By Nicole Roder, LCSW-C, DBT-LBC
If you are parenting teens with intense emotions–that is, teenagers who frequently yell, fight, run away, self-harm, or engage in other risky behaviors–you might have heard of Dialectical Behavior Therapy (DBT). Many therapists and medical providers refer emotionally dysregulated adolescents to DBT programs because they know that it is an evidence-based treatment that has been proven to help people get their emotions and behaviors under control.
Comprehensive DBT therapy includes individual sessions, skills group sessions, and between-session phone coaching. DBT for Adolescents (DBT-A) includes the parents in this process as well. Parents join the multifamily skills group along with their teens. They often participate in family sessions with their teen and the individual therapist. And many times they have a DBT parent coach who meets with them individually and offers phone coaching as well.
Naturally, parents who are considering DBT therapy for their teens want to know what they’re signing up for. How will DBT help your kids feel better, and how can the therapist help you know what to do when your teen feels upset or acts out? Here are 7 tips that illustrate some of the advice that DBT therapists offer for parenting teens with big emotions.
7 Tips for Parenting Teens Based on DBT Therapy
1. Understand what is causing your teen’s intense emotions and behaviors.
You’ve probably noticed that there are times when your teen seems to be in control and behaving rationally, and there are other times when they are yelling, making threats, breaking rules, hurting themselves, and engaging in other dangerous behaviors. Since they are sometimes able to control themselves, it’s easy to assume that they always have that capability. And if they always have that capability, then they must be choosing to misbehave, right? Not quite.
Some people are born with a biological predisposition to have dysregulated emotions. This means that it’s easier for them to get up into the emotional “red zone,” where their emotions are 100% in charge and the logical part of their brain is unreachable. This is intensely painful. When your teen is in the red zone, it is much harder for them to make rational decisions about how to act. On top of that, they have probably experienced a lot of invalidation from the people around them. This means that when people see them behaving emotionally, they communicate that the teen’s emotions or behaviors don’t make sense.
In DBT, we teach that intense emotional dysregulation is caused by a combination of biological factors and invalidation from others. This means that throughout their lives, when they express their big emotions, the people around them have behaved as though the emotions didn’t make sense. This tends to cause teens to either express their emotions in a much bigger way, or shut down emotionally.
2. Regulate your own emotions.
“Before you can help your teen change their emotions and behaviors, it’s important to get your own emotions in check,” says Nicole Roder, LCSW-C, a DBT-Linehan Board of Certification, Certified Clinician™ at Gladstone Psychiatry and Wellness. “It’s perfectly natural to feel afraid or stressed out when your child is running away, skipping school, or threatening suicide. That would scare me too! And it’s also true that you can’t help your child if you are in emotion mind.”
Nicole recommends using the DBT skills paced breathing and paired muscle relaxation (from TIP) to come back down to wise mind before approaching your teen, especially if you are feeling your own intense emotions. It’s also a good idea for parents to have their own therapists to help them with these skills. “It can be traumatic to witness these dangerous behaviors in your kids,” says Nicole. “That means parents need therapy too.”
3. Accurately express your emotions without judgment.
Very often in families of teens with intense emotions, people express a lot of judgment and blame. Teens blame their parents for causing them to develop mental health problems. Parents blame their teens for their destructive behaviors. And people outside the family often judge both the parents and the teen pretty harshly. All of this leads to guilt, shame, and anger, and it does nothing to help solve the problem. This is why parenting teens with big emotions is so tough!
DBT advocates taking a non-judgmental stance toward all emotions and behaviors. Instead of judging and blaming, we look for the causes of the behaviors and try to change them. We also recommend accurate expression of emotions.
Accurate expression means being aware of and expressing your primary emotions plus your wise mind goals and desires. Do this by describing what is, rather than interpreting events. Your primary emotion is the emotion you feel immediately and naturally in response to an event.
For example, if you discover that your teen has run away from home, your immediate, natural reaction might be to feel fear or despair, because running away is scary and sad. Some parents quickly start to feel anger as a secondary emotion as well. If you feel anger toward your child after a scary or sad situation, it’s very likely that this is a secondary emotion. Secondary emotions are not natural responses to the event. What’s more, anger can be destructive to relationships. So, look inward to identify your primary emotion and express that accurately, without judgment. In this example, accurate expression might be, “I’m terrified because my child ran away and I don’t know where they are right now. I want them to come home, and I want them to respect their curfew from now on.”
4. Validate your teen’s emotions.
If you only learn one DBT skill for parenting teens, let it be this: It’s super important to validate your child’s emotions. Emotional validation means communicating to your teen that you understand how they feel, and that their feelings make sense.
“Validation is such a powerful parenting tool,” says Rebecca Blake, LCSW-C, a DBT-Linehan Board of Certification, Certified Clinician™ and Co-Director of Gladstone’s DBT Program in Maryland. “When parents validate, it helps promote a positive relationship with their teens. It lets your teen know that their feelings are important to you. This can help them begin to regulate their emotions and reduce their urge to express them in a bigger, more destructive way.”
Here’s how to do it. Notice whatever emotions your teen is expressing–through words, actions, or tone of voice–and reflect them back. Do this in a non-judgmental way, and then let them know that their feelings make sense. You don’t have to validate the invalid, like self-harming behavior or rule-breaking. You can always validate emotions, though.
5. When parenting teens, stop reinforcing negative emotions and destructive behaviors.
We know you don’t intend to do this, and it’s also true that you are probably reinforcing your teen’s negative emotions and destructive behaviors. “Imagine this scenario,” says Nicole. “Your teen asks if she can go to a party on Friday night. You say no because she has a D in math and there’s a big test on Monday and you want her to stay home and study. She screams at you that you’re ruining her life. You still say no. She begins crying uncontrollably, and she tells you that she’s worried that she’ll be freezed out of her friend group if she doesn’t go. You try to console her for two hours, and her emotions escalate throughout that time, until you are afraid that she might hurt herself. Out of fear, you agree that she can go to the party, and you write a note to the teacher asking for more time for the math test. You’ve just taught your child that it takes two hours of intense emotions plus the risk of self harm for her to get what she wants.”
This can happen on a smaller scale too. If your teen argues with you and you argue back, you’re reinforcing arguing. If they leave dishes around the house and you pick up after them, you’re reinforcing that behavior too.
The most effective way to eliminate behaviors is to stop reinforcing them all together. “Just be careful that you completely stop reinforcing them,” says Nicole. “If you, say, resist arguing back for an hour and then finally give in, you will strengthen the behavior rather than eliminate it. This is because your teen will learn that it now takes an hour of arguing to get you to argue back.”
6. Reinforce the behaviors you want to see.
Every teen is doing the best they can, which is why we are sure that your teen is currently doing something that you can reinforce. So anytime they ask for something politely, bring home a good grade, do a chore, or any other positive behavior, be sure to let them know that you appreciate it and you’re proud of them.
Reinforcers can also help draw out new behaviors that you are hoping to see. Let your teen know that if they do something you ask them to do, like spending more time studying and bringing their grades up, you will reward them.
“It helps to ask your teen what kinds of rewards they would find reinforcing,” says Christina White, LCPC, a DBT-Linehan Board of Certification, Certified Clinician™ and Co-Director of Gladstone’s DBT Program. “Lots of teens like extra screen time, a later bedtime, or even money. And it’s also important to include mild praise and validation if that’s something your teen finds reinforcing. Some kids feel really uncomfortable with praise, so be sure to do what works for them.”
7. Get help from a DBT therapist.
“DBT is an evidence-based type of therapy for treating chronic emotional dysregulation,” says Rebecca. “If your teen’s moods seem long-lasting or very intense, DBT could be a good fit. We encourage clients and parents to search for programs with high fidelity, in other words, sticking to the DBT treatment model as it was developed by Marsha Linehan. Using the DBT-LBC search feature is a great way to ensure you are getting high quality DBT.”
How Can I Find a DBT Therapist Near Me?
If you are in Maryland and you are interested in DBT therapy, Gladstone Psychiatry and Wellness can help. We are a comprehensive, DBT-Linehan Board of Certification, Certified Program™ with offices in Hunt Valley, Frederick, Columbia, and Bethesda, Maryland. We also offer online therapy via zoom. We are in network with most Blue Cross/Blue Shield insurance plans.
New client’s can get started by emailing dbt@gladstonepsych.com. Email us today for an application so that you and your teen can get the help you deserve.