DBT for Adolescents and Families in Washington state
When Your Family Feels Like It's Breaking Apart
Your teenager is struggling, and you feel helpless. Maybe they're hurting themselves, exploding in rage over seemingly small things, or shutting down completely. Perhaps they're using substances, refusing to go to school, or saying things that terrify you. You've tried everything you can think of—talking, consequences, reasoning, pleading—and nothing seems to work.
Meanwhile, your teen might feel misunderstood, controlled, or like no one gets how hard everything is. They might feel overwhelmed by emotions they can't control, ashamed of behaviors they can't stop, or hopeless that anything will ever get better.
And everyone in the family is exhausted. Arguments erupt over small things. Siblings walk on eggshells. Partners disagree about what to do. The tension is constant, and the moments of peace feel rare and fragile.
If this is your family right now, you're not alone. And there is help.
What Makes Adolescence So Hard
Adolescence is already one of the most challenging developmental periods. Teen brains are undergoing massive changes, emotions intensify, peer relationships become central, and the pressure to figure out identity and future feels enormous. For some teens, this developmental storm becomes a crisis.
When a teenager struggles with intense emotions, impulsive behaviors, difficulty in relationships, or thoughts of self-harm, it affects everyone. Parents feel scared, guilty, and lost. Siblings feel neglected or resentful. The whole family system gets pulled into patterns of conflict, crisis, and disconnection.
Traditional therapy approaches sometimes fall short because they focus only on the individual teen, missing the reality that families are systems where everyone affects everyone else. Or they place blame on parents, leaving you feeling judged rather than supported.
DBT for adolescents and families takes a different approach.
How DBT Helps Teens and Their Families
DBT recognizes that teens are doing the best they can with the skills they have right now, and that with the right support and new skills, they can build lives they experience as worth living.
What makes DBT especially effective for adolescents is that it involves the whole family. We don't just teach your teen skills—we teach you skills too.
The Core Components
Individual Therapy for Your Teen. Your teen works one-on-one with a therapist who provides support, validation, and strategies to make behavioral changes. This is their space to be heard without judgment, to understand their own patterns, and to work toward their goals. The focus is on helping them manage intense emotions, improve relationships, reduce harmful behaviors, and build a life that feels meaningful.
Skills Training. Teens and parents attend group sessions where they learn and practice skills in four areas: mindfulness (staying present and aware), distress tolerance (getting through crises without making things worse), emotion regulation (understanding and managing feelings), and interpersonal effectiveness (communicating needs and maintaining relationships). These aren't abstract concepts—they're practical tools you and your teen can use in real situations. Parents learn the same skills the teen is learning. You'll understand what your teen is working on, speak the same language, and be able to use the skills to help with challenging parenting situations, so you can stay calm. You'll also learn specific strategies for responding to your teen's emotions and behaviors in ways that reduce conflict and support change.
Phone Coaching. Between sessions, your teen can reach out to their therapist for coaching on using skills in the moment. This real-time support helps translate what's learned in therapy into real life.
Consultation Team. Your teen's therapist is part of a team that meets regularly to ensure they're providing the most effective treatment. This means your family benefits from the wisdom and support of multiple trained clinicians.
Addressing Common Concerns
"My teen won't go to therapy." We hear this often. Many teens are reluctant at first, but DBT approaches this differently. We don't shame or force. There is a built-in phase before treatment starts, to talk with the teen individually, understand what their personal goals are, and build commitment to the treatment. We only proceed with treatment if the teen voluntarily agrees.
"We've tried therapy before and it didn't work." DBT is highly structured and skills-focused in a way that many other therapies aren't. If previous therapy felt like just talking without practical tools, or if the therapist didn't address crisis behaviors effectively, DBT offers something different. It's also one of the most researched treatments for the kinds of struggles that bring families to us.
"I'm worried about being blamed." DBT explicitly rejects blame. The model recognizes that both biology and environment contribute to emotional sensitivity, and that everyone in the family is doing their best while also having room to grow. You won't be treated as the cause of your teen's problems. You'll be treated as a crucial part of the solution.
"What if my teen has a diagnosis like borderline personality disorder?" DBT was originally developed for borderline personality disorder, but it helps with a wide range of difficulties including depression, anxiety, self-harm, suicidal thinking, substance use, eating disorders, and trauma. Many adolescents don't have a specific diagnosis or don't meet criteria for BPD but still benefit greatly from DBT. We treat the struggles, not just the labels.
“Can you treat adolescents in Washington via telehealth?” Yes, we provide DBT to adolescents across the state of Washington because we know this treatment can be life saving, and is hard to access for adolescents and families who do not live near Seattle. We provide the full program, including multi-family skills group, virtually for families that are unable to come in-person to our office.
