Tag: DBT for children

This feature by Francheska Perepletchikova, PhD is Part 3 of 3 in a series about understanding DBT-C, presented in a question and answer format. In the first part, we defined DBT-C, addressed the target population and the most frequent diagnosis, and examined how symptoms may differ from other disorders. In the second part, we explored how emotional dysregulation develops, what kind of parenting is needed, and the main goals and primary treatment targets of DBT-C. Now, we wrap up with part 3, in which Francheska gives an example of how DBT-C hierarchy is applied during a session, as well as an example of a child-friendly modification to standard model DBT. She will also talk more about therapy-interfering behaviors, secondary treatment targets, and the main mechanists of change.

This feature by Francheska Perepletchikova, PhD is Part 2 of 3 in a series about understanding DBT-C, presented in a question and answer format. In the first part, we defined DBT-C, addressed the target population and the most frequent diagnosis, and examined how symptoms may differ from other disorders. In this second part, we will explore how emotional dysregulation develops, what kind of parenting is needed, and the main goals and primary treatment targets of DBT-C.

This feature by Francheska Perepletchikova, PhD is Part 1 of 3 in a series about understanding DBT-C, presented in a question and answer format. In this first part, we define DBT-C, address the target population and the most frequent diagnosis, and examine how symptoms may differ from other disorders.

DBT for children (DBT-C) was developed to address treatment needs of pre-adolescent children with severe emotional dysregulation and corresponding behavioral discontrol. These children experience emotions on a different level, and much stronger than their peers. Little things irritate them, and emotions may be so overwhelming that verbal or physical aggression occurs. It may seem at times that these children are manipulative and are trying to push everyone’s buttons. However, the child’s volatile behaviors may indeed be the best way they know how to deal with their intense emotions. Further, these behaviors may continue because they are frequently reinforced (e.g., attention from adults and peers, getting their way when parents finally give in, reduction in the intensity of emotional arousal). The environment may not be ready to effectively manage the challenges such children present, and “good-enough parenting” may not be sufficient to meet these demands. As a child’s needs cannot be adequately met by the environment, the environment frequently invalidates these needs, and destabilizes the child further. A more destabilized child continues to stretch an environment’s ability to respond adequately, which leads to further invalidation, and so forth. This transaction over time may lead to the development of a psychopathology. Indeed, research shows that such children are at an increased risk to develop alcohol and substance use problems, suicidality and non-suicidal self-injury, depression, anxiety, and personality disorders in adolescence and adulthood (Althoff, Verhulst, Retlew, Hudziak, & Van der Ende, 2010; Okado & Bierman, 2014; Pickles et al., 2009). The main goals of DBT-C are to teach these children adaptive coping skills and effective problem-solving and to teach their parents how to create a validating and change-ready environment.