Navigating your teen years can feel like riding a rollercoaster of hormones and constant challenges. If you struggle with anxiety, OCD, or ADHD, it may seem like you can never get off the hamster wheel, especially when emotions run high and everyday situations become overwhelming. Dialectical Behavior Therapy (DBT) is a very successful form of therapy that gives you a toolkit that helps you manage your emotions during times of stress and angst.

What Is DBT?

DBT teaches skills to help people stay present, manage stress, regulate emotions, and build healthier relationships. While it was originally developed for adults with borderline personality disorder, its hands-on approach is incredibly effective for teens. For teens with anxiety, OCD, or ADHD, DBT helps find balance between accepting yourself and making positive changes.

The Four Core DBT Skills

DBT skills training is made up of four modules: Core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Together these skills help teens better manage their thoughts, emotions, and behaviors.

1. Mindfulness: Living In The Present

Mindfulness is about paying attention to the present moment without any judgment. If you have anxiety, ADHD, or OCD, your mind might jump to future worries, or create scattered thoughts. 

  • How Mindfulness Skills Helps⎯Mindful exercises can quiet the mental noise, reducing the urge to react impulsively, and to help you notice your feelings without being controlled by them.
  • Mindfulness Exercise⎯Sit quietly and focus on your breath, noticing the air moving in and out. When your mind wanders to thoughts, you gently guide it back to your breath. This gives you a brief moment of calm, creating space to think more clearly.

2. Distress Tolerance: Surviving A Crisis Without Making It Worse

Life can be unpredictable, and sometimes things feel unbearable because of this. Distress tolerance skills help you navigate those intense, high-stress moments when you feel overwhelmed. These skills aren’t going to make the problem go away, but help you get through the moment without acting on impulses that could make things worse.

  • How Distress Tolerance Skills Help⎯Distress tolerance can help resist a compulsion, get through a panic attack, or deal with something extremely upsetting.
  • Distress Tolerance Exercises⎯Examples of using distress tolerance skills are: If you’re feeling overwhelmed after school, put on your favorite TV show to help calm down. If a friend made you mad, and you’re thinking about sending an angry text, pause instead, take a breath, and decide to wait until you’ve cooled down before communicating.

3. Emotion Regulation: Understanding & Managing Your Feelings

Emotions aren’t “right” or “wrong,” but are signals from your brain trying to tell you something. Emotion regulation skills help you understand what you’re feeling, why it matters, and how to keep your emotions from taking over.

  • How Emotion Regulation Skills Help⎯Knowing how to regulate your emotions is very important for managing the emotional swings that can come with anxiety, OCD, and ADHD. Using emotion regulation skills will help you have more control over your reactions, to keep your emotions from taking over.
  • Emotion Regulation Exercises⎯Saying your emotion out loud or writing it down can help calm your brain and give you a sense of control. Also, ask yourself if your reaction is based on facts or assumptions?

4. Interpersonal Effectiveness: Building Better Relationships

Interpersonal effectiveness is all about navigating relationships with friends, family, and teachers. It shows you how to ask for what you need, set boundaries, and handle conflicts in a way that respects both yourself and others.

  • How Interpersonal Effectiveness Skills Help⎯Interpersonal effectiveness skills can reduce social anxiety, help you set healthy boundaries, and improve your communication. 
  • Interpersonal Effectiveness Exercises: You need to ask your teacher for an extension on a project because you’re feeling overwhelmed. Instead of avoiding the conversation or getting angry, you use a skill called DEAR MAN. You Describe the situation, Express how you feel, Assert what you need, and Reinforce why it would be helpful. Be sure to stay Mindful of your goal, Appear confident, and be open to Negotiation. This structured approach makes the conversation less intimidating and more likely to have a successful outcome.

DBT Skills Therapy For Teens

Learning DBT skills will take practice, patience, and giving yourself grace. As you continue to see progress, you’ll be more confident navigating challenges and speaking up for yourself and what feels right to you.

For more information about DBT skills therapy for teenagers or to schedule a telehealth or an in-person session in DC, Bethesda, Alexandria, or McLean, please contact Sarah Smathers, our Client Services Specialist, at sarah@georgetownpsychology.com or (301) 652-5550.