“Because the prefrontal cortex of the brain is not fully developed in adolescents, they don’t always think through the consequences of their behavior — particularly in emotionally charged situations that require immediate decision-making,” says Laura D’Alessandro, LCSW, Clinical Manager of the Child/Adolescent Program at Princeton House’s outpatient site at Hamilton. “In addition, teens are more vulnerable to emotion at this stage of life and often lack a defined sense of self. As a result, they tend to use what we call the ‘emotion mind’ when making decisions.”
Per the concepts of dialectical behavior therapy (DBT) introduced by its developer, Marsha Linehan, PhD, D’Alessandro explains that the emotion mind uses intense feeling as a guide, relying on what would make a person feel better in the moment. On the opposite end of the spectrum, the reasonable mind uses analytical thinking and facts to guide decisions, but doesn’t consider what might make someone content in the long term. A happy medium is the wise mind, which finds balance between the two and uses aspirations to determine the best course of action.
DBT is an effective tool in helping adolescents use the wise mind. According to D’Alessandro, the four components of DBT can each play a role:
- Mindfulness: Adolescents must recognize in the moment that they are not thinking with the wise mind.
- Emotion regulation: They must be equipped with the ability to regulate their feelings.
- Distress tolerance: At the same time, they must be able to manage emotional intensity.
- Interpersonal effectiveness: They must then use interpersonal effectiveness skills to carry through the wise mind decision effectively.
“Therapists can help their adolescent patients reduce impulsivity by taking inventory of where skills are lacking in these four areas, and then focusing in to work on those areas,” adds D’Alessandro. “Using these skills to develop the wise mind is almost like building a muscle — with practice, adolescents can become more reflective, more aware, and less impulsive in their actions.”
Princeton House offers a full array of outpatient programs that address the specific needs of adolescents ages 13 to 18. Click here for more information, or call 888.437.1610.
Article as seen in the Summer 2017 issue of Princeton House Behavioral Health.
