Issues with DBT process with child

[jennaberk]

My 14 yo stepdaughter has started DBT over the last month. I am not trained in it despite my clinical background and I am concerned regarding the lack of accountability we are seeing in some circumstances.

The therapist is emphasizing to my husband in sessions and group with his daughter, being non-judgements and validity. This isn't our issue--for us it is the lack of judgement, accountability and validity from his daughter to the experience of everyone else.

Specially her session this week ran 30 minutes long, making everyone in the house late for dinner, because his daughter was upset about one incident over a month ago where I told her her behavior was impacting everyone. I had never been this direct with her in my 8 years. She took that one incident and told her therapist she was afraid to tell my husband (he knew all details as I told him when it happened), had to read it because she was scared to say it, he would be mad etc. then proceeded to tell a very black and white version of the situation, totally neglecting the list of inappropriate things she did and also the rules she had broken to prompt the exchange. Her version is something like "I just want to feel loved and accepted and not worry people won't want to be around or move away" and my version is "she had been disrespectful, blamed me for her mistakes, had multiple calls from school and behavior write ups, said she needed horomones because she was trans (now she's not) and I got tired of the other family members experience being ignored".

Basically I feel like we keep being told to validate her, to listen but then we are also put in a situation where she is enabled to play victim or blame us for issues, and we never receive acknowledgement or have discussion about the other circumstances or how everyone else in the family is experiencing things. Have we not gotten to this part in the DBT, or are the therapists maybe not understanding what is happening according to her vs what we are seeing?

The therapist  wants to have an additional family session on this topic alone but I feel like we are starting to indulge these situations where she's using her flawed logic, seeing things as black/white, ignoring the circumstances that led to my reaction... which seems counter to our goals. Anyone have insights or advice on this?

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Kat816]

Hi there,

My daughter is 16.  She has been in DBT, left and she did not want the group skills and new someone from our street that was in the course, she was embarrassed and I can understand it is a hard thing on it's own and then to know other people know you have issues as well.

DBT starts with validation.  It is important to everyone to be validated. DBT is slow and has several levels they work through. Emotional is near the end.  Also the family needs to be on the same page to learn the skills as so you can better manger with this illness.

Realize this issue causes then to lash out, especially with parents and they feel save around us.  We won't run away from them. The say things they don't mean.  DBT is here to help them control and better manager their feelings and emotions.

A.C.E.   = acknowledgment (validate)  c = calm - stay calm do not show anger, e = exhaust, when communication can't be made - exit and leave.  Let them know that you understand they are upset and that you are leaving until they are calmer and can't talk in a more responsible manner.

As parents we need to learn self control and understand where all this is coming from.  I understand and I ignore the hurt words that come out. I know they are not true and only being said out of anger. This has really helped and changed as far as the explosiveness my daughter would have that led to her cutting.  They really do feel bad but can't control it.

Get outside help, join group with parents in the circle of BPD, read as much as you can about it.  It really helps understand where they are coming from.  Take baby steps, don't overload them.  The tend to hate themselves so us adding to it only makes in worse.  Set boundaries. I have also asked for honesty and respect in our house. Not always the case, but I lead with it and remind by daughter when she is out of bounds.

Hope this helps... .hang in there it is a day to day and is takes a lot out of us.

[jennaberk]

Thank you for your response.

I guess I still am wondering if part of this process will include the therapist or whomever discussing these things when she has created a false scenario in her head and is now alleging we have wronged her. I can understand the piece of this is her insecurity and often she projects it onto us as if we caused this, but is there a poin where that flawed processing is explored?

[Kat816]

Hi Again,

You can look up DBT programs and see what it entails, theory elements in a practical manner that gives them the skills they need to effectively manage their issues There are 5 categories; 1) emotion dysregulation 2) interpersonal dysregulation 3) self dysfunction 4) beharvioural dysregulaton 5) cognitive dysregulation.

They really need to apply these to learn from them and do the homework.  I found from my brief time about validating which is a big part of the first steps. Then we started to learn how to deal with their actions and control out of control moments. I can also go and see the skills counselor to learn about the same skills she will learn. Everyone needs to be on the same page. This will make us aware and see they are applying their skills.  I saw this right away with my daughter as she was validating me ... .LOL.

She was willing last year to take this on but right now she is not in the same frame of mind and it is a constant roller coaster. She gets angry says she's not going anymore etc.  So I am not sure where we will be but hoping for the best.  Last resort I have her admitted to a hospital program which uses DBT. I have been told by several different centers I have taken my daughter to that DBT is really expensive and while she is still under the age of 18 it is covered by our Ministry of Health.  Going to a private will be costly but just waiting to see how this goes first.