November 2014

Dialectical Behavioral Therapy (DBT); An Evidenced Based Approach to Treating At Risk Adolescent Behavior

A recent The New York Times "Why Teenagers Cut, and How to Help Them" discusses the difficult topic of self-harm, especially prevalent in teenagers. We expect teens to be moody, but when adolescent behavior becomes at-risk and/or self-injurious behavior (SIB), it's time to learn some skills. Teens who self-harm, express suicidal ideation, and demonstrate impulsive or aggressive behavior sometimes feel like their emotions are taking over. These overwhelming emotions can interfere with school, relationships and living a meaningful life.


Marsha Linehan developed dialectical behavior therapy (DBT) in the early 1990s. DBT is a proven evidence-based treatment that can help teens and their families learn strategies to find balance. Through involvement in a DBT skills training program, adolescents and their parents can gain insight and skills to manage behaviors, thoughts and emotions.


The therapy focuses on four skill modules:

  1. Mindfulness teaches the states of mind and encourages the use of the wise mind.

  2. Emotion Regulation focuses on emotions and how to manage them.

  3. Interpersonal Effectiveness teaches skills to manage healthy relationships

  4. Distress Tolerance instructs on how to deal with emotional crisis.  

As the young person and their parents learn about these real life skills, they work toward progress around how to control emotions rather than feeling that their emotions are controlling them.


An essential aspect of DBT is using the skills and looking at emotional experience non-judgmentally.  Parents and teens are taught skills to aide in the validation and acceptance (not agreement with) the emotion and working toward change.  The DBT skills training group works to develop awareness, while increasing understanding, and communication skills with a focus on navigating challenging situations.


The Sterling office of In Step will be offering DBT Skills Training groups for adolescents age 14-18 with concurrent parent groups.  We expect that all clients participating in the skills training group will be working individually with a DBT therapist. Our clinicians collaborate to create a circle of care around our group participants and are available for consultation with group member's individual therapists, psychiatrists and/or school personnel.


Please see this flyer for more information on our DBT group.

About our Group Leaders:

Combined, Rachel Cherian, LCSW, Erika Carlson, MSW, Supervisee in Social Work, and Sharon Williams, LCSW offer over 30 years of experience working with children and adolescents and share the approach that changes in cognition can lead to positive changes in behavior through learned skills and experiences. 



Grow With Us 


As we expand our office in Loudoun County, we are interested in talking with experienced, licensed clinicians whose passion is working with kids and teens in group therapy settings. As independent contractors, our therapists have the flexibility to work 10-20 hours per week seeing individuals during the day and training to become group leaders during the evening. Many of our clinicians work in the healthcare system or schools full time and work with us in private practice on a part-time basis. Please contact our Associate Director, Dara Adams, at if you would like to learn more about this opportunity.




Group Openings at In Step 





Elementary School Age Children



    Sterling - Call 703-433-5771            Fairfax - Call 703-876-8480



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8500 Executive Park Avenue, Suite 204, Fairfax, VA 22031
6 Pidgeon Hill Drive, Suite 200, Sterling, VA 20165