Dialectical behavioral therapy: An effective tool in treating self-harm


Protect your kids.

It’s the fundamental duty of any parent, one that’s practically ingrained from a child’s birth.

Look both ways before crossing a street, don’t forget your jacket when its cold out, be careful around matches, always wear your seatbelt: These are among the lessons of childhood we all learned from our parents.

But what happens when children harm themselves?

Seeing anyone cut or burn themselves deliberately – or the scars that self injury leaves behind – is frightening. A parent feels helpless, or like they’ve failed. Although self-harm isn’t necessarily a sign of suicidal behavior, adolescents who harm themselves may come to believe there’s no better ways to deal with their problems. Fortunately, there’s an answer for self-injuring behavior: Dialectical behavior therapy (DBT).

What is DBT?

Dialectical behavior therapy was created by Marsha Linehan, Ph.D, in the late 1980s. Linehan developed the therapy to work with patients with borderline personality disorder. The therapy works with the assumption that some people will react in more intense, unusual ways toward emotional situations, particularly situations involving personal relationships. The Linehan Institute divides DBT into four components:

  • A skills training group, where patients meet in a classroom setting to learn behavioral skills.
  • Individual therapy sessions that help patients use the skills they’ve learned.
  • Phone coaching, which gives patients a resource to turn to in daily life.
  • A consultation team to provide therapy to therapists. DBT therapists often work with high-stress patients.

The skills DBT teaches include learning how to change one’s emotions, tolerating emotional pain and improving interpersonal skills.

DBT and self-injury

A study recently published in the “Journal of the American Academy of Child and Adolescent Psychiatry” showed DBT is an effective way to treat self-injury in adolescents. Over a year, researchers studied young people who had engaged in repeated self-injurious behavior and had received either DBT or enhanced usual care at psychiatric clinics.

Data showed that the patients who received DBT had a lower frequency of self-injuring behavior at the end of the year. Additionally, researchers found that DBT helped patients recover from suicidal thoughts and depression quickly.

An additional study published in the International Academy for Suicide Research in 2014 also found that DBT was effective at reducing self-injuring behavior in adolescent patients.

The who and why of self-injury

The Cornell Research Program on Self-Injury and Recovery states there’s no simple profile for those who injure themselves. Although it’s often assumed to be more typical of females, Cornell University reports that both males and females engage in this behavior at more or less the same rate.

It sounds strange, but people who injure themselves do so because it may have a calming effect. A paper published in Biological Psychiatry in 2010 by researchers from the University of Heidelberg found that subjects with borderline personality disorder used painful stimuli – in this case, heat – to reduce and regulate emotional stress. The Cornell report said, “Self-injury may best be understood as a maladaptive coping mechanism, but one that works – at least for a while.”

A child who deliberately hurts themselves is in need of professional help. White River Academy uses a therapeutic boarding school environment to treat boys between the ages of 12 and 17. Our rural Utah campus is staffed by experts in the fields of treatment and education. We will help your son work through his problems and achieve his full potential. Call our 24/7 helpline for more details.

About the author

Brian Moore is a staff writer and graphic designer. A 20-year veteran of the newspaper industry, he writes articles and creates graphics. Brian enjoys music, bicycling and playing the tuba, which’s he’s done with varying degrees of success for over 25 years.

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