Top DBT Residential Treatment Center for Teens in Crisis
When your teen is in deep distress (struggling with anxiety, depression, trauma, substance use, self-harm, or other complex behavioral and mental health challenges), every day can feel like a crisis. If outpatient care hasn’t been enough and you're now considering longer-term residential treatment, you're not alone. This journey is overwhelming, but there is a compassionate path forward, and lasting healing is possible.
One evidence-based treatment option gaining recognition for its effectiveness is Dialectical Behavioral Therapy (DBT). In DBT Residential Treatment Centers (specialized behavioral health facilities), teens receive intensive, tailored therapy within a structured and supportive environment provided by licensed therapists and staff. These residential DBT programs are designed to address a wide range of mental health and behavioral issues. This article offers essential insights for parents seeking this effective treatment approach in a residential treatment center.
In a residential DBT program, teens receive help through:
- individual dialectical behavior therapy
- a therapist consultation team
- dialectical behavior therapy groups
DBT focuses on helping individuals find a balance between opposing thoughts and managing extreme emotions. Teens learn skills for emotional regulation, relationship improvement, and behavior management, which they can apply in their daily lives.
If you'd like to learn more about DBT. This article is meant to be as extensive as possible and will probably include sections that may not interest you. Please use the table of contents to find the information you need.
Enhance Your Treatment with RO DBT
In Addition to Being a Residential DBT Program, Discovery Ranch South Also Offers Radically Open Dialectical Behavior Therapy (RO DBT).
What is Dialectical Behavior Therapy (DBT)?
DBT is a special type of therapy created by Dr. Marsha Linehan. It was first developed to help people with Borderline Personality Disorder (BPD). Over time, research shows it also works well for many other conditions, like:
- anxiety
- depression
- struggles with drugs or alcohol
The main idea behind DBT is finding a balance between accepting things as they are and working to change things for the better. It's like learning to accept the rain while also learning to dance in it! Dialectical behavior therapy helps teens understand their strong emotions. It can help them control or stop harmful habits as well as build better relationships. It teaches them useful skills to handle tough feelings and make positive changes in their lives.
Why Choose a DBT Residential Treatment Center?
Imagine a place where your teen can truly focus on getting better, surrounded by support. That's what a DBT residential treatment center offers. These centers provide a safe and caring environment where teens can heal and grow.
Here's what you can expect:
- Full Support: Your teen will get help through one-on-one talks with a therapist. Take part in group sessions with other teens. Also, access to family therapy to help everyone communicate better.
- Skill Building: Specially trained therapists teach important DBT skills. These include how to handle stressful situations without making them worse (distress tolerance). How to manage strong emotions (emotion regulation). As well as how to get along better with others (interpersonal effectiveness).
- Extra Activities: Many centers also offer fun and creative activities like art therapy or other ways to relax. All these things work together to help your teen get better and stay healthy for the long term.
A residential center makes sure your teen gets all
Individual DBT Therapy
The first key component of dialectical behavior therapy is individual therapy. Therapists will often have their patients use diary cards. These are specially formatted cards. Patients use them to track when their target symptoms occurred. Also, the skills they used to cope with them. During individual therapy, the therapist and patient discuss the problems that came up.
The therapists will follow a treatment target hierarchy when addressing the patient's issues.
- Life-threatening behaviors take first priority.
- Behaviors that interfere with the course of mental health treatment take second priority. (Ones that aren't directly harmful to self or others).
- Quality of life issues take third priority.
The patient and therapist will discuss these issues. The therapist then teaches the patient problem-solving behaviors. The goal is to help them better deal with mental health challenges in the future.
Therapist Consultation Team
The DBT consultation team includes:
- individual therapists
- group therapy leaders
- case managers
- and others who help with the patient
The purpose of the consultation team is to provide support in the residential treatment center. They also help therapists stay motivated and competent. This assures they can provide the best mental health treatment possible.
DBT Therapy Groups:
In a dialectical behavior therapy skills group, teens learn essential coping skills. The following four modules are foundational to our DBT therapy groups:
- mindfulness
- distress tolerance
- emotion regulation
- and interpersonal effectiveness
We also have a team of therapists who work together to make sure your teen gets the best care. And, teens join group sessions where they learn and practice important life skills.
Our DBT program helps teens learn tools to handle even the toughest situations with strength and confidence. These tools help them deal with big feelings, stress, and getting along with others.
What Are DBT Skills?
Think of DBT skills as a toolkit for your teen's feelings. These are special tools and tricks that help them:
- Handle tough feelings so they don't get overwhelmed.
- Deal with hard situations without making things worse.
- Get along better with others.
- Feel generally happier and healthier.
These skills are based on four main ideas:
- Mindfulness This is about paying attention to the present moment without judging it. Tuning in to what's happening right now, without getting caught up in worries about the past or future.
- Emotional Regulation This teaches teens how to understand, control, and change strong emotions. It's about not letting feelings take over completely.
- Distress Tolerance This skill helps teens navigate a crisis or very strong, painful feelings. To get through those feelings without doing something harmful to themselves or others. It's about riding out the storm without crashing.
- Interpersonal Effectiveness This is about learning how to ask for what you need. Say "no" to things you don't want. And also deal with conflicts in a way that helps relationships. It's about being good at talking and getting along with people.
We will look closer at each of these tools. This way, you can see how they help teens with big feelings, stop harmful habits, and get along better with family and friends.
DBT Skill #1: Mindfulness
The first foundational skill taught in dialectical behavior therapy is mindfulness. Mindfulness is the process of bringing one's attention to the current moment. It is about paying attention to what is happening in the moment without judgment. Trying not to overthink or invalidate the experience. Mindfulness is a major tool in DBT. It helps people accept and cope with the powerful emotions they feel. Especially when challenging their habits or exposing themselves to upsetting situations.
Mindfulness and the meditative exercises used for it come from traditional Buddhist practices. The version taught in DBT does not involve any religious or metaphysical concepts. DBT is about living in the moment and experiencing one's emotions and senses fully. Mindfulness makes people more aware of their environments using all five senses.
To understand mindfulness, it is important to understand the DBT mindfulness sub-skills of "Wise Mind", “What”, and“How”
“Wise Mind"
When your teen is going through tough times, their feelings and thoughts can get really mixed up. A special DBT skill called "Wise Mind" helps them find balance.
Think of "Wise Mind" as finding the sweet spot between your teen's logical brain (facts and sense). As well as their emotional brain (feelings and gut feelings). It's where they can make smart choices that also consider how they feel. We help our teens learn to use this "Wise Mind" skill so they can make good decisions while understanding and accepting their feelings.
“What” Skills
The "What" skills in DBT are all about how your teen can practice mindfulness. Mindfulness is simply paying attention to the present moment. These "What" skills help them:
- Observe: This means simply noticing things around them or inside them. Not judging if it's good or bad. It's just watching what's happening.
- Describe: After observing, this skill is about explaining what they noticed using only facts, without adding opinions or judgments.
Participate: This means diving fully into whatever they are doing right now. It's about being completely focused and involved in the activity, whether it's playing, doing homework, or talking with someone.
“How” Skills
"How” skills are how you do the “What” skills. These skills are done
- nonjudgmentally
- one-mindfully
- and effectively
To be nonjudgmental, you describe the facts without evaluating them as good, bad, fair, or unfair. The reason is that these terms are judgments rather than factual descriptions.
Being nonjudgmental helps you get your point across. You are mindful by focusing on one thing. This helps you appreciate the moment. You are then effective by doing simply what works. It is a very broad-spectrum skill and can be applied to any other skill.
In the nurturing environment of Discovery Ranch South, our residents learn to use their "What" and "How" skills and to access their "Wise Mind". On a teenager's path to healing, these mindfulness techniques become a compass. Helping to steer them towards balance, resilience, and a brighter future.
DBT Skill #2: Emotional Regulation
The second foundational skill taught in Dialectical Behavior Therapy (DBT) is emotion regulation. Emotional regulation helps patients manage negative/overwhelming emotions while increasing their positive experiences. Patients learn that negative emotions are not bad and do not need to be avoided. Instead, they learn that negative emotions are a normal part of life. Patients learn to acknowledge and then let go of negative emotions so that their feelings do not control their behaviors.
The emotional regulation skill consists of the parts or subskills:
ABC PLEASE
“ABC PLEASE” is an acronym that sets guidelines on how patients should take care of their physical health. Since our physical health is tied so closely to our mental health. You know how when we're on an airplane, they say to put on your own oxygen mask before helping others? Well, that's what this is about – taking care of ourselves so we can be strong for others. When we are sick/exhausted/generally unhealthy, we are more likely to experience negative emotions. When taking care of our bodies, we tend to have positive emotions and can be more present/engaged in our relationships and life. "ABC PLEASE" stands for:
- (A) Accumulate positive emotions - This is all about doing stuff that makes us happy, like watching a funny movie or hanging out with friends. When we do things we like, it's like adding drops of happiness to our day.
- (B) Building mastery - Doing things we enjoy, while also pushing ourselves outside our comfort zone. Like reading a new book genre, cooking a new kind of food, or fixing something we haven't before. These activities help us build self-confidence and feel good about ourselves.
- (C) Cope ahead - We imagine what might happen and make a plan to handle it. Ever heard of practicing before a big game? That's what this is like, but for life challenges.
- (P/L) Physical illness - If you are sick or injured, get proper treatment.
- (E) Eating - Eat a healthy, balanced diet.
- (A) Avoid mood-altering drugs - Do not take non-prescribed medication or drugs. They can be harmful to your body and can make your mood unpredictable.
- (S) Sleep - Do not sleep too much or too little. Teenagers should get 8-10 hours of sleep each night.
- (E) Exercise - Regular exercise will make you healthier and happier. Exercise will improve your body image, release endorphins, and help you be more active.
Practicing "ABC PLEASE" is like wearing mental armor that protects us from getting too sick or overwhelmed. When we take care of ourselves, we're less likely to get hurt by tough situations or feel down in the dumps.
Opposite Action and Problem Solving
Opposite Action is used when patients have an unjustified emotion (an emotion that doesn't belong in the current situation). Patients use Opposite Action by doing the opposite of what their urges tell them to do at the moment. It is a tool that brings them out of an unwanted or unjustified emotion. It then replaces it with an emotion that is opposite and justified. When their negative emotion is justified, patients learn to use problem-solving.
Opposite action steps include:
- Identifying and describing emotions
- Identify the urge associated with each emotion
- Ask, "Does the urge fit the facts? Is it effective in this situation?"
- Decide if you want to change the emotion
- If so, do the opposite in thoughts, actions, etc
- Repeat these opposite actions until you notice a change in emotion
Ride the Wave
Specific emotions don't last, they come and go like waves in the ocean. Positive emotions peak and fade back into a sense of normalcy. Similarly, negative emotions also have a peak and then eventually decrease back to a normal baseline. Problems arise when we get stuck in believing that a negative emotion will last forever. As well as trying to control life in an attempt to preserve a positive emotion forever.
The key to "riding the wave" of emotions is to believe two things:
- This is not the last time you'll ever have this positive emotion
- That the negative emotion will indeed pass
DBT Skill #3: Distress Tolerance
The third foundational skill taught in Dialectical Behavior Therapy (DBT) is distress tolerance. Distress tolerance increases a patient's tolerance of negative emotions. The goal is to be able to calmly recognize negative situations and their impact, rather than becoming overwhelmed or hiding from them. This allows patients to make wise decisions about how to take action instead of falling into intense and often destructive emotional reactions. There are three DBT specific acronyms used to identify the sub-skills for distress tolerance:
Three additional sub-skills of distress tolerance are:
Distract with ACCEPTS
Patients use the acronym “ACCEPTS” to distract themselves temporarily from unpleasant emotions.
- (A) Activities: Do an activity or hobby that you enjoy.
- (C) Contribute: Serve the people around you or contribute to service in your community.
- (C) Comparisons: Compare yourself to less fortunate people. Or how you used to be when you were in a worse state.
- (E) Emotions: Cause yourself to feel something different by provoking your sense of humor. Focus on a positive emotion to counteract the current negative one.
- (P) Push away: Put your situation on the back burner for a while. Put something else temporarily first in your mind.
- (T) Thoughts: Force your mind to think about something else.
- (S) Sensations: Do something that has an intense feeling other than what you are feeling. An example is taking a cold shower or eating spicy food.
IMPROVE the Moment
Patients use the acronym “IMPROVE” to help them relax in stressful situations.
- (I) Imagery: Imagine relaxing scenes, things going well, or other things that please you.
- (M) Meaning: Find some purpose or meaning in what you are feeling.
- (P) Prayer: Either pray to whomever you worship or, if not religious, chant a personal mantra.
- (R) Relaxation: Relax your muscles and breathe deeply.
- (O) One thing in the moment: Focus your entire attention on what you are doing right now. Keep yourself in the present.
- (V) Vacation: Take a break from it all for a short period of time.
- (E) Encouragement: Cheer yourself on. Tell yourself that you can make it through this.
TIPP: Changing Body Chemistry
Teens can use a trick called "TIPP" to quickly change how their body reacts when they're feeling really stressed or upset. TIPP stands for:
- (T) Temperature: Decrease the temperature of your body to calm yourself down fast. You can do this by holding an ice cube, taking a cold shower, or even using an ice bath.
- (I) Intense exercise: Strong exercise helps your body work through those powerful "fight, flight, or freeze" feelings. Which then helps your body transition back to a relaxed state of rest and digestion.
- (P) Paced breathing: Gradually slow your breath down. Breathe out even slower. You can choose your own counts, like inhaling for 5 and exhaling for 7. Slowing your breath also slows your pulse and brings calm.
- (P) Paired muscle relaxation (P): Progressively tighten and then relax each muscle in your body. Observe the shift in how your body feels after releasing muscle tension.
Pros & Cons List
When faced with a distressing situation, you can create a Pros and Cons list to decide if you should act on or simply tolerate an impulse. The exercise helps you move out of the emotional mind and uses more of your reasoning mind. To do this, you:
- Describe the urge, impulse, or crisis behavior you are trying to avoid.
- Examine the pros and cons of both acting on the impulse and the pros and cons of tolerating the impulse.
- Look at the immediate and longer-term consequences when listing the pros and cons of each behavior.
Self-Sooth With the Five Senses
Self-soothe skills involve physical methods that engage your senses. Use them when you're upset, emotions are intense, or situations seem unbearable. Reduce the intensity of negative emotions by using your body's senses:
- Vision - go for a walk in nature, go to a museum or your favorite place, or look at a photo album
- Hearing - listen to your favorite music or focus on isolating specific sounds around you
- Smell - use your favorite scented lotion, smell a favorite meal, or smell a flower
- Taste - eat a favorite food or eat mindfully and try to isolate specific flavors or textures in your food
- Touch - take a shower, pet a dog, or wear tactile and comfortable clothing
- Movement - paying attention to sensations within your body, mindfully stretch, or exercise
Radical Acceptance
While you might not alter the stress around you, you can change how you feel about and respond to a situation. Radical Acceptance involves embracing your situation without judgment. Aiming to let go of resistance and stop battling reality.
Radical Acceptance involves asking:
- What is the painful situation?
- What are my choices?
- What are the consequences of each choice?
- What is the best choice?
- Accepting it as the best choice and acting on it.
Radical Openness is an alternative to Radical Acceptance and is better suited for teens struggling with overcontrolling behaviors. Learn more about Radical Openness.
DBT Skill #4: Interpersonal Effectiveness
The fourth foundational skill taught in Dialectical Behavior Therapy (DBT) is Interpersonal Effectiveness. Interpersonal Effectiveness teaches teens how to communicate well, respect themselves, and improve their relationships. These three acronyms and other sub-skills are used to understand and apply Interpersonal Effectiveness:
DEAR MAN
Patients use the acronym “DEAR MAN” to convey their needs to another person.
- (D) Describe your situation using specific factual statements.
- (E) Express your emotions experienced when the situation occurred, why this is an issue, and how you feel about it.
- (A) Assert yourself by asking clearly and specifically for what you want.
- (R) Reinforce your position by offering a positive consequence if you were to get what you want.
- (M) Mindfulness of the situation. Keep your focus on your goal, maintaining your position, and not getting distracted.
- (A) Appear confident and assertive, even if you don't feel confident.
- (N) Negotiate and come to a comfortable compromise.
FAST
The acronym “FAST” helps patients maintain self-respect.
- (F) Fair: Be fair to both yourself and the other person.
- (A) Apologies (few): Don't apologize more than once for what you have done ineffectively.
- (S) Stick to Your Values: Stay true to what you believe in and stand by it. Don't allow others to encourage you to act against your own values.
- (T) Truthful: Don't lie. Lying can only pile up and damage relationships and your self-respect
GIVE
The acronym “GIVE” helps patients maintain relationships in conversations. Whether they are with friends, coworkers, family, romantic partners, etc.
- (G) Gentle: Use appropriate language. No verbal/physical attacks or put-downs. Avoid sarcasm unless you are sure the person is alright with it. Be courteous and non-judgmental.
- (I) Interested: Act interested when the person you are speaking with is talking about something. Maintain eye contact, ask questions, and so forth. Avoid using your cell phone during an in-person conversation.
- (V) Validate: Show understanding and sympathy of a person's situation. Validation can be shown through words, body language, and facial expressions.
- (E) Easy Manner: Be calm and comfortable during the conversation. Use humor and smile.
Walking the Middle Path
The "Walking the Middle Path" skill is used to move away from "either-or" thinking and develop a "both-and" way of thinking. This involves both Validation of Others and Validation of Self.
Validation of Others means to:
- Validate others' feelings, thoughts, and behaviors
- Actively listen with eye contact, etc.
- Pay attention to verbal and non-verbal reactions
- Observe the other person's feelings in the moment
- Reflect the feeling back without judgment
- Show tolerance as you look for truth and what makes sense
- Respond to show you are taking this seriously
Validation of Self means to:
- Listen to your thoughts, feelings, and behaviors
- Describe your feelings without judgment
- Respond by accepting that it is OK to have your own emotions
- Acknowledge that the emotion makes sense
- Be non-judgmental of yourself and your emotions
- Use FAST and other Interpersonal Effectiveness skills to maintain self-respect
What to Expect from Treatment
It's completely natural to wonder what happens when your teen comes to a DBT residential center. Please know that at our center, you can expect a caring and structured approach every step of the way.
We begin with a thorough assessment to truly understand your teen's unique needs. This helps us create a personalized treatment plan that's just right for their healing journey.
Treatment is a blend of helpful approaches:
- Individual therapy: Dedicated one-on-one time with a therapist.
- Group therapy: A supportive space where teens can practice new skills together.
- Family therapy: Designed to help your whole family communicate better and grow stronger.
- Medication management: If a doctor believes it will be helpful.
We understand that recovery is a journey, not a destination. Many centers, including ours, offer a continuum of care. This may include stepping-down options like Intensive Outpatient Programs (IOP) or Partial Hospitalization Programs (PHP). These programs help bridge the transition from residential care back into daily life.
Our admissions team is here for your family. We continue to work closely with you to ensure ongoing support throughout your teen's recovery. Your teen will have many opportunities to learn these valuable DBT strategies while with us. All these efforts are truly designed to help them make lasting positive changes.
Family Involvement
Your family is a key part of your teen's success in DBT residential treatment.
Family therapy sessions help you gain a better understanding of what your teen is going through. You will both learn practical ways to support their healing. These sessions create a loving, supportive space. Families can practice new ways to talk, reduce arguments, and make their relationships stronger.
When families are involved, it helps teens build healthier connections. It also supports lasting recovery and well-being for everyone. This complete approach makes sure both your teen and your family have the tools to handle mental health challenges together.
Quality Care for Your Teen: Choosing Discovery Ranch South for Your Residential DBT Program
We know how tough it is to see your teen struggling. That's why at Discovery Ranch South, our DBT program is all about comprehensive and compassionate care for your child.
Through individual and group therapy, our skilled therapists teach essential DBT skills. This helps teens handle tough situations with strength and confidence.
Our mission is to support your teenager's healing journey. We strive to give them the tools they need to thrive. We are dedicated to partnering with you, the parents, to build a brighter future for your teen. You can trust that your child will receive the highest level of care here.
Contact us today to learn how Discovery Ranch South can help your teenager on their path to wellness.
Additional Resources
About the Author: Rashell Stubbs, LCMHC
Rashell has been with Discovery Ranch South since 2017 and became Assistant Clinical Director in 2021. Prior to joining the Discovery Ranch South team Rashell worked with adolescents since 2005 as a residential staff and therapist. Rashell graduated from the University of Phoenix with a Master’s Degree in Mental Health Counseling in 2008. She has worked primarily with adolescents during her career.
She has experience working with youth who experience depression, anxiety, attachment challenges, trauma, and those with Autism. Rashell is a DBT therapist who has completed the Level 1 Intensive Training for Radically Open DBT, and Phase 1 of Brainspotting. Rashell currently leads the RO DBT group and a Horsemanship Group.
Rashell loves working at Discovery Ranch South. She loves to see the healing of the students and families. She is grateful and appreciates the opportunity to be a part of this process in the lives of students. Rashell’s background includes riding horses and raising livestock. Naturally one of her favorite things about Discovery Ranch South is the calf and equine program.
Rashell is married, has three daughters and a dog, Posh, who comes to work with her each day. Outside of life at Discovery Ranch South, you will find Rashell spending time with her family at their cabin, on the lake, golfing or hiking in the many places that Southern Utah has to offer.