DBT Treatment Assumptions for Teens in Group Skills Training

Closeup rear view photo of teen and parent with ponytail sitting on park benchDialectical behavior therapy (DBT) is an evidence-based therapeutic model originally developed by Dr. Marsha Linehan. She found that traditional cognitive behavioral therapies did not always help people who experienced chronic suicidal ideation or symptoms of borderline personality. Since then, DBT has been found to be effective with several other groups of people, including teenagers.

One component of DBT involves group skills training in addition to weekly individual counseling. In the group setting, people can learn and practice skills in a helpful and supportive environment, with active peer feedback. (Individual counseling can then focus on how a person is applying the skills to their own life, as well as process any concerns or issues that pop up over the course of the week.)

Positive Assumptions for Teens in DBT Group Skills Training

Many people know the playful phrase, “When you assume, you make an ass out of you and me.” Why is this? Because assumptions are unproven beliefs. If you assume wrongly, without taking the time to gather or confirm your assumptions with credible sources, it can hurt relationships. However, assumptions can benefit the therapeutic process when everyone agrees on the same positive assumptions.

The following are DBT’s Treatment Assumptions for Teens in a Skills Training Group. Agreeing to these assumptions is believed to be helpful for teens, their caregivers, and the skills trainers. The idea is to become more accepting, less judgmental, and to think and act more dialectically (one of the core concepts of DBT).

  • Everyone in the group is doing the best they can. People are behaving, thinking, and emoting the best way they are capable at this time. It is hoped that, with time and practice, their “best” will improve.
  • Everyone in the group wants to improve. People don’t want to stay feeling, behaving, or thinking the way they currently are. As humans, we are always striving to grow and develop in meaningful ways.
  • Everyone needs to do better, and be more motivated to change. This assumption goes hand-in-hand with the first two assumptions. While people are doing the best they can and want to improve, they need to do (or behave) better and increase their motivation in order to make these changes.
  • People may not have caused all of their problems, but they have to solve them anyway. The phrase “the best-laid plans oft go awry” applies here. If someone rear-ends your car, you may not have caused the accident or be considered “at fault,” but you still need to figure out how you are going to fix your car. The same concept applies to group members’ experiences. Note: For adolescents, given that they are underage, they may need to reach out to supportive adults to help solve problems that are beyond their control or ability to solve on their own.
  • The lives of group members are painful as they are currently being lived. The average person experiences many challenges. However, if you consider the experiences that contributed to a group member being recommended and accepted to a DBT skills training group, it would be ridiculous not to consider that life may be extra hard and painful right now.
  • Group members must learn and practice new behaviors in all important situations in their lives. It’s always awesome when a group member can master a skill in the therapy or group room. However, if you aren’t taking and using the skills all the other hours of the week you spend outside of these rooms, you aren’t getting the most bang for your buck. This means practicing and discussing your experience using these skills in daily life experiences.
  • There is no absolute truth. This is a difficult concept to grasp and live. By valuing the validity of two viewpoints, even when they seem like polar opposites, people can learn to value and respect each other. This is a concept that is often further discussed and practiced when members learn more about how to think and act more dialectically.
  • Teens and their family members cannot fail in DBT. This is a radical concept for some people. Often, people in therapy and their families are blamed for not being motivated enough, working hard enough, or trying hard enough. In DBT, blame is not effective (plus, you would never tell someone suffering from a broken bone that isn’t healing properly that they aren’t working hard enough to heal themselves). It may simply be time to consider a different course of treatment if things are not improving, just as an orthopedist may discuss a different treatment if a broken bone is not healing as expected.

If these assumptions make sense to you, and you are interested in enrolling yourself or your teen in DBT skills group therapy, I urge you to talk with your therapist or contact one about options in your community.

Reference:

Rathus, J. H., & Miller, A. L. (2015). DBT Skills Manual for Adolescents. New York, NY: Guilford Press.

© Copyright 2016 GoodTherapy.org. All rights reserved. Permission to publish granted by Mallory Grimste, LCSW, therapist in Woodbridge, Connecticut

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Laird

    Laird

    November 2nd, 2016 at 12:17 PM

    I would love to try this with my family but we are so right and wrong oriented that I am not sure how well most of us will be with the concept that in this there is no absolute right or wrong. That might be one we would all have to work on pretty carefully.

  • Mallory Grimste, LCSW

    Mallory Grimste, LCSW

    November 9th, 2016 at 11:38 AM

    Laird, it takes lot and lots of practice and it is such a freeing experience when you can find the kernel of truth and understanding in both “sides” of a situation. Be kind to yourself along the way.

  • Avery

    Avery

    November 3rd, 2016 at 11:51 AM

    My worry is that I would have to speak in front of a group of people that I did not know. I know that in my heart they wouldn’t be judging me but you know how you can sometimes feel that way around new people? That is practically me all the time. I guess the biggest problem is that I am more worried about what they are thinking of me than I am about doing what is the right thing for me which would probably be sharing and trying to relate to other people. I struggle with this a whole lot, because I guess that at the end of it all I am too worried about what others might think of me.

  • Mallory Grimste, LCSW

    Mallory Grimste, LCSW

    November 9th, 2016 at 11:42 AM

    Avery, it sounds like you could really benefit from DBT’s crisis skills for when you feel overwhelmed. I actually wrote a blog with an overview of these skills a few months ago. You can check out those skills here: https://www.goodtherapy.org/blog/emotional-overwhelm-how-dbt-crisis-survival-skills-help-0721165/amp/?client=safari
    Best wishes to you in your journey with public speaking!

  • ezekiel

    ezekiel

    November 5th, 2016 at 8:25 AM

    Can’t look down on others, because you have to look at it from the perspective of what can I learn and take away from this, not what I can condemn or judge them for

  • Mallory Grimste, LCSW

    Mallory Grimste, LCSW

    November 9th, 2016 at 11:43 AM

    Ezekiel- I love this response! What a great reminder!!

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