Over the past couple of decades, there has been much interest in the use of DBT to help youth (children and adolescents) with a variety of difficulties. I think part of this interest stems from the fact that adolescents, in particular, sometimes seem to have great difficulty managing their emotions, curbing their impulses, and so forth. Their emotions can seem unreasonably intense, they sometimes lack the social grace, tact, or skills to communicate effectively, and they often make decisions without considering the long-term consequences. Indeed, adolescents can sometimes seem like members of some kind of out of control, alien species. Adolescence is also a period when kids are exposed to increasingly complex social and cognitive challenges, and they have to somehow manage their emotions and control their behaviour in order to successfully navigate all sorts of stressful situations with school, peers, extracurricular activities, parents, siblings and so forth. At the same time, some evidence suggests that adolescents are particularly vulnerable and reactive to stress (Miller & Prinstein, 2019). The good news is that adolescence is also a period of considerable change in brain areas related to emotions and emotion regulation (for an excellent review, see Ahmed et al. 2015).
Some youth, however, need some extra help learning to understand and manage their emotions. In particular, signs that a teen might need this kind of help include self-injury, suicidal thoughts or behaviours, drug or alcohol use (particularly early use of substances), declining school performance, and alienation or avoidance of peers or school, among others. Teens who have an impulsive personality are particularly prone to these kinds of difficulties. Further, research suggests that kids with impulsive personality traits are especially vulnerable to the negative effects of trauma or abuse and are at risk of likely to develop self-injury or become suicidal (Crowell et al., 2014; Beauchaine, Hinshaw, & Bridge, 2019). Many of the adolescents that we help have had this combination of impulsive or highly emotional temperament and difficult, stressful experiences growing up. Their emotions are very intense and hard to manage, and they’ve learned that self-injury, substances, and other risky behaviours offer some degree of relief. As a result, learning to understand and manage emotions becomes a very important goal. In the next blog, I’ll talk about DBT for adolescents and what we know about how it works. ~ Alexander L. Chapman, Ph.D., R.Psych.