectives
• Easy manner: Use humor and smile when appropriate

FAST (for maintaining self-respect):

• Fair: Be fair to yourself and others
• No Apologies: Don't apologise for having needs
• Stick to values: Act according to your moral compass
• Truthful: Be honest

For young people showing early signs of BPD:

• Reduces self-harm behaviours
• Improves emotional stability
• Strengthens relationship skills
• Builds identity and self-worth

DBT skills help by:

• Providing tools for managing overwhelming feelings
• Building behavioural activation strategies
• Improving distress tolerance
• Enhancing social connections

DBT complements ADHD treatment by:

• Improving emotional regulation
• Building mindfulness and attention skills
• Enhancing interpersonal relationships
• Providing structure and routine

DBT addresses:

• Emotional triggers for disordered eating
• Distress tolerance without food behaviours
• Interpersonal challenges
• Body image and self-acceptance

Components include:

• Weekly individual therapy sessions
• Phone coaching for crisis situations
• Skills practice and homework
• Therapist consultation team support

Benefits of group format:

• Learn from peer experiences
• Practice skills in social setting
• Reduce isolation and shame
• Build supportive community

Family DBT includes:

• Teaching family members DBT skills
• Improving family communication
• Reducing family conflict
• Supporting the young person's skill use

At Shake, we integrate DBT with:

• Movement-based therapy
• Creative and expressive approaches
• Peer mentoring programs
• NDIS support coordination

Modifications for teenagers:

• Shorter skills modules
• Visual and interactive learning
• Relevant examples and scenarios
• Flexibility in skill application
• Family and peer involvement

Ensuring cultural relevance:

• Incorporating cultural values and practices
• Adapting examples to cultural contexts
• Including family and community perspectives
• Respecting cultural communication styles

Studies consistently show DBT effectiveness for:

• Reducing self-harm and suicidal behaviours
• Decreasing hospitalisations
• Improving emotional regulation
• Enhancing quality of life
• Strengthening relationships

Young people who learn DBT skills often show:

• Improved academic performance
• Better peer relationships
• Reduced family conflict
• Lower rates of substance use
• Enhanced overall functioning

Common concerns:

• "These skills are too simple"
• "I shouldn't have to change"
• "This won't work for me"

Responses:

• Validate the difficulty of change
• Start with most relevant skills
• Use real-life examples
• Celebrate small improvements

Helping skills transfer:

• Practice in multiple settings
• Use reminders and cues
• Involve family and friends
• Regular skill review and refincement

Family members benefit from learning:

• Basic DBT principles
• Communication skills
• Validation techniques
• Distress tolerance strategies

Ways to support skill use:

• Model DBT skills yourself
• Praise skill attempts
• Avoid criticising "skill failures"
• Create supportive environments
• Maintain hope and patience

Determining DBT suitability:

• Emotional regulation difficulties
• Interpersonal challenges
• Distress tolerance needs
• Motivation for skills learning
• Family support availability

What to expect:

• Skills learning takes time and practice
• Progress may be slow initially
• Skills need regular use to be effective
• Family involvement improves outcomes
• Commitment to the process is important

Creating supportive environments:

• Regular practice schedules
• Skills reminders and cues
• Celebrating skill use attempts
• Problem-solving barriers
• Maintaining long-term perspective

Innovations in development:

• Technology-enhanced DBT
• Culturally adapted programs
• Trauma-informed DBT
• Family-based intensives

Areas of investigation:

• Optimal program length and intensity
• Technology integration
• Prevention applications
• Cross-cultural effectiveness