Therapy for Children: Helping Kids Navigate Big Feelings with DBT

Written By: Habeebah Abdus-Salaam, LSW, CSSW

Children are incredibly resilient, yet they are also navigating a world full of complex emotions that can feel overwhelming. From the highs of joy and excitement to the lows of anger, sadness, and frustration, kids experience a full range of feelings. However, because their brains and emotional toolkits are still developing, many children struggle with understanding, managing, and expressing their emotions in healthy ways. When these big feelings become overwhelming, they can lead to behavioral challenges, social difficulties, and even long-term emotional problems if not addressed.

Dialectical Behavior Therapy (DBT) has emerged as one of the most effective approaches to help children learn to regulate their emotions and develop adaptive coping strategies. Initially developed for adults with severe emotional dysregulation, DBT has been tailored for younger populations with remarkable success. In this blog post, we’ll delve deeply into how DBT used in therapy for children can support children in navigating their emotional worlds, examine the key components of DBT, share practical strategies, and explore the critical role that parents and caregivers play in reinforcing these skills at home.

The Importance of Emotional Regulation in Childhood

Childhood is a period of rapid emotional, social, and cognitive growth. As children learn about themselves and the world around them, they naturally encounter a wide range of emotions. Unlike adults, who may have years of experience and a more developed capacity to process feelings, children are just beginning to build their internal emotional libraries. When children are overwhelmed by intense emotions such as anxiety before school, anger during sibling disputes, or sadness after a disappointing event, they often lack the language or strategies to understand what’s happening inside them.

Unmanaged emotions can manifest in many ways, including tantrums, withdrawal, impulsivity, and even self-harming behaviors. These challenges affect a child’s immediate well-being, academic performance, peer relationships, and overall development. Fortunately, there are therapeutic interventions that can help children gain control over their emotional experiences. DBT, with its structured yet flexible approach, equips children with a set of tools to recognize, understand, and manage their feelings in healthy ways.

What Is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a form of cognitive-behavioral therapy (CBT) that emphasizes the need to balance two powerful, often opposing, forces: acceptance and change. In DBT, the term “dialectical” signifies this balance. On one hand, children are taught to accept their current feelings and experiences without judgment; on the other, they learn strategies to change unhelpful thinking and behavior patterns. This dual focus makes DBT especially effective for children who may feel trapped by overwhelming emotions.

The Origins and Evolution of DBT

Originally developed by Dr. Marsha Linehan in the late 1980s for adults with borderline personality disorder (BPD), DBT was designed to address severe emotional dysregulation and self-destructive behaviors. Over time, clinicians began adapting DBT techniques for other populations, including adolescents and children, who also struggle with intense emotions. Today, DBT has been successfully used to treat a range of issues, such as anxiety, depression, trauma, and behavioral challenges.

For children, DBT is not just about symptom reduction; it is about empowering them with skills to navigate life’s challenges, build self-esteem, and create healthy interpersonal relationships. DBT for children is designed to be accessible and engaging, often incorporating playful activities, visual aids, and real-life scenarios to help young learners internalize its core concepts.

Why DBT Works for Children

The effectiveness of DBT for children lies in its structured yet adaptable approach. Here are several reasons why DBT is particularly well-suited for helping kids navigate big feelings:

1. Skill-Building Focus

DBT is a skills-based therapy that provides children with concrete, actionable techniques to manage their emotions. Rather than only exploring the origins of their feelings, children learn practical tools they can use in everyday situations. These skills help them pause, think, and choose a response rather than simply reacting impulsively.

2. Emphasis on Mindfulness

Mindfulness—the practice of staying present and aware—is central to DBT. For children, mindfulness helps create an awareness of bodily sensations, thoughts, and emotions as they occur. This awareness is the first step in learning to regulate emotions. By understanding what they’re feeling in the moment, children can begin to identify triggers and develop strategies to manage their responses.

3. A Balance of Acceptance and Change

Many children struggle with feelings of self-blame or shame when they have intense emotional reactions. DBT teaches the importance of accepting one’s feelings without judgment while also recognizing that it is possible to change behaviors that aren’t helpful. This balanced perspective helps reduce internal conflict and builds a stronger sense of self-worth.

4. Structured Modules That Cater to Developmental Needs

DBT is broken down into four core modules: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness. Each module is tailored to address different aspects of emotional and social functioning, making it easier for children to grasp and apply these concepts in various situations.

5. Involvement of Caregivers

DBT for children often includes a strong family component. Parents and caregivers learn about DBT skills and how to reinforce them at home. This consistency between therapy sessions and the child’s home environment enhances learning and helps ensure that the skills become a natural part of the child’s daily life.

The Four Core DBT Skills Modules for Children

One of the hallmarks of DBT is its focus on skill development. Each of the four core modules addresses a different area of emotional and interpersonal functioning. Below, we explore each module in detail, discussing how they work and providing examples of how these skills are taught to children.

Module 1: Mindfulness—Staying Present in a Busy World

Mindfulness is the foundation of DBT, teaching children to be aware of their thoughts, feelings, and surroundings in the present moment without judgment. In an age of constant distractions—from digital devices to the fast pace of daily life—mindfulness offers a way to slow down and truly engage with the world.

Key Components of Mindfulness in DBT

• Observation: Children are encouraged to observe their thoughts and emotions as if they were watching a movie. For instance, a child might be taught to notice the signs of anger—a tight chest, clenched fists, or rapid heartbeat—without immediately reacting.
• Describing: Once a child learns to observe their feelings, the next step is to describe them. This might involve using simple words or pictures to label emotions such as “sad,” “happy,” “angry,” or “scared.” A “feelings chart” or “emotion wheel” can be a helpful visual tool.
• Participating: Mindfulness encourages full participation in the present moment. For example, rather than being lost in thought during a classroom lesson, a child can learn to focus on the teacher’s words and the activities at hand.
• Non-judgment: One of mindfulness’s most challenging yet crucial aspects is learning to experience emotions without judgment. Children learn that feelings are not “good” or “bad”—they simply are. This helps to reduce self-criticism and the fear of having strong emotions.

Mindfulness Techniques for Children

• The Five Senses Exercise: This exercise asks children to identify five things they can see, four they can touch, three they can hear, two they can smell, and one they can taste. It’s an excellent way to ground them in the present moment.
• Balloon Breathing: Children imagine their belly as a balloon in this activity. They take a deep breath in (inflating the balloon) and then slowly exhale (deflating the balloon), focusing on the rhythm of their breath.
• Mindful Coloring: Using coloring books or blank pages, children are encouraged to color slowly and deliberately, paying close attention to the colors, textures, and shapes they create.

By practicing mindfulness, children develop a greater awareness of their inner experiences, setting the stage for effective emotion regulation.

Module 2: Distress Tolerance—Coping in the Moment

While mindfulness teaches awareness, distress tolerance equips children with skills to manage and survive intense emotional states without resorting to harmful behaviors. Distress tolerance is especially critical when children encounter situations that trigger strong negative emotions.

What Is Distress Tolerance?

Distress tolerance involves learning to tolerate and cope with uncomfortable feelings and stressful situations. Instead of trying to eliminate or avoid distress, children learn to sit with it, understand that it is temporary, and use strategies to reduce its impact.

Key Strategies in Distress Tolerance

• STOP Skills: This acronym stands for Stop, Take a step back, Observe, and Proceed mindfully. When a child feels overwhelmed, they can use the STOP strategy to pause and choose a more constructive response.
• Self-Soothing Techniques: These techniques help children calm themselves through their senses. For example, holding an ice cube, listening to soothing music, or looking at a favorite picture can provide immediate relief.
• Distraction: In moments of high distress, sometimes the best strategy is to distract oneself temporarily. Activities such as playing a game, drawing, or reading a book can help shift focus until the intense emotion subsides.
• Radical Acceptance: Teaching children that some situations are beyond their control—and that it’s okay to feel upset about them—can reduce their struggle against their emotions. Radical acceptance involves acknowledging reality without trying to change it immediately.

Distress Tolerance Activities for Kids

• Calm Down Box: A box filled with comforting items—a favorite toy, a soft blanket, a stress ball, or a book—can be a practical tool for a child when emotions run high.
• Counting and Breathing Exercises: Simple techniques like counting slowly to ten while taking deep breaths can help interrupt the escalation of distress.
• Sensory Activities: Using items with various textures or smells (such as playdough or scented markers) can help refocus attention away from overwhelming feelings.

Mastering distress tolerance teaches children that intense emotions can be painful but manageable. This knowledge builds resilience and confidence in handling stressful situations.

Module 3: Emotion Regulation—Understanding and Managing Feelings

Emotion regulation is at the heart of DBT, teaching children how to identify, understand, and modulate their emotional experiences. This module helps children build a vocabulary for their feelings and discover practical ways to respond to them.

Core Elements of Emotion Regulation

• Identification: Many children struggle to articulate their emotions. DBT provides them with tools such as feelings charts or emotion wheels that help them recognize and name their feelings accurately.
• Understanding Triggers: Emotion regulation also involves understanding what triggers certain emotions. For instance, a child might learn that loud noises or a specific social situation tends to trigger anxiety.
• Modulating Intensity: Children are taught techniques to reduce the intensity of their emotions. These strategies may include deep breathing, exercise, or engaging in pleasurable activities.
• Changing Emotional Responses: Sometimes, avoiding triggers is impossible, so children learn to change how they respond. Techniques such as “opposite action” (doing something contrary to the impulse driven by the emotion) are key here.

Emotion Regulation Techniques for Kids

• The “Feelings Thermometer”: This tool helps children rate the intensity of their emotions on a scale from 1 to 10. By recognizing the intensity level, children can choose the appropriate coping strategy.
• Journaling: Encouraging children to write or draw about their feelings can help them externalize emotions and provide insight into their emotional patterns.
• Positive Self-Talk: Teaching kids to use affirmations like “I am strong,” “I can handle this,” or “It’s okay to feel upset” empowers them to combat negative thoughts.
• Role-Playing Scenarios: Children practice expressing and managing emotions in a safe, controlled setting through role-playing. For example, acting out a scenario where they feel left out can help them rehearse a positive response when it happens in real life.

Emotion regulation reduces the risk of emotional outbursts and lays the groundwork for healthy social interactions and stronger self-esteem.

Module 4: Interpersonal Effectiveness—Building Healthy Relationships

For many children, the challenges of emotional dysregulation extend to their interactions with peers, family members, and teachers. Interpersonal effectiveness focuses on developing communication skills and strategies to constructively build positive relationships and resolve conflicts.

Why Interpersonal Effectiveness Matters

Healthy relationships are essential for a child’s overall well-being. Children who can communicate effectively and resolve conflicts are likelier to interact positively in school and at home. DBT teaches interpersonal effectiveness skills that help children:

• Express Their Needs Clearly: Use “I” statements to communicate their feelings and needs.
• Set Boundaries: Learning to say no or walk away from overwhelming situations.
• Develop Empathy: Understanding and respecting the feelings of others, which is essential for building friendships and resolving disagreements.
• Negotiate and Problem-Solve: Approach conflicts with a collaborative mindset rather than resorting to blame or aggression.

Interpersonal Effectiveness Techniques for Kids

• “I” Statements: Teaching children to say, “I feel [emotion] when [situation] because [reason].” For example, “I feel hurt when you don’t play with me because I want us to spend time together.”
• Role-Playing Social Scenarios: Practicing different scenarios—such as sharing, negotiating playtime, or dealing with teasing—can help children build confidence in real-life interactions.
• DEAR MAN (Simplified for Kids): An acronym for a structured way to ask for what they need:
  • D: Describe the situation.
  • E: Express how they feel.
  • A: Assert what they need.
  • R: Reinforce the positive outcome.
  • M: (Mindful) Stay focused on their goal.
  • A: Appear confident.
  • N: Negotiate if necessary.
• Group Activities and Teamwork: Structured group activities encourage children to practice these skills in a real-world setting, learning to work cooperatively and resolve conflicts amicably.

Interpersonal effectiveness skills help children feel more secure in their relationships and reduce the stress associated with social interactions.

The Role of Parents and Caregivers in Supporting DBT for Children

DBT is most effective when its principles are consistently reinforced in therapy sessions and at home. Parents, caregivers, and teachers can all play a critical role in helping children internalize DBT skills. Here are several ways that adults can support children in their DBT journey:

Creating a Supportive Environment

• Establishing Routines: Consistent daily routines provide children with stability and predictability. This environment can make it easier for children to practice new skills.
• Modeling Healthy Behavior: Children learn by observing. When parents model effective coping strategies—such as pausing to take a breath during a stressful moment—they show children that managing difficult emotions is possible.
• Validating Emotions: A key part of DBT is that all emotions are valid. Caregivers should acknowledge them instead of dismissing or punishing a child’s feelings. For example, saying, “I understand that you’re upset, and it’s okay to feel that way” can help the child feel heard and understood.

Active Participation in Therapy

• Family Therapy Sessions: Many DBT programs for children include sessions where caregivers participate. This collaborative approach helps reinforce children’s skills and ensures the whole family benefits from healthier communication patterns.
• Home Practice: Caregivers can set aside time to practice DBT skills together. Whether doing a mindfulness exercise in the morning or discussing feelings at dinner, these activities reinforce the therapeutic work.
• Encouragement and Praise: Recognizing when a child uses a DBT skill successfully—such as calming down using a breathing exercise—helps reinforce positive behavior and builds self-esteem.

Addressing Challenges and Building Resilience

• Problem-Solving Together: When challenges arise, parents can help children think through what went wrong and what they might do differently next time. This reflective process not only builds problem-solving skills but also encourages emotional resilience.
• Seeking Professional Support: In some cases, additional professional guidance may be needed. Working closely with child therapists ensures that the child and the family are supported throughout the process.

By integrating DBT principles into everyday life, caregivers can help children build a strong foundation for emotional well-being, which will ultimately lead to improved behavior, better academic performance, and stronger relationships.

Research and Evidence Behind DBT for Children

The application of DBT to pediatric populations has been the subject of growing research interest over the past decade. Studies indicate that DBT can lead to significant improvements in emotional regulation, reduction in behavioral issues, and enhanced overall functioning for children and adolescents facing a variety of mental health challenges.

Key Findings from Research Studies

• Reduction in Self-Harm and Suicidal Behaviors: Research conducted in clinical settings has demonstrated that DBT can reduce incidents of self-harm and suicidal ideation in adolescents with severe emotional dysregulation.
• Improved Emotional Awareness: Studies have shown that children participating in DBT-based programs exhibit improved emotional literacy, meaning they can better identify and name their feelings.
• Enhanced Social Functioning: Children who learn interpersonal effectiveness skills are better equipped to navigate social challenges, leading to more positive peer relationships and improved academic engagement.
• Family Dynamics: When caregivers participate in DBT programs, there is often a noted improvement in family communication and overall household functioning, further supporting the child’s emotional development.

Translating Research into Practice

The evidence supporting DBT’s effectiveness is encouraging for practitioners and parents alike. It reinforces that a structured, skills-based approach can yield measurable improvements in a child’s emotional well-being. Clinicians often adapt traditional DBT modules to suit a child’s developmental stage, using visual aids, storytelling, and interactive activities to make abstract concepts more accessible.

Overcoming Challenges and Barriers in DBT for Children

While DBT can be a powerful tool for children, implementing it is not without challenges. Several barriers may arise during the therapeutic process:

1. Developmental Limitations

Children’s cognitive and language skills vary widely depending on their age and developmental stage. Child therapists must tailor DBT concepts so that they are age-appropriate and easily understandable. This often means simplifying language, using more visual aids, and incorporating play-based activities.

2. Consistency and Practice

Like any new skill, the techniques taught in DBT require consistent practice. Children may initially struggle to remember and apply these strategies outside of the therapeutic setting, so reinforcement at home—through routines and caregiver support—is crucial.

3. Resistance to Change

Some children may resist learning new ways of dealing with their emotions, especially if they have long-standing behavior patterns. It’s essential for therapists and caregivers to be patient and to celebrate small victories along the way.

4. Family Dynamics

For DBT to be effective, the entire family must be on board. This can be challenging in households where parents or caregivers are dealing with their mental difficulties. Family therapy sessions and caregiver training can help address these challenges, ensuring everyone is equipped to support the child’s progress.

Practical Tips for Integrating DBT at Home

Even if your child is in therapy, there are many ways that DBT skills can be reinforced at home. Here are some practical tips for caregivers:

Establish a Routine

• Daily Mindfulness Practice: Dedicate a few minutes daily to mindfulness exercises. These could be simple breathing exercises in the morning or guided imagery sessions before bed.
• Consistent Check-Ins: Discuss the day using a feelings chart or journal. Ask your child, “How did you feel today? What made you happy or upset?”

Create a Calm Space

• Calm-Down Corner: Set up a designated space in your home where your child can go to calm down. This space might include soft pillows, a favorite book, sensory toys, or a calm-down jar.
• Reduce Stimuli: When emotions run high, reducing distractions can help your child focus on their feelings and practice DBT skills.

Model the Skills

• Practice What You Preach: Children learn by imitation. When you face stress, demonstrate healthy coping strategies. Explain what you’re doing, such as “I’m taking a few deep breaths because I feel a bit overwhelmed.”
• Family Mindfulness: Engage in family mindfulness activities like walking and noticing the colors and sounds around you or doing a group relaxation exercise.

Reinforce Positive Behavior

• Praise and Encouragement: Recognize and praise your child when they use DBT skills. Even small successes are worth celebrating.
• Problem-Solving Together: When challenges occur, sit down with your child to discuss what happened and explore which DBT skills might help next time.

Stay Informed

• Educate yourself: Read books, attend workshops, or speak with your child’s therapist to understand more about DBT and how it can be reinforced at home.

Empowering Children for a Brighter Future

DBT offers a robust, evidence-based framework for helping children navigate the complex world of emotions. DBT empowers children to face life’s challenges with resilience, confidence, and a sense of control by equipping them with mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills. Whether dealing with anxiety, anger, or sadness, children learn that while emotions are a natural part of life, they do not have to be overwhelming or unmanageable.

The Role of Supportive Adults

With the support of skilled therapists, proactive educators, and dedicated caregivers, DBT can transform how children understand and interact with their emotions. By fostering emotional literacy and healthy coping strategies, DBT not only improves behavior in the short term but also lays the groundwork for long-term mental health and well-being.

For parents and caregivers, embracing DBT means creating an environment where children feel validated, supported, and empowered. It’s about recognizing that every emotion, no matter how big or small, has value—and that with the right tools, children can learn to navigate even the most challenging emotional landscapes.

Meeting The Needs of Today’s Children

In today’s fast-paced, often overwhelming world, teaching children how to manage their feelings is more critical than ever. Whether you’re a parent struggling to help your child through a difficult phase, an educator looking for effective classroom strategies, or a therapist exploring innovative treatment approaches, DBT offers a roadmap to emotional balance and healthier relationships.

By integrating DBT skills into daily routines, reinforcing positive behavior at home and school, and continuously seeking new strategies to support emotional growth, we can help our children build the resilience they need to thrive. With each mindful breath, every successful use of a coping strategy, and each peaceful resolution to a conflict, children learn that they can manage life’s ups and downs and that their emotions, however intense, do not define them.

The journey to emotional well-being is a lifelong process, and DBT at DBT of South Jersey provides children with the tools they need to embark on this journey with hope, determination, and a renewed sense of self-worth. As research continues and our understanding of child development evolves, DBT offers hope for families seeking a path toward greater emotional harmony and a brighter, more balanced future.

Find Supportive Therapy for Children in South Jersey

If your child is struggling with big emotions and you’re looking for effective support, DBT of South Jersey is here to help. Our team of skilled child therapists specializes in empowering children with practical tools to manage overwhelming feelings and build lasting emotional resilience. Discover how therapy for children in South Jersey can create meaningful change for your family—reach out to begin your journey today. Follow these three simple steps to get started:

1. Contact us to book a free consultation with our intake team
2. Meet with one of our skilled child therapists
3. Start seeing your child overcome big emotions!

Additional Services Offered at DBT of South Jersey

At DBT of South Jersey, we go beyond traditional therapy for children by offering a supportive, healing environment where kids can learn to manage intense emotions and build emotional strength. Understanding that no two families are the same, our approach reaches far past child-focused care. From our locations in Voorhees and Moorestown, we also serve couples and families, offer trauma-informed treatment, support the LGBTQIA community, and provide specialized care for OCD. For those seeking holistic support, we offer services like individual Reiki sessions. Be sure to check out our blog for helpful tips, resources, and more information about therapy for children and teens.