June 6, 2023
Content trigger warning. Please be advised that today’s episode discusses the topic of suicide. If you are having thoughts of suicide or have concerns that someone you know may be at risk of suicide, please contact the suicide and crisis lifeline at 988 or text HOME to 741741 to reach a crisis counselor. You are not alone.
Cindy Lopez:
Welcome. My name is Cindy Lopez, the host of this CHC podcast, Voices of Compassion. We hope you find a little courage, feel connected and experience compassion every time you listen. DBT, what is that? According to expert, Dr. Michele Berk of Stanford Dialectical Behavioral Therapy or DBT is quote, “currently the only well-established evidence-based treatment for decreasing suicidal feelings or self-harming behaviors in youth,” unquote. Through DBT students learn important social, emotional and resilient skills for life.
In today’s podcast episode, we talked with CHC experts, Dr. Zahra Murtaza, Ravenswood coordinator and psychologist, and Dr. Sarah Griest, RISE, IOP clinician about DBT, what it is, how it helps, and specific D B T strategies that we can all use.
Welcome Dr. Mutaza and Dr. Griest.
Dr. Zahra Murtaza:
Hey Cindy, thanks so much for having us here today. I am so excited to be here and to talk about DBT with all of you. So I was trained in DBT in my postdoc fellowship here at Children’s Health Council, and I have loved it so much that I use it as a skillset that I teach to so many teens and families in my work, and I’ll pass it on to you, Dr. Griest.
Dr. Sarah Griest:
I’m so excited to be here, I do DBT all day with work and with RISE, and honestly I love podcasts, so this is just like a dream come true.
Cindy Lopez:
Thank you. We’re really glad that both of you’re here today to talk about DBT. As Dr. Murtaza noted really valuable method and intervention for everyone really, but we use it specifically in our IOP, our intensive outpatient program, which is called RISE, R-I-S-E, which we run in collaboration with Stanford, and we also run DBT skills groups at CHC where students can participate and families as well. So if you’d like to find out more about all of that, you can see more at chconline.org.
So Dr. Murtaza And Dr. Griest, what is DBT, and how is it different from CBT or cognitive behavioral therapy? How does it work? Tell us a little bit about that.
Dr. Sarah Griest:
Yeah, I think a lot of people have heard of CBT. It’s definitely entered the zeitgeist and is super helpful for a lot of people, got a huge evidence base. DBT evolved from CBT actually, so it’s like the next generation of behavioral therapies. CBT came first, and it’s focused on using skills to really change your thoughts and how that might be able to help, you know, with mental health and all sorts of things, but for some people, CBT doesn’t really capture the whole picture. It’s harder when we’re working with really extreme emotions or the edges of that emotional spectrum. So DBT kind of turns it on its head, and if CBT is using thoughts to impact your behaviors and emotions, DBT is using your behaviors and emotions to help change your thoughts. It really takes that thoughts, feelings, behavioral principles that CBT started with and transforms it to help with the specific needs of people who have really intense emotions, self-harm behavior, or suicidal behavior.
Cindy Lopez:
Yeah. And just for our listeners, in case we haven’t said this yet, DBT, Dialectical Behavioral Therapy, CBT, cognitive Behavioral Therapy.
Dr. Zahra Murtaza:
Exactly. I think the definitions and the lingo there are so important, and I also wanna add dialectics, right? That’s a huge part of what is dialectical behavioral therapy, and to me it’s really that idea that two things could be true at the same time. And we really acknowledge that intense emotions could be happening at the same time, or someone could really want to change and at the same time needs to accept certain parts of their life as they are. So there is that philosophy of acceptance versus change or looking at different things being true at the same time. Teens and parents’ opinions, both could be true at the same time from their different perspectives.
Dr. Sarah Griest:
Yeah, so basically DBT is like a therapeutic strategy, kind of just like how CBT is. It’s a way, an approach to try to help you if you’re having a hard time.
Cindy Lopez:
Yeah, it’s so interesting and the way that you described that Dr. Griest, the differences between CBT and DBT, where you start with the thoughts that will impact behaviors and emotions and with DBT start with the behaviors and how that impacts your thoughts. I haven’t ever heard it described that way it was helpful. I feel like we’ve just been hearing about DBT in recent years so why is it that we’re hearing more about it now?
Dr. Zahra Murtaza:
Mm-hmm, right. One thing that I will say in just naming it is we are still at the edges and reeling from a global pandemic. And during this global pandemic, teen mental health was at the forefront, and we are still facing a teen mental health crisis. We saw suicide attempts rise dramatically during the pandemic, self-harm behaviors as well, which led a lot of kids and teens to the emergency room. In fact CDC data has also talked about this. In 2021, more than a third of high school students reported poor mental health during the COVID-19 pandemic, 44% reported persistently feeling sad or hopeless. There could be many other factors going on, but because DBT targets suicide, self-harm and risky behaviors, I think it’s become more popularized. So just because of like the knowledge we have and the access we have now to many different kinds of therapy.
Dr. Sarah Griest:
I also think these things take time to build traction just in our culture. CBT, like I said, it came first, so we’ve had a lot more time to get used to that idea, to have it reach people and get curious about it and spread around. DBT you know, it’s an established therapy, it’s got a lot of research and evidence about it, but that research base is constantly growing and the more that we know about it, the more other people can start to know about it, the more podcasts like this, the more outreach like this, that’s how things like this begin to spread and people start to learn about it. It It just takes time.
Cindy Lopez:
So let’s talk about how DBT works. Can you explain that a little bit?
Dr. Zahra Murtaza:
Sure. Now, one of the things that also makes DBT really special is it’s focus on creating a life worth living. So it’s not just about how do I learn tools to increase my coping or to reduce my stress, it’s also about how do I put all these things together and create the life I wan to live. This is especially helpful for teens, even for adults who want to create a life where they are valuing what they prioritize, and it’s not just about how do I reduce the negative things, but it’s also how do I add in things I enjoy? How do I build mastery in areas I wanna build mastery in? Marsha Linehan, the developer of DBT, talked about life worth living a lot and stated, “no life is not worth living, but what is important is that you experience your life as worth living – one that is satisfying and one that brings happiness.” So I really like that as a foundation and as a framework for why we do DBT. So in terms of now, you know, what are the aspects of DBT that make it work? One of them really is motivation and willingness from the client. I think that is something we emphasize from the get-go when we work with a client or even with a group, you know, what is bringing you here? Are you coming here cause you want to, is it just cause your parents are making you? We really talk about that and talk about barriers to willingness at the beginning. I think the other mechanisms are how do we notice our emotions, including where are our emotions in our body? How do we notice when those emotions are getting too strong or hard to deal with? And then how can we slow those down before I make emotionally driven decisions? So I think really that noticing of emotions, connecting it with our body sensations, connecting that with our behaviors and thoughts, right, it’s all connected and that’s what I think really helps DBT work is helping connect all of those things together.
Dr. Sarah Griest:
I think it could be boiled down to like three different ideas. The first is that we wanna help people learn how to slow down their emotions, like Zahra was saying, like bringing it down so they’re not exploding off the charts cause people that often benefit from DBT are those that have those really intense emotions. So first thing we’re gonna teach you is how do we slow that down from exploding? Then how do we stop making these emotionally driven decisions that we would later regret? So that can be anything from like saying something hurtful when you are really mad to all the way to self-harm or suicide attempts. The third thing that we teach in DBT that we really think creates that change is learning to listen and respect your own experiences rather than being vulnerable to others or the environment controlling how you feel. So the way that we do this is by teaching you all sorts of skills, this dialectical framework of thinking, and also we don’t shy away from the big, dark, scary things in life that might have brought you here.
Dr. Zahra Murtaza:
Yeah, it’s naming all of the hardships that people go through and validating, wow, you know, you do feel this way, and let’s name it, let’s work on all of those areas together.
Dr. Sarah Griest:
Yeah, it’s the equal part like how can you change what’s going on and how can we kind of validate and understand what’s happening for you too?
Cindy Lopez:
Yeah, it’s so interesting and, you know, kind of going back to, it seems like a newer method, as you noted previously, like CBT came first and it also seems to be really effective. So why do we use it?
Dr. Zahra Murtaza:
DBT from the research that we have available is the strongest evidence-based treatment to reduce self-harm and suicidality for teens and also for adults. This is the therapy that’s been studied compared to other therapy, including supportive individual therapy and supportive group therapy. This is a therapy that showed the best results. So six months later, when you looked at teens and you compared how many of them had made another suicide attempt? Those who received DBT were less likely than those who had only received individual or supportive therapy or supportive group therapy. So why is that? I mean, DBT provides a comprehensive framework. You know, when we look at comprehensive DBT, which includes different ingredients for treatment that could be individual therapy, at the same time, you’re receiving a dose of group therapy, you’re receiving phone coaching, where you can call your therapist 24/7. That’s a part of what we call comprehensive DBT. All of those ingredients put together are what we know help teens to, you know, reduce their likelihood of self-harm and suicidality. I like to think of it like um just support system that encompasses you or surrounds you, right? It’s not just you on your own and you get one time a week therapy, or you process your emotions rather you’re getting a skillset, and you’re getting the support throughout the week, and your parents are hopefully getting that too, so they can reinforce that and help you at home as well.
Dr. Sarah Griest:
That’s something that I think I always emphasize with my clients that I really want them to use phone coaching. It’s something that makes DBT really special, like, I don’t know if anyone else has felt this way, but this idea that, you know, the moment you sit down to talk to somebody about it things are actually okay or maybe you can’t remember what was going on when you were having the hard time, or, hey, like, where are you when I’m actually having a crisis versus just gonna tell you about it later about how everything went sideways. With DBT with a comprehensive program like RISE is, you have the power to call your therapist when it’s happening, doesn’t matter if it’s two o’clock in the morning or like in the middle of class. You can step out and call people when you need help to learn the skills live, and I think that’s really a huge part of what makes DBT effective for these teenagers, for these humans.
Cindy Lopez:
Wow, I didn’t realize that was part of the program, and I think that’s great because being able to help in the moment, it can be just so much more effective.
Dr. Sarah Griest:
Not only do I try to encourage all of my clients to use it, but when teens graduate from our program so consistently, they’re always telling the other people who are still in the program use phone coaching, it was so helpful. So it’s not just me that’s saying it’s good. The teens also like it once they get used to it.
Cindy Lopez:
Does every DBT program include that or is it just ours?
Dr. Sarah Griest:
So in the Bay Area, RISE is the only intensive outpatient program that offers phone coaching. However, there are lots of different levels of care and any program that has the title of like comprehensive DBT, that’s an official label, and that has to include phone coaching component. There are other therapies that might include like elements of DBT. They might say they’re DBT informed and those are great, they have pieces of it. They use the skills, they reference the framework, but they’re not necessarily having all of the pieces that make it that official comprehensive program.
Dr. Zahra Murtaza:
The gold standard, yeah.
Mike: CHC’s Voices of Compassion podcast is made possible by the generosity of people like you. To learn more about supporting CHC, go to chconline.org/donate. Also make sure to follow us on social media for more inspiring and educational content from CHC.
Cindy Lopez:
IOP, we said it previously, but just say it again, intensive outpatient program and that is again, our RISE program that we do in collaboration with Stanford. So what is DBT used to treat, and how do we use it at CHC and in our programs?
Dr. Sarah Griest:
So DBT is designed for people who have really intense emotional responses who have self-harm behavior or have suicidal thoughts or have attempted suicide. It’s not just good at treating those things. It’s literally built for helping those presentations, which is hard cause I think people who are experiencing those things like really intense emotions, self-harm, suicide, like that can be really challenging, and it can be really hard to find the right level of care or the right treatment. And there’s a lot going on and we respect that. DBT is designed for that type of support and the way that we offer that level of care at CHC is through our RISE program, which is, as you said, an intensive outpatient program, a higher level of care than just your weekly therapy. There’s a lot more that goes to it. It’s a three month crash course in everything that you could learn, all the different skills in DBT to help get you started on the right foot, to help make a change happen when you’re having those really tough experiences, those really hard times. We also have other programs that aren’t that comprehensive, but we have other DBT resources at CHC too.
Dr. Zahra Murtaza:
Yeah, thanks Dr. Griest. I wanted to also share in addition to the RISE program, we do have a step down, which is our DBT groups. We have high school DBT groups and the middle school multi-family DBT group, and each of those could be a nice supplement to weekly therapy if you feel you need, or, you know, your child needs that additional level of skills training, the group could be a great addition. So, for example, even if you feel your teen is not struggling with self-harm or suicidal thoughts, but has intense emotions or difficult relationships or needs help with managing strong emotions such as anger, anxiety, stress these groups could be really helpful in giving you the skillsets. The high school group I know has two different modules, eight weeks each, and they focus on different topics. One of them focuses more on emotion regulation, the other focuses on distress tolerance and then in terms of the middle school group, similarly, they have one module focusing on emotion regulation with interpersonal effectiveness. And then the other module, 12 weeks each focuses on distress tolerance, and all of them also incorporate mindfulness, which is a really important ingredient that we’re going to get into.
Cindy Lopez:
Yeah, hearing you talk about that, I think you just mentioned some of the components of DBT. Can you kind of run through the list? What is included? What are the core components of DBT?
Dr. Zahra Murtaza:
Absolutely. I was giving you a teaser there, Cindy. So, with our core components, you know, we always start off with mindfulness because we know that being in that present state of mind, in that state of mind where we can make wise decisions, you know, that can help us with regulating our emotions or making decisions that are effective. So we always start with mindfulness and practice mindfulness in a lot of our sessions. The next is distress tolerance, which is, you know, getting through that moment.
Dr. Sarah Griest:
Yeah. I think mindfulness is another one of those things like CBT that has definitely gone into the culture. People have tried it, it’s kind of talked about in schools, which is great. It’s a useful skill. It’s also a very broad skill. So in some cases it can mean like, you know, a way to be grounded, and I think people might consider it like meditation or try to find like peace, right or calm. In DBT, it’s also used in a framework of just being mindful as in paying attention. So are we being mindful? Are we paying attention to what’s going on for us? We need to essentially gather that data before we can do anything else about it, which leads us to distress tolerance. So once we realize that we have something going on that we might need to deal with, whether it’s a crisis or just a lot of stress, then we teach you some core skills about getting through that terrible time. So without making a decision that you regret, we’ll deal with changing it later, at this moment it’s just about getting through the crisis without making things worse.
Dr. Zahra Murtaza:
Right, and I think with distress tolerance, it’s about those really challenging moments. And in terms of our daily life, we may have moderately challenging moments where we’re stressed out, feel strong emotions, but we’re not in that crisis zone. And so those kind of moderately stressful moments or mildly stressful moments, we can use emotion regulation skills for those and emotion regulation as another key component of DBT. It’s really about calibrating your emotions in a situation so that your emotions work for you rather than against you and to me it’s all about noticing our emotions, bringing awareness to them before we can, you know, change them. In fact, just validating ourselves, accepting our emotions, oh my gosh, that can do wonders for our own emotion regulation, right? You’re having a hard day and you’re just like, “hey, I’m having a hard day. I’m really anxious right now.” Even labeling that can bring your emotions more stability versus like running through your day and like not even noticing them.
Cindy Lopez:
Yeah.
Dr. Sarah Griest:
So we’ve got mindfulness, distress tolerance, emotion regulation. The last one, last module is interpersonal effectiveness, and this one’s a lot of fun because it’s really all about, you know, the fact that we don’t exist in a vacuum. We’re engaging with other people throughout the day, and it’s about balancing what you want and what you need from others, strengthening your relationships, and also keeping yourself respect, which I feel can sometimes get left by the wayside.
Cindy Lopez:
Yeah, it’s so interesting hearing you both talk about the components of DBT makes me think that I need to go join a DBT group.
Dr. Sarah Griest:
I’ve honestly learned so much from teaching. It’s so useful. Like I said, it’s designed for those like really intense emotions, sometimes scarier, really intense behaviors, but we can all use so many of these skills in our daily life, and we see that like teens, siblings, parents, when they’re learning this, they use it at work. They use it at school. They use it outside of crisises, and I do every day too. It’s really helpful.
Dr. Sarah Griest:
The fact is there are tons of skills that you learn for all the different parts, and it’s about figuring out which ones work for you and in what situations.
Cindy Lopez:
So speaking of that, like let’s talk about some of the specific tools that are associated with each of those core components of DBT, maybe some of your favorite ones.
Dr. Sarah Griest:
We started off with talking about how dialectics is really the foundation of DBT, like that’s what the D stands for dialectical, dialectic, which means holding two things that feel opposite, but they’re true at the same time. So, we always teach this first because it is really, like I said, the foundation. We gotta start here and move forward from it, like someone could be trying their absolute best and still need to do better in order to make the changes that they want. It’s also the idea of balancing acceptance of your situation, acceptance that you might be someone that feels really extreme emotions and you might wanna change the way that you cope with that. Acceptance and change. There are a lot of them that get brought up throughout the program and throughout DBT, but those are two like key ones for dialectics that really start us off in getting into the DBT mindset.
Dr. Zahra Murtaza:
Yeah, thanks for starting us off on dialectics, Sarah. I’m gonna talk a bit about mindfulness now. Mindfulness and DBT, you know, it can have different purposes, but one of them is about how can I be in the present moment without judgment, with a sense of openness and curiosity and you have skills of in terms of what to do to be mindful and then how to be mindful. One of my favorites though, is describing a situation without judgment. For me, I know that can really bring down the distress in the moment. So if I, let’s say, had a really tough moment or a tough day, I can say, “hey, this was just, you know, it was terrible or I’m judging the moment and sometimes that can get me more amped up about the situation, or if I say, “hey, this person I was interacting with was, you know, and then insert X, Y, or Z, right? This person was a jerk.” If I describe it that way, I’m gonna be more emotionally amped up versus if I say simply what was happening and just describe it non-judgmentally, “I was in a situation where this person used a tone of voice I didn’t like.” And I’m like, oh, I’m simply describing it without judgment or a food I didn’t like, “hey, this was the most disgusting food I ate in my whole life,” rather than that, okay, notice the sour flavor and the additional spice. And as I’m doing that, I’m mindful, I’m in the moment and it brings some of those strong emotions down. So I love the describe without judgment, I think we can use it all the time, including about our own selves, reducing judgment towards ourselves.
Cindy Lopez:
So we talked about dialectics, mindfulness. What about distress tolerance?
Dr. Sarah Griest:
Love distress tolerance, like I said, that’s about getting you through a situation just to not make things worse for yourself before you can calm down and make some on purpose decisions about it. So the number one skill that we teach for this is called TIPP, T-I-P-P. And each of those letters sounds for a different skill that is basically a biohack to try to trick your body into regulating itself when you are just you know, 11 outta 10 on how hard things are. And as much as I would love to absolutely go into all the different pieces, I feel like that’s maybe not for this exact moment in time, but it’s really something that I think every single teen that goes through a program walks away with that one in their pocket because it is truly the emergency break for when things get really hard.
Cindy Lopez:
Now I’m gonna go look it up. Thank you.
Dr. Zahra Murtaza:
One you already probably know is deep breathing and you know, just noticing, “hey, I’m in that 11 outta 10.” Let me do my breathing so I can bring my sympathetic nervous system, you know, the fight or flight into that calm space, the parasympathetic nervous system.
Dr. Sarah Griest:
So TIPP is like our emergency break skill, but there’s also things that you can do in advance to prepare for if you’re in kind of a crisis mode.
Dr. Zahra Murtaza:
Yeah, another one that I really like from distress tolerance is self-sooth. This could be using your five senses, and one thing I tell my clients is to create a toolkit beforehand, before they get into crisis mode with maybe a little bag or a little, you know, pocket that they have in their backpack and put in something they can smell when they’re in distress, something they can taste, something they can look at, maybe a photo they like, something they can hear, and something they can touch so that when they’re going into a stressful moment, they’re prepared or, you know, so you have something in your office or in your classroom that you can use when you’re really overwhelmed. I know the next one is emotion regulation. Sarah, do you wanna get into that?
Dr. Sarah Griest:
Definitely. So emotion regulation is different from distress tolerance. Like distress tolderance is about like getting through, right? We’re still having some really intense emotions, and we are trying to bring down the intensity, but emotion regulation is about kind of calibrating your emotions so that they work for you, so that they fit a situation, not just get rid of them, but you know use them in a way that makes sense, that is helpful. So one way that we can help calibrate our emotions is the skill check the facts. It’s basically a reality check of the situation that helps give you perspective, and we’re not being self-critical about it. It’s just a matter of taking a step back and looking at the observable objective aspects of what’s going on, removing judgements, any assumptions that you might be making, things that you can’t prove are true about maybe what people are thinking or how they feel. If they haven’t told you, you don’t know that’s for real, and also any extreme statements like, “I’ll never go to college because I failed this test.” It’s like, eh, are we sure about that? Let’s try to calibrate, and then once we’ve kind of adjusted the situation, taken a second look at it, a lot of time that’s enough to really turn down the temperature of what we’re feeling. It might even have us reflect and be like, wait, maybe I’m not actually mad, I’m actually really sad that my friend ghosted me, like it’s kind of helps us accurately identify what’s going on, and that can help us make, again, on purpose decisions for what happens next.
Dr. Zahra Murtaza:
Yeah. And now I’d like to get into interpersonal effectiveness. One of my favorite skills from interpersonal effectiveness is validation. This is one that if you’re a part of DBT, you’re gonna hear multiple times. And we actually start off with DBT talking about biosocial theory, which is a foundation of DBT, which is saying we each have a biological vulnerability to experiencing emotions. However, when we feel or perceive that we’re in an invalidating environment that combination is what can create emotional dysregulation, feeling invalidated, so that you have to maybe scream louder to show that you’re struggling or that you’re suffering, right? And that creates this transaction with you and your environment that can be unhealthy and may lead to risky behaviors. So just to kind of bring it back to validation, we talk about validating ourselves, telling ourself my emotions make sense. It’s okay to feel this way, or for parents tell your teens, “hey, it makes sense that you’re worried right now or that you’re sad right now. And remembering that validating emotions does not mean you’re validating someone’s behavior.” Doesn’t mean that you’re agreeing with somebody, however you’re saying the feeling behind it makes sense. And that can bring down the emotional escalation so much and bring you closer in your relationships to one another.
Dr. Sarah Griest:
Yeah, you can validate that someone’s really mad without saying that it’s okay that they broke the vase, right? can say, “yeah, I can understand. I can see that you’re really mad.” It’s totally a different saying, and I’m really glad that you acted the way that you did. Totally different, but it’s amazing. This is like a stealth skill. This is something that we teach early on in this module, and we really encourage, especially from parents because it is really the first thing that we want people to do when someone is upset is really just state, “I understand you. I believe you. What you’re feeling is real and makes sense and that can just automatically just bring down the temperature in the room and give you a more even playing field to take the next steps.
Cindy Lopez:
So What can a person expect to experience if they’re in therapy using DBT?
Dr. Sarah Griest:
It’s definitely a different style. We don’t beat around the bush. We honestly talk to you straight about the things that are going on for you. Like I said, a lot of the people that this program is designed for, that DBT is designed for are dealing with some really serious stuff, and so we’re gonna talk about it. So you can really expect an honest conversation, a genuine conversation, radically so and to the point where like, we’re gonna tell you how it is, we’re not gonna be mean about it, we’re not gonna judge you. We’re just not going to pretend basically, and I think that can be a little surprising at first because it’s different than what you might expect from like a therapeutic environment, but again, we prioritize validation as well. It’s just a matter of like, we know how serious some of these things are, and so let’s talk about it.
Cindy Lopez:
Yeah, I can also imagine that it would provide some relief. It’s like, oh, there’s somebody who actually wants to talk about this with me. We’re not afraid of not afraid of it. All the, all the darkness, all the scary stuff that you’re not sure how to talk about with the other people in your life, this is our whole job is to talk about that stuff. So we’re ready for it.
So, Dr. Murtaza, is there anything you want to add?
Dr. Zahra Murtaza:
Yeah, I was gonna say, we know through the research and just our clinical base that we have that talking directly about suicide is a huge intervention that clinicians can utilize, parents, teachers can utilize, and DBT does that, we name that. We name it right away. We make a safety plan and involve the client and family in that conversation.
So the other thing I’ll say that’s different in DBT is it’s quite structured versus other therapies, and a lot of therapies you talk about where does the client want to go today? What do they want cover? And in DBT, you do have an agenda in your session. You start off with talking about the risk behaviors, anything getting in the way in therapy right now. And then you talk about other things going on for that client, and you’re always learning skills, you’re practicing skills. So it is gonna feel more structured. However, if you’re willing to do the work, I think you are gonna get a lot out of it, including a whole new way of thinking.
Cindy Lopez:
Yeah, and it doesn’t sound like there’s a lot of DBT programs around. So how would one of our listeners, say they’re a parent or a caregiver, how would they get their child into a DBT program or just get them the help that their child needs, especially if they’re observing these kinds of behaviors, the self-harm, suicide ideation kinds of things?
Dr. Zahra Murtaza:
Yeah, great question. I think one of the benefits we have nowadays with mental health awareness is so many providers know about mental health now, whether it’s your pediatrician, your therapist, your school counselor, and so I would say talk to whoever you’re already meeting with to say, “hey, I’m concerned about my child, what resources are out there?” Nowadays, a lot of pediatricians are able to refer to a program such as RISE or a DBT program, or if you’re already at a clinic asking, “do you guys offer DBT?” We would say doing a first intake phone call or a consultation phone call with one of our coordinators here at CHC. One of them who works in our DBT program is Nicole. And, you know, just scheduling a call with Nicole to say, “hey, this is what I’m observing.” I’m observing, you know, these behaviors, these emotions coming up. Is this the right fit? And someone like Nicole would be able to tell you,” hey, the group is a better fit versus the RISE IOP program is a better fit.”
So I know that it’s a lot of information with levels of care. We’ve talked about comprehensive DBT versus DBT informed therapy, versus groups. So talking with someone at that clinic such as Nicole would be a great step. I would also say, look at what your schedule is like right now, are you able to drive out to a program? Do you prefer online programs? There are a multitude of offerings. Some DBT programs are virtual completely, and some such as the RISE program have two days of the week virtual, two days of the week in person, right? Maybe you’re looking for three hours of the week DBT versus RISE, it’s 12 hours of the week of DBT.
Cindy Lopez:
Mm-hmm.
Dr. Sarah Griest:
That’s the intensive part.
Dr. Zahra Murtaza:
Right, it’s about determining what level your child or teen needs and then, making that step to call them, but we’re always here at CHC to talk to you about, you know, referrals or what would make sense for your child.
Cindy Lopez:
Yeah. Thank you. And for our listeners, Dr. Murtaza just mentioned Nicole, who’s part of our intake process for IOP, and we will include that information in our resources. So make sure if you’re listening and you want that information to check out our resources or show notes for this podcast episode.
So, Dr. Murtaza, and Dr. Griest, I’ve learned a lot just by listening and by talking with you about this, and I can tell also that you’re both very passionate about the topic and your work with teens, and that truly came across and I just wanted to thank you for that and everything that you do. As we close up, what do you really want our listeners to walk away with as a result of hearing this episode today?
Dr. Zahra Murtaza:
Yeah, you know, it’s just been an honor and a pleasure to be here, and I reflect upon the work I’ve done with teens, with their families, and sometimes they come into my office, and they are crying. They’re struggling. Nothing has worked yet. And what I want to say is there is hope and this treatment can offer you so many ingredients of change, and just starting off though with “I’m doing the best I can right now,” right? I made it here into this office, or I made it even onto this podcast, and I’m willing and interested in learning and you know, I can do better. So I just really wanna leave you with that self-compassion while kind of holding yourself accountable at the same time that can help us in so many settings in our lives.
Dr. Sarah Griest:
As for me, I’m hoping this reaches people who either know someone or maybe themselves experience those really intense emotions that maybe they’ve engaged in some self-harm behavior or have suicidal thoughts and hey, maybe you’ve tried therapy or used some coping skills, but it just hasn’t been enough, or maybe it feels like there’s no way out of how hard things are right now, or that just other people don’t get it. We get it, we do, and I’d want that person to know that DBT is designed for this, and hey, it might just work.
Cindy Lopez:
Thank you so much for sharing your time, your insights and expertise with us on this topic around DBT. For our listeners, thank you for joining us. I also wanna mention we do have a couple other podcast episodes around this topic. There’s a parent who shares her journey with her child in DBT. We have another episode on Radical Acceptance, which is one of the tools of DBT. So, be sure to check those out as well. You can reach us at chconline.org. You can reach out to our care team at careteam@chconline.org, and they can help you get to where you need to go. So thank you all for listening. Thank you Dr. Murtaza and Dr. Griest for joining us today.
Dr. Sarah Griest:
I’m really happy be here. Thanks for having us.
Cindy Lopez:
Visit us online at podcasts.chconline.org. Make sure to subscribe to Voices of Compassion so you never miss an episode, and we’d love it if you’d leave us a rating and review. Have a question? Send us an email or a voice memo at podcasts@chconline.org. We’re here for you when you need us.
