DBT skills groups for adolescent girls
What are some examples of the problems that your skills groups help adolescents solve?
- problems with extreme emotions
- high conflict
- shutting down, avoiding, and withdrawing
- self harm/ threats of suicide
- emotional sensitivity and reactivity
- eating disordered behaviors
- intense anxiety that gets in the way with other problems
- self consciousness, self-hatred, and shame
- difficulty with peer relationships
- crisis generating or other high risk behavior
DBT skills groups for adolescent girls:
I currently offer a DBT skills group for adolescent girls, with the approximate age range of 14-18. The current meeting time for this group is 4:00-5:15 in Stoneham, MA. I selectively take girls from different high schools and discourage communication between groups. This increases privacy, lessens the chance for gossip to get spread around at school the next day, and gives girls the opportunity to work on the problems they already have instead of worrying about additional social/group conflicts. I generally require that adolescent girls be in individual therapy while in group.
How long are the groups?
Although the group is ongoing, the suggested minimal commitment for the group is three months. Because there is a lot of benefit to having a peer group throughout high school, adolescents are welcome to stay as long as they benefit and need the group. Unlike the adult groups, I do not focus on one skill per week- as I have found that the girls often need a combination of skills- quickly! Skills are implemented and introduced throughout; repetition of skills is ongoing and re-introduced in a variety of ways. Experiential participation is encouraged with a focus on using and applying skills across contexts and situations. Group changes, shifting dynamics, and opportunities for personal problem solving will allow adolescents ample opportunity to revisit skills and integrate them across contexts and situations.
It is helpful to bear in mind several things about group that may impact treatment length that is not relevant in individual psychotherapy. When a person joins a group, it may take some time to get to know me as the group leader, to feel comfortable with peers, develop trust, and to disclose problems openly. Changes in group dynamics can impact the group (such as peers joining or leaving the group). The cohesion of the group -or the group’s ability to work well together- can be negatively impacted when attendance is irregular or members are frequently absent.
Peer relationships can be an important factor in determining how quickly learning and skills acquisition occurs. Some group dynamics foster this more quickly than others. I make every effort to create an environment in which change or conflict can be handled adaptively and skillfully; and to foster a group dynamic in which new learning can take place comfortably.
Groups do meet over the summer.
What are the adolescent groups like?
All groups begin with mindfulness. Mindfulness is geared towards calming the brain, focusing attention, paying attention to thoughts and feelings, becoming aware, showing up in the present moment, and quieting the mind. In some cases it helps adolescents get ready for the group.
Adolescents are welcome to bring their own situations and emotionally distressing difficulties into group. Group consists of role-plays, acting, discussions, peer feedback regarding adaptive skill use, problem solving, educational content, and homework handouts. Group content is 1) relevant to individual situations on a weekly basis and 2) Conducted in the context of skill use. Adolescents will also be asked to track changes in psychotherapeutic goals.
What materials are needed?
I ask clients to purchase the original “nuts and bolts” materials that come straight from the person who developed the treatment: Dialectical Behavior Therapy Skills Training Manual for Borderline Personality Disorder by Marsha M. Linehan. This book has a red and black cover and was published by Guilford Press in 1993. It is true that this book was written for clinicians and may not seem appropriate for adolescents; however, the homework and handouts that take up the last 1/3 of the book really are quite relevant- and I use them throughout the group.
How do I get my adolescent into your groups?
I offer three pre-screening sessions that include 1) An intake with a parent/guardian present to review consents and provide a background of the problem as they see relevant. During this first intake I usually also meet with the adolescent privately. I generally always require a release of information to speak with the individual therapist. 2) A second intake which includes psycho-educational information about DBT, information about the group itself, payment policies, group parameters, etc. 3) A third intake in which I meet with the adolescent 1:1.
The best way to reach me is over e-mail (although please bear in mind this is not considered 100% confidential) or phone. If you let me know available times I can reach you I will likely be able to call you back before 2:00 PM on most days.
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