What is DBT? Dialectical Behavioral Therapy (DBT) provides a bridge between our clinical and residential programs at La Europa. DBT is both a philosophy to help view students' challenges from a functional, strength-based perspective and a structure that helps staff move students toward positive change. The DBT philosophy is based on a dialect frame of reference. A "dialectic" is a tension between two points of view that appear to be in opposition and in which there is no "right" answer. For example, in residential treatment, a dialectical dilemma occurs between providing enough structure for the students to help them "contain" their emotions and behavior but enough freedom for them to safely explore, grow and practice new skills. A dialectical approach to therapy means that the treating professionals are attempting to create a synthesis between the students' need to change and her need to accept herself. This approach is important for helping the treatment team and the student not get stuck in a negative cycle of behavior but rather focusing attention on understanding behavior, recognizing incremental positive changes and moving forward.
Why is DBT helpful? The behavioral aspects of DBT help students learn to break behaviors down into smaller action steps and identify and practice effective skills to manage behavior and emotions. The structure of DBT increases the students' chances of effectively transitioning home by providing practical, in-the-moment understanding of how to use skillful behavior and translating insight gained in therapy into action!
How does La Europa Academy use DBT? The following DBT components are used at La Europa:
- DBT Skills Group: Students are taught and practice the four DBT skills of mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness. Staff are trained to coach students in skill use on a daily basis.
- Diary Cards: When students are on levels 1 through 4, they complete a daily diary card to help gain awareness about certain behaviors they are working to change and feelings they are learning to manage more skillfully. Diary cards are reviewed by residential staff and therapists each week and discussed with students.
- Target Behavior Group: Adolescents often have unrealistic expectations about change. They have difficulty seeing that most changes happen incrementally and set themselves up for failure by expecting too much of themselves. This weekly group helps students identify smaller steps that can be taken to achieve larger change and gives them an opportunity to get appropriate feedback from their peers about their progress.
- Behavioral Analysis: When a student is struggling to extinguish an ineffective behavior, a behavioral analysis is undertaken with the student's therapist to help the student identify triggers, thoughts and feeling perpetuating the behavior and consequences of the behavior. This helps the student and therapist see where new skills may be applied or other changes made to provide the student with more options for engaging in effective behavior. Insights gleaned from Behavioral Analysis are shared with the residential team so that interventions can occur in conjunction with behavior in the moment.