Missouri Girls Town has begun implementing a new therapeutic approach called Dialectical Behavior Therapy (DBT). The majority of our clients are struggling with intense emotions, impulsivity and harmful behaviors, often including self-harm. DBT offers a highly structured and intensive approach for dealing with problem behaviors. It is one of the very few such programs of its kind available in the United States.

DBT helps with the problematic actions sometimes used to deal with extreme emotional intensity. DBT emphasizes taking responsibility for one’s problems and helps the person examine how they deal with conflict and negative feelings. The goals of the DBT group include identifying maladaptive coping patterns and providing clients with adaptive coping strategies to promote healthier lifestyles and psychological well-being.

DBT encourages the individual client to accept reality while maintaining a strong and conscious commitment to change. DBT has also been modified so that it can be used with other difficulties such as eating disorders, substance use, self-harm and anger management. DBT targets the issues that cause distress and teaches skills to deal with them without having to resort to self-defeating behaviors. It does so in a framework that helps us understand that we are doing the best we can even though we need to learn ways that work better.

DBT has proven so effective with our population that it is integrated into our entire program. In keeping with the structured approach that DBT favors, our girls carry diary cards with them throughout the day to track and monitor personal DBT goals, such as “respect” or “positive thinking.” Each day they review their diary in the context of a peer support group to practice giving and receiving feedback.

Our entire staff is given training in DBT so they can assist with behavior chain analysis and other activities that reinforce our clients’ DBT work. Incorporating DBT strategies into the daily routine, the milieu and our curriculum helps girls generalize their new skills into everyday life.