Dialectical behavior therapy for adolescents (DBT-A) is a clinical program within the Young Adult and Family Center that targets high risk, multi-problem adolescents. We specialize in identifying and treating depression and risky behavior in adolescents, including self-injury, suicidal ideation and suicide attempts, substance use, binging and purging, risky sexual behavior, physical fighting, and other forms of risk-taking.
DBT-A has been adapted by Alec Miller and Jill Rathus from Marsha Linehan’s initial conceptualization of DBT, which was developed for adults diagnosed with borderline personality disorder. Our adaptation follows the work of Miller and Rathus, who originally modified DBT for use with teens. Our program targets five areas:
- Confusion about self
- Emotional instability
- Interpersonal problems
- Parent-teen problems
The treatment has been shown to be effective in treating self-harming adolescents with depression who demonstrate some traits of borderline personality disorder that are beyond that expected of typical adolescent development.
Depression in adolescence is characterized by depressed or irritable mood, changes in appetite and sleep, withdrawal from and loss of interest in usual activities and friends, feelings of hopelessness and worthlessness, agitation and/or fatigue, difficulty concentrating, difficulty making decisions, and suicidal ideation.
Some traits of borderline personality disorder that may be of concern to teens and parents include: unstable sense of self, unstable interpersonal relationships, inappropriate or uncontrollable anger or other emotions, serious mood swings, recurrent self-harm or and/or suicide attempts, chronic feelings of emptiness, and impulsivity that puts the teen at risk.
Teens referred to the DBT-A Program typically have many or all of the problems listed above, which can lead to difficulties fulfilling their obligations in school and at home. This perpetuates their negative ideas about themselves.
The DBT-A Program is a comprehensive outpatient service intended to reduce self-harming and other dangerous behavior. It consists of four compenents:
- Weekly multifamily skills group (20 weeks) - Teens learn skills to help them cope with the five problem areas identified above and to help in decreasing their target behavior (e.g., cutting, purging)
- Weekly individual therapy - Teens learn to generalize the skills they are learning in group and gain greater insight into the cognitions and vulnerabilities which contribute to their problem behaviors
- Family therapy - Individual therapists may schedule collateral family sessions as needed
- Emergency paging system for coaching - Teens are encouraged to contact their therapist for skills coaching before engaging in their target behavior. Parents learn many of the same skills their teen is learning, as well as others to help improve family functioning
To make an appointment, please call the DBT-A Program at (415) 476-7227, or call our intake and referral service at (415) 476-7500 or toll-free at (800) 723-7140.
Core faculty and staff
- Kim Norman, MD
- Alison Yaeger, PsyD
- Samantha Fordwood, PhD
- Auran Piatigorsky, PhD
- Esme Shaller, PhD
- Barbara Stuart, PhD
- Justine Underhill, LCSW