How is Dialectical Parenting Delivered?

Dialectical Parenting starts with a comprehensive assessment. Based on the results of the initial assessment, treatment goals are identified and an individualized treatment plan is developed, integrating elements of Dialectical Behavior Therapy (DBT) and Behavior Parent Training (BPT), in conjunction with other evidence-based treatments such as Cognitive Behavioral Therapy (CBT) for anxiety, Exposure and Response Prevention (ERP) for OCD, Family-Based Treatment (FBT) for eating disorders, and Behavioral Activation (BA) for depression. Dialectical Parenting also involves consultation with other members of a teen’s treatment team, including educators, medical providers, and other clinicians, in order to obtain collateral information and coordinate care across settings. 

Next, the skill acquisition phase begins. Lessons are taught in a structured manner, with each skill layering upon the next, in order to build a strong therapeutic foundation. Caregivers are taught strategies for promoting emotion regulation and distress tolerance in their teen, in addition to effective communication, behavior management, conflict resolution, crisis intervention, and safety planning skills. In two-parent households, both parents are required to attend all sessions, so that strategies are implemented consistently across caregivers. 

The direct application phase follows the skill acquisition phase. During this phase, sessions are focused on discussing the challenges and triumphs caregivers faced in applying what they’ve learned each week, and problem solving any remaining issues. Throughout treatment, caregivers are offered crisis intervention support to further their real-world adaptation and use of the skills. This support includes emergency consultations and crisis management plans. Given the volatile nature of high-risk adolescents, this out-of-session support is a critical component of the treatment. 

Once parents have mastered skill application, they enter the maintenance phase, where ongoing monitoring begins to ensure that progress is sustained across time, settings, and circumstances. At the end of treatment, recommendations are made for additional care based on the course of treatment, with the goal of preventing symptom relapse.

Dialectical Parenting is meant to be short-term, with the goal of achieving symptom reduction and improved functioning within several months.