While play therapy is widely considered the gold standard in working with children in
mental health therapy, there are other types of therapy that can be incorporated as well.
Dialectical Behavior Therapy (DBT) is one type of therapy that can help
kids, teens, and adults improve their understanding of their emotions, and help deal with life’s
challenges. Involving DBT into children’s therapy requires specialized training, and a
slightly more directive approach in the therapy room.
What is DBT?
DBT was created in the 1970’s and 1980’s by Marsha Linehan at the University of
Washington. DBT uses the concept of ‘dialectics’ which means balancing two opposite
things. For example, it is okay to feel sad and happy at the same time. Dialectics
focuses on the fact that we can hold two differing feelings or opinions at the same time,
honoring both. The ‘behavior’ part of DBT focuses on understanding and changing
behaviors by learning new skills, managing emotions, and improving relationships.
Skills Taught in DBT
DBT involves 4 main pillars:
1) Mindfulness: Mindfulness skills help a client stay in the here and now-aware of
feelings and thoughts. To help teach kids mindfulness skills, therapists can use
grounding play using textured fidgets, sensory grounding techniques, body
awareness games, and mindful breathing with things like balloons or bubbles.
2) Distress Tolerance: These skills can help cope with tricky emotions that make
children feel uncomfortable and lead to behavioral outbursts. This includes
calming skills, distraction and self-soothing. Therapists can use coping boxes, art
techniques, and sensory play to help tolerate intense emotions.
3) Emotional Regulation: The ability to regulate emotions is something even
adults can struggle with. This involves identifying feelings, understanding
and expressing them, while increasing our positive emotional experiences. Prompted
journaling, using clay or sandtray to express feelings through symbolism, and
teaching them to externalize their feelings can help with this pillar.
4) Interpersonal Effectiveness: This involves focusing on improving relationships
with others. Communication strategies, setting boundaries and building healthy
relationships helps navigate life’s relationships more effectively. Children can
learn this through role playing, imaginary games, and practicing expressing
feelings and needs to other people. Using DBT with children is more effective
when caregivers can be involved in the sessions. DBT should be used for older children
at least age 7 and up and depending on their ability to engage with the activities.
Please reach out to Treehouse Counseling for more information on supporting yourself or your child.
Contact Ivy Ross, LMFT, RPT-S at ivy@treehousecounselingoregon.com, or get in touch with the Treehouse team to schedule a virtual appointment or an in-person appointment at one of our Beaverton clinics.
