THE DBT SKILLS WORKBOOK FOR TEENS: Practical DBT Exercises for Mindfulness, Emotion Regulation, and Distress Tolerance (2023 Guide for Beginners)

Introduction

DBT (Dialectical Behavior Therapy) starts with the premise that life’s challenges are best managed by making adjustments in someone’s thoughts and behavior, rather than attempting to get rid of or modify other people, places, or things. DBT seeks to educate people on how to cope with issues by altering how they think about themselves, others, and the world.

DBT begins with core beliefs, which are presumed ideas that lead to behaviors that may be difficult or impossible to modify. Beck et al. (1990) defined these underlying ideas as core irrational beliefs, which include views that life is not worth living that nothing will ever get better, that one is inept and unworthy of aid, and so on. These beliefs are called irrational because they have no basis in reality or cause people to do things that are worse.

DBT is intended to assist individuals in managing the symptoms of mental illness. For those with BPD, a treatment that does not concentrate on the indications of illness (i.e., BPD) but instead focuses on the behaviors indicative of this condition is more beneficial. According to Linehan (1993), current therapies for BPD are often ineffective because they treat symptoms without addressing the disorder’s defining behaviors.

The core belief, also known as an irrational belief, is an assumption about oneself or others that inhibits people with BPD from making significant adjustments in their life. DBT addresses the dysfunctional fundamental beliefs that drive persons with BPD’s actions via education and behavioral treatment. DBT therapists may help patients with BPD acquire practical coping strategies for dealing with emotional triggers by assisting them in identifying their basic beliefs. These coping skills will educate children on how to successfully deal with their emotions, eliminate harmful behaviors, and restore balance to their lives.

Cognitive therapy addresses dysfunctional cognitive processes associated with the maladaptive behaviors of people with BPD. Cognitive restructuring means changing a person’s bad ideas and wrong beliefs to ease emotional pain and improve behavior.

DBT employs two ways to assist people with BPD in changing maladaptive behaviors. DBT therapists work with their patients to find the core beliefs that are behind their bad behaviors. They then help their patients learn new ways to deal with stress that will change these bad ways of thinking and acting by replacing dysfunctional core beliefs with healthy ones. The new coping abilities are also linked with procedural learning behavioral trials in DBT, in which patients are taught how to use these new coping skills in tough settings.

DBT is intended to replace BPD’s dysfunctional ways of thinking and acting with more positive and adaptable ones. It has been shown to be effective in treating patients and lowering the number of hospitalizations necessary. It’s also been shown to minimize harmful behaviors, including self-injury and suicide ideation. Finally, DBT is beneficial for treating BPD because it is a long-term therapy. In fact, it is the only effective and long-term scientifically validated therapy for BPD.

The Dialectical Behavior Therapy skills model is a four-step interpersonal effectiveness approach that employs a dialectic method. This implies that the abilities build on one another. As one talent is achieved, another builds on it until all four abilities have been mastered.

Chapter 1

Basic Distress Tolerance Skills

The DBT Distress Tolerance Skills Module takes into account that some people tend to act in bad ways. It understands that these habits may be overwhelming for such people; thus, they must be handled all at once. Even small amounts of stress can make them feel overwhelmed, so they often pick up bad habits. To aid these individuals, most traditional therapy techniques stress avoiding painful circumstances. However, the goal of the distress intolerance module is to help clients recognize that it is sometimes difficult to prevent discomfort and that the best approach to dealing with such circumstances is to accept things as they are and practice accepting the pain that goes along with them.

The distress tolerance module is based on the notion of radical acceptance. This means that you have to accept the reality of a hard situation and realize that you can’t change it. Clients become less sensitive to acquiring persistent, elevated, and powerful negative sensations when they practice radical acceptance without opposing reality or being judgmental.

In DBT, four distinct abilities make up the distress tolerance module. These abilities are intended to assist people in coping with challenging circumstances and experiencing distress without exacerbating the problem. These are as follows:

Distracting

Self-soothing

Improving the situation

Considering the advantages and disadvantages

Distracting

Distracting the client assists them in shifting their attention away from painful emotions and thoughts and toward neutral or pleasurable activities. It essentially deals with everything that might help you divert yourself from your distress, such as a hobby, a brief stroll in the garden, helping others, or watching a movie. These exercises assist clients in disengaging from an unpleasant environment or a difficult state of mind.

The abbreviation ACCEPTS is used to assist people in practicing the art of distraction:

Activities: Positive activities are used to overcome painful circumstances.

Contribute: assist others in your immediate vicinity or in your community.

Comparisons: comparing yourself to individuals who have it worse than you or to yourself at your worst.

Emotions: making oneself feel different by inducing pleasure or humor via appropriate actions.

Push away: temporarily putting your situation in the back of your mind and replacing it with something less stressful.

Thoughts: attempting to ignore what is bothering you and redirecting your attention to other things.

Sensations: doing something severe to give oneself a sensation that is different from the one you are presently experiencing, such as eating a spicy meal or jumping into the shower for a cold bath.

Self-Soothing

The self-soothing program teaches you to appreciate and treat yourself with kindness. It encompasses everything that helps you establish a good picture of yourself using your five senses. For example, looking out the window at a beautiful view (seeing), hearing natural sounds like birds chirping (hearing), burning a fragrant candle (smell), eating a full meal (taste), and caressing an animal are all examples of sensory experiences (touch).

This ability comprises employing self-managed techniques to soothe irritated and agitated customers. In the distress tolerance module of DBT, learning to self-soothe is a crucial milestone. You treat yourself with care, love, and compassion when you self-soothe. This increases your resilience and makes it easier to recover from adversity.

Improving the Situation

The primary goal of this technique is to use positive mental energies to improve your present image in your own eyes. This talent may be honed by remembering the acronym IMPROVE.

Imagery: Imagery entails envisioning something that soothes you in order to dissolve bad ideas.

Meaning: Meaning entails drawing meaning or purpose from suffering or a tough circumstance. Simply said, it is all about looking for the silver lining in whatever you do. This assists the customer in finding optimism in all situations and in learning something new.

Prayer: Prayer entails asking God for strength and confidence. Many customers find that prayer strengthens their spiritual side and helps them to calm down.

Relaxation: Relaxation is relaxing your physical body