Teenagers don’t come with a manual, and anyone raising or working with one knows how unpredictable this phase of life can be. One moment, things seem fine. The next, a simple comment triggers a storm of emotion. For some teens, this emotional rollercoaster isn’t just a typical part of growing up—it’s a daily challenge that starts affecting their relationships, their school life, and their ability to cope.
That’s where Dialectical Behavior Therapy, or DBT, comes in. Originally developed to treat adults with intense emotional responses, DBT has been adapted to meet the needs of adolescents who are struggling with behavior that feels out of control. It’s not a quick fix, and it’s not about telling teens to “calm down.” It’s about giving them real tools to deal with what they’re feeling—and helping them build lives that feel more manageable.
What Is DBT, Really?
At its core, DBT teaches teens two things: how to accept themselves as they are, and how to change behaviors that are making their lives harder. It sounds simple, but for many adolescents, it’s a game-changer.
Rather than focusing only on talking through problems, DBT gives structure. Teens learn specific skills across four areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. That might sound clinical, but in practice, it means things like knowing how to pause before sending an angry text, how to sit with anxiety without shutting down, or how to ask for what you need without starting a fight.
For teens who feel like their emotions are always in the driver’s seat, that kind of control can feel empowering.
How It Works in Practice
Most DBT programs include a mix of individual therapy and group sessions. In one-on-one settings, therapists work closely with the teen to talk through recent situations, identify triggers, and figure out how to respond differently next time. Group sessions are more like skills classes—they provide a place to practice what’s being learned and hear how other teens are handling similar stuff.
There’s homework involved, which might sound like a hard sell for teenagers, but it’s not about busywork. It’s about tracking emotions, noting when skills are used (or forgotten), and reflecting on what worked. Therapists often check in on these notes during sessions—not to grade them, but to guide the work.
Therapists trained in DBT take a very collaborative approach. They’re not there to lecture or punish. They show up with curiosity, compassion, and a willingness to meet teens where they are—on their best days and their worst ones.
The Types of Challenges DBT Can Help With
While DBT was originally created for people with borderline personality disorder, it’s now used for a wide range of adolescent mental health challenges. Teens who benefit from DBT might be dealing with:
- Intense mood swings
- Impulsive behavior
- Self-harm or suicidal thoughts
- Frequent conflict with family or peers
- Chronic anxiety
- Difficulty handling disappointment or rejection
It’s not just for kids in crisis. DBT can be incredibly helpful for teens who appear “high-functioning” but are secretly burning out from trying to manage overwhelming feelings. It’s also a good fit for those who’ve tried other types of therapy but didn’t feel like they were getting concrete, actionable help.
A Glimpse Into the Therapy Room
For therapists, the goal is to create a space where teens feel safe enough to let their guard down. That’s easier said than done—especially with adolescents who’ve learned that being vulnerable often backfires. But once that relationship is built, therapy becomes a place to explore the messy middle of things.
Teens might come in after a rough week, venting about a teacher who “hates them” or a fight with a friend that spun out of control. The therapist isn’t there to invalidate those experiences. Instead, they might help the teen look at what emotions showed up, what thoughts they had, and what they did next. Then comes the skill-building—what could they try instead next time? How could they express themselves without losing control? What can they do to soothe themselves when everything feels too big?
This kind of work is equal parts emotional and practical. And for many teens, that balance is exactly what’s needed.
What About Parents?
Parents are often a big part of the process, whether they’re attending family sessions or just staying in touch with the therapist outside of appointments. Some DBT programs include parent coaching or separate skills groups to help caregivers learn what their kids are working on. That way, when a teen starts using language from therapy—like “I’m practicing distress tolerance”—parents know how to support it instead of accidentally undoing the progress.
It’s common for families to start DBT in the middle of a tough season: after a hospitalization, during a mental health crisis, or when things just feel completely unmanageable at home. But with time and consistency, many parents begin to see real shifts—less yelling, fewer meltdowns, more moments of calm. It’s not magic, but it does work.
A Note from the Field
In cities like Denver, more therapists are offering DBT as part of their adolescent treatment services. Rachel Cohen, a licensed Denver therapist working with teens and young adults, integrates DBT techniques into her sessions with clients facing anxiety, identity concerns, and emotional dysregulation. While she also draws from other trauma-informed approaches, she sees DBT as a reliable framework for helping young people take ownership of their choices without feeling judged.
That blend of accountability and compassion is what makes DBT so effective—and why therapists continue to rely on it when working with teens who feel like they’re drowning in their own emotions.
Why This Matters
Teenagers today are under pressure from every direction—school, social media, family expectations, and their own internal worlds. When that pressure builds up without an outlet, it often shows up as behavior: yelling, withdrawing, self-harming, or exploding at seemingly small things.
DBT doesn’t try to shut those reactions down. It tries to make sense of them. It helps teens learn how to survive hard moments without making things worse—and over time, how to build lives that feel calmer, more connected, and more in their control.
And for families who’ve felt like they’ve tried everything, that kind of progress can be nothing short of life-changing.
