Radical Genuineness and Therapy-Interfering Behaviors in DBT for Teens

United States Department of Homeland Security

Validation, radical genuineness, and irreverence are essential for developing clinical rapport with adolescents.
Validation involves providing mindful attentiveness, which includes attunement to both verbal and non-verbal communication. Validation also involves the component of realness, which can sometimes include the additional component of irreverence.
Irreverence is especially effective when working with adolescents.
Since adolescents are immersed in technology, it’s possible—in fact, it’s advisable—to use technology to fight fire with fire. Therapists can integrate movie clips, music, and even social media to teach various DBT skills, including and especially mindfulness.
Jean recommends allocating 25% to 50% of the session to teaching skills, devoting the remainder of the session to practicing the skills, especially with the use of technology.
Since adolescents present with many potential treatment-interfering behaviors, it’s important to prioritize which ones to address.
The glorification of maladaptive coping is perhaps the most problematic treatment-interfering behavior with adolescents. Also, the non-judgmental stance is perhaps the most challenging skill to teach, given the inherent judgmentalism of this developmental stage, especially regarding ego development.