How Dialectical-Behavioral Therapy (DBT) Helps Adolescents Suffering from Self-Harm Behavior

How Dialectical-Behavioral Therapy (DBT) Helps Adolescents Suffering from Self-Harm Behavior

While it can be very concerning to find out that your adolescent is struggling with depression or anxiety, it can be utterly heartbreaking to learn that they engage in self-harm behaviors to deal with their intense negative feelings. 

Two decades ago, the global mental health community dedicated March 1 as Self-Injury Awareness Day. In recognition of the annual international event, our team at EXIS Recovery Inc. in West Los Angeles wants to draw attention to this common coping mechanism — and help squash the stigma that surrounds it.

Read on to learn more about what drives young people to self-harm, and find out how an innovative treatment approach called dialectical-behavioral therapy (DBT) can help. 

Understanding self-harm behaviors

Self-injury isn’t a mental health disorder, it’s a behavioral coping mechanism that some people use to endure intense, negative emotions. Also known as self-harm, it involves the deliberate self-infliction of physical injury and pain, without suicidal intent. 

Someone who self-harms may:

While people of all ages practice self-injury, the behavior is most common in adolescents and young adults between the ages of 12 and 24 years old. A significant number of young people who self-harm report learning the behavior from their peers. 

There are many circumstances that lead people to self-injury, and adolescents often cite more than one reason for their behavior. It may be an attempt to:

A widespread misconception about self-harm behavior is that it’s merely attention-seeking or somehow manipulative. In reality, most teens who self-injure are ashamed of the behavior and go to great lengths to hide it.

DBT: a mindfully proactive approach

Learning that your adolescent practices self-harm behaviors can leave you feeling distraught and powerless, but there’s plenty of room for optimism: Self-injury is a treatable problem that can improve or even resolve completely with the right approach.

As one of the most effective ways to address self-harm behaviors, DBT combines two leading treatment techniques of mental health care — mindfulness and cognitive-behavioral therapy (CBT).

The term “dialectical” means the therapy works through opposing or seemingly contradictory forces. Specifically, it promotes the acceptance of negative or overwhelming feelings through mindfulness, followed by the action of reframing those feelings to change ensuing behaviors with adaptive skills learned through CBT. 

To put it another way, the dialectical truth behind DBT for self-harm empowers your teen by giving them permission to say, I’m doing the best I can, on one hand, and I need to do better, on the other.

Initially developed to treat people suffering from borderline personality disorders and chronic suicidal ideation, DBT is a solution-focused practice that identifies negative coping behaviors and works to replace them with healthy ones. To do so, it teaches four essential skills:


Mindfulness centers on developing awareness and acceptance of the present moment. It’s about learning to redirect attention from the past or future to what’s directly in front of you, allowing you to notice your negative thoughts and overwhelming emotions as they emerge, and accept them without judgment. 

By teaching you how to stay present and detach judgment, mindfulness essentially places a “pause” between extreme, negative emotions and reactive behaviors.

Distress tolerance

Exercising mindfulness naturally feeds into distress tolerance, another “pause” practice that aims to make negative thoughts and emotions easier to endure when they arise. 

Life is full of ups and downs, many of which are unpredictable. Distress tolerance teaches you to endure uncertainty and the painful feelings that result with forbearance, so you’re less likely to resort to harmful coping mechanisms.

Emotion regulation

Emotion regulation uses CBT strategies to help you identify and change the intense feelings that cause problems in your life. It helps you understand that, despite how it may seem at the time, no emotion is permanent; on the contrary, all feelings are momentary and fleeting.

Overcoming the impulse to self-harm requires developing control over your emotions, especially during moments of extreme emotional highs or lows.

Interpersonal effectiveness

Self-harm often rises from communication difficulties: Many adolescents who turn to self-injury do so because they don’t feel comfortable reaching out to another person to talk about what they’re going through. 

Interpersonal effectiveness builds your interpersonal communication skills — and helps you establish personal boundaries — so you can express your needs instead of burying them.

If your adolescent is struggling with self-injury behaviors, the team at EXIS Recovery is ready to help. With early intervention and care, we can put an end to self-harm and develop new, healthy coping skills. Call 424-244-3513 to learn more, or click online to book an appointment with one of our experienced DBT specialists today.

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