The Wavefront DBT Clinic provides services to high risk, multi-problem adolescents and young adults. We specialize in identifying and treating depression and risky behavior, including self-injury, suicidal ideation and suicide attempts, substance use, binging and purging, risky sexual behavior, physical fighting, and other forms of risk-taking.
We implement dialectical behavior therapy as it has been implemented in research studies that have designated it an evidence-based approach for decreasing adolescent suicidality and self-harm. Marsha Linehan’s initial conceptualization of dialectical behavior therapy (DBT) was developed for adults diagnosed with borderline personality disorder. Our adaptation follows the work of Alec Miller and Jill Rathus, who originally modified DBT for use with adolescents and young adults. As of January 2023, our clinic was recognized as a DBT-Linehan Board of Certification, Certified Program™. We target the following five areas:
- Confusion about self
- Impulsivity
- Emotional instability
- Interpersonal problems
- Parent-teen problems
The treatment has been shown to be effective in treating self-harming adolescents with depression who demonstrate some traits of borderline personality disorder that are beyond that expected of typical adolescent development.
Depression in adolescence is characterized by depressed or irritable mood, changes in appetite and sleep, withdrawal from and loss of interest in usual activities and friends, feelings of hopelessness and worthlessness, agitation and/or fatigue, difficulty concentrating, difficulty making decisions, and suicidal ideation.
Some traits of borderline personality disorder that may be of concern to teens and parents include: unstable sense of self, unstable interpersonal relationships, inappropriate or uncontrollable anger or other emotions, serious mood swings, recurrent self-harm or and/or suicide attempts, chronic feelings of emptiness, and impulsivity that puts the teen at risk.
Teens referred to the Wavefront DBT Clinic typically have many or all of the problems listed above, which can lead to difficulties fulfilling their obligations in school and at home. This perpetuates their negative ideas about themselves.
Services
The Wavefront DBT Clinic is a comprehensive outpatient service intended to reduce self-harming and other dangerous behavior. All appointments are in-person. It consists of four components:
- Weekly multifamily skills group (24 weeks) – Teens learn skills to help them cope with the five problem areas identified above and to help in decreasing their target behavior (e.g., cutting, purging)
- Weekly individual therapy – Teens learn to generalize the skills they are learning in group and gain greater insight into the cognitions and vulnerabilities which contribute to their problem behaviors
- Family therapy – Individual therapists may schedule collateral family sessions as needed
- Phone coaching – Teens are encouraged to contact their therapist for skills coaching before engaging in their target behavior. Parents learn the same skills as their child, including skills to improve family functioning, and are encouraged to call their group leader for skills coaching as well.
Community collaborations
Our DBT experts provide training and collaborate with many agencies in the Bay Area to increase access for this evidence-based practice:
- We work closely with the Child, Youth, & Family System of Care in the San Francisco Department of Public Health to implement DBT in the county system. If you currently receive care through San Francisco County (i.e., MediCal, Healthy Families, etc.) and are interested in DBT, please email [email protected].
- We also consult with our partners at UCSF Benioff Children’s Hospital Oakland. If you are insured under Alameda County MediCal and would like to receive DBT in the East Bay, please call their intake and referral line at (510) 428-8428.
- We have worked closely with Child and Adolescent Behavioral Health in Contra Costa County since 2011. If you currently receive care through Contra Costa MediCal and are interested in DBT, please contact Floris Mendoza, LMFT, at (925) 608-8755.