The Dialectical Behavior Therapy Skills Workbook For Teens: Simple Skills To Balance Emotions, Manage Stress, and Feel Better Now Debra Moreno Garcia PDF Available
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si m p s,
a g e s t r e ss & f e e l b e t t e r n
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THE
DIALECTICAL
BEHAVIOR
THERAPY SKILLS
WORKBOOK
FOR TEENS
“This workbook not only makes the components of DBT easily digestible for therapists and their clients, but
does so in an incredibly engaging way. The exercises and tools are useful and easy for folks to utilize outside
the session, like the ‘e-mantras!’ Highly recommend this workbook for any therapist working with teenagers
and young adults!”
—Judi Stadler, LCSW, director of clinical services for Para Los Ninos Mental Health Program
“This workbook is a delightful guide, full of important information for adolescents to understand themselves.
It is also a great resource for therapists to use with the adolescents they work with.”
—Evelyn Lizeth Coria, LCSW, infant-family and early childhood mental health specialist, and
Reflective Practice II Facilitator
“The Dialectical Behavior Therapy Skills Workbook for Teens is an exceptionally practical book that illuminates
the core principle of DBT in a very concise, coherent, and strategic approach. The book contains numerous
examples, exercises, and handouts which can be utilized by readers. This book is an excellent guide for
teenagers who are dealing with emotional dysregulations. I endorse this book as an additional therapeutic tool
for teenagers, parents, and mental health practitioners.”
—Iman Dadras, PhD, LMFT, associate professor of couple and family therapy at Alliant International
University, Los Angeles
“Moreno Garcia and Ho have a keen understanding of the challenges faced by today’s teenagers. The
Dialectical Behavior Therapy Skills Workbook for Teens dives deep into the topic of stress and its impact on
overall well-being. This book is certain to help readers recognize and reflect on stressors, and gain a greater
understanding of their own experiences. A great tool for teenagers to begin the journey of improving their
well-being.”
—Olga Aguilar, MA, LMFT, CEO of Arroyo Seco Family Therapy Inc.
p le s k i lls to balance emotions
si m ,
a g e s t r e ss & f e e l b e t t e r n
man ow
THE
DIALECTICAL
BEHAVIOR
THERAPY SKILLS
WORKBOOK
FOR TEENS
26 25 24
10 9 8 7 6 5 4 3 2 1 First Printing
This DBT workbook is dedicated to my mom, Teresa Martinez, aka “Granma Terry.”
Her relentless support through the years of my every whim (without judgment) has
allowed me to forge new adventures and accomplishments. I owe my bravery to her.
Her perseverance and kind generosity to all she met built encouragement
for those in pursuit of their passions.
CHAPTER 4 MINDFULNESS 45
ACKNOWLEDGMENTS 174
REFERENCES 175
A LETTER TO YOU FROM US
Dear Teenager,
Thanks for opening this book. So, what intrigued you? Seems like there’s something you want to
dive into to learn more about yourself and how to get through this awesome, yet confusing and
stressful thing called life.
By carefully listening to teenagers like yourself, we have learned about the magnitude of
adolescent stressors and worries that make life complicated. Adolescents have taught us to
understand the heightened levels of stress and accompanying pain and angst you may be
experiencing. And you know what? That’s okay! This workbook will help you reduce stress, find
comfort, and build a sense of belonging on your journey.
We hope this workbook, with examples of diverse life circumstances from other teens, will help
connect you to yourself and others—especially since we understand that adults don’t always
acknowledge teen stress-related issues nor provide meaningful exchanges of support and
guidance. You’ve probably experienced an adult’s attempts at good advice turning out to be
dismissive, with misinterpretations of your situation. This workbook offers you the chance to tell
your own story and write about the changes you want to create for yourself.
We want to thank you for letting us guide you through this process of change, discovery, and
well-being. We know you can do it!
Dialectical behavior therapy (DBT) is a therapeutic approach that has been proven to reduce
anger, stress, depression, hostility, and dissociation (Dimeff and Linehan 2001). People who have
received this treatment have demonstrated a profound shift in how they feel and have made
gains in everyday functioning.
The primary component of DBT is to replace embedded, rigid ways of thinking. This thinking is
similar to a term you may have heard before: “all-or-nothing thinking.” This is when a person gets
stuck in perceiving experiences and challenges as either all good or all bad. As you might know,
this can alter the way we feel about difficult situations and may cause an insurmountable amount
of internal distress.
Another fundamental feature of DBT is validation and acceptance (Dimoff and Linehan 2001).
The activities in this workbook are designed for you to feel validated in how you feel in your
response to complex interactions. Drawing on DBT techniques of mindfulness, emotion
regulation, distress tolerance, and interpersonal effectiveness, these activities will guide you
toward self-acceptance and personal change (Linehan 1993; Lynch et al. 2006).
Ultimately, the activities in this book will help you find liberation from faulty ways of thinking,
internal chaos, and thorny social relationships. They’ll also help you reduce overall stress
and boost your well-being. You can start by allowing yourself to be who you are with the
understanding that you can always improve.
The structure of this book includes some warm-up chapters (1–3) to help you gain an
understanding of how stress impacts your health, create a support network, and build your
strengths to guide you through the DBT process.
The subsequent chapters (4–7) are designed around the therapeutic delivery of DBT and are
folded into the core concepts of acceptance and change.
We hope that your interactions with this book will help you begin to change the way you think,
accept who you are, and free yourself from any negative emotions that have hindered your day-
to-day life.
x
LETTER TO TEEN ADVOCATES
This workbook is designed to help teens understand the key concepts of DBT: mindfulness,
emotion regulation, distress tolerance, and interpersonal effectiveness by using everyday language
that is digestible for teens to process and practice. The language shared in this book is meant
to enable adolescents to find comfort in utilizing therapeutic tools to decrease daily stressors
through DBT activities. This is especially important since approximately half of all adolescents in
the US report a minimum of one adverse childhood experience (Child and Adolescent Health
Measurement Initiative 2018–2019), which threatens mental health.
Each chapter in this workbook uniquely presents primary DBT concepts using intuitive adaptations
to deliver a complex therapeutic intervention in an approachable and less intimidating manner for
teens, serving as a catalyst to self-understanding and an aid to combat mental health struggles.
This allows teens to use therapeutic resources to mediate stress using accessible DBT methods.
The pervasive benefits of DBT have been well documented, with clients reporting a profound
shift in how they feel and improvements in everyday functioning. We recommend that a
constellation of activities within the four core domains of DBT be used within your clinical
sessions, as therapeutic homework between sessions, or for your teen mental health consumers
to work on independently (please see Framework of DBT Activities in the appendices).
We hope this DBT workbook serves as a bridge to understand your client, build rapport, and
support the assessment and case conceptualization process.
Like most teens, you’re probably experiencing heightened levels of general stress due to conflicts,
hardship, adversity, and expectations. In fact, teens today experience stress more than any other
generation in American history. But what is stress?
Well, stress is your body’s physical response to difficult circumstances that are hard to cope with.
We understand you’re living with many difficult scenarios that can cause heightened exposure to
stress. In fact, most teens identify with at least one of the following areas of stress in their lives
(Garcia et al. 2018).
This workbook will share real-life stories from teenagers who’ve experienced many of the stressors
you likely face. Activities in this workbook will help you to identify the stress areas listed above
and provide you with strategies to manage and overcome daily stressors to improve your well-
being. Handling your emotions, the natural feelings that affect your mood, will support your overall
health. So, let’s get started with reading about Theo, who is dealing with a stressor at school:
* THEO’S STORY
Theo is a high school senior who is trying to complete his courses in order to get admitted
into college the following year. However, his school counselor forgot to give him a specific
class that was necessary to graduate. Theo had to improvise and take a semester-long class
crammed into one month!
“
The thing that made it so stressful was that he did not tell me until a month before
school ended, and it was a course I needed to graduate, so I had to get my sisters involved to
help me to do all the work. I had to do an online course to get it all done by the end of the
”
year to graduate.
When we worry, we center our goal on finding a solution—fixing the problem! And that’s exactly
what Theo did. He was feeling stressed and was able to identify his problems and tackle them.
Once he addressed the problem, Theo was able to experience the excitement and rewards of
graduation.
2
FRIEND OR FOE?
Stress can be both a friend and an enemy. It can lead to positive outcomes or dramatically
compromise your health. At times, stress can feel ever-present and unmanageable. It can
feel overwhelming, as if it’s attached to you like your shadow. It follows you around, and you
can’t seem to shake it. Other times, you learn how to take control of stress and use it to your
advantage. In Theo’s case, as a foe, his stress put him under immense pressure to accomplish a
task, but as a friend, his stress motivated him to achieve his goal.
As a frenemy, stress has three distinct pathways: healthy stress, unhealthy stress, and chronic
stress. Let’s explore them briefly.
Examples of eustress: your team winning a home game, saving Princess Peach from Bowser,
finishing your first 5K, beating your personal record for how long you can sleep, or even asking
someone to a dance.
3
Discovering Diverse Content Through
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