I practice DBT with adults. If you are going to go with an individual route, it's best to try to meet up twice a week and have one session designated to therapy while the other is designated to skills. That being said, I am surprised that your skills groups are so expensive. I co-lead one with a social worker. We charge $60 out of pocket for a two hour group. We typically have 10 people in the group, and it costs us very little in overhead, so we are still well-reimbursed for our time. Many groups only have one leader who often has masters, not phd level training, so I would expect them to cost even less. I wonder if the $2000 quote you got wasn't for the whole 12 months of treatment rather than a monthly cost.

The DBT practices (Rathbone, Wake-Kendall) will tell you that individual is not "true" DBT. I say, so what?

Your plan is solid. A lot will depend on how your DC responds to this particular provider, of course. But many providers out there incorporate DBT elements (skills around emotion regulation and distress tolerance), and teaching those skills in the context of a therapeutic relationship seems to me a legitimate starting point.

It will be helpful for you and your partner to get versed in DBT skills, too, though. That's what you'll need to add in: some education for yourselves in the skills of DBT and how those might lead to different approaches to the challenge of parenting a kid with Borderline.

Anonymous wrote:
I feel so overwhelmed by all of this. Since the issue has been raised, I have been reading a lot about BPD and it makes so much sense when I apply it to my son. So I have no concerns about the correctness of the recommendations. I am just trying to figure out how to maximize our resources and give my son the best chance possible to be successful. And he isn’t an only child so I have other balls in the air.

Again thank you so much. You all have such a great wealth of information and experience that is so helpful and the support you offer is so awesome.

Thank you everybody. Another question. I found a provider who offers DBT. I believe it is individual counseling only. It is covered by insurance. I have my son on a waiting list and he is expected to get a slot this summer. I also found programs which provide the individual and group full programs. That is not covered by my insurance and is very expensive.

As I mentioned before, commitment to recovery is an issue we’re struggling with right now. It’s a tie between me and the school as to who is most committed to his recovery and he comes in last place in terms of making an effort. But I know he has the potential to grow up to be a productive adult and that he will be great if we can get past this dark place where he’s stuck.

Does it make sense to try the insurance covered program and then if/when we some progress toward change that we move toward more intense services? Can individual DBT therapy alone be enough? I mean it doesn’t sound like something where there would be harm from this approach and it would give me time to get finances in order to try to pay for it and maybe even transportation so we don’t have to lose time from work.

I feel so overwhelmed by all of this. Since the issue has been raised, I have been reading a lot about BPD and it makes so much sense when I apply it to my son. So I have no concerns about the correctness of the recommendations. I am just trying to figure out how to maximize our resources and give my son the best chance possible to be successful. And he isn’t an only child so I have other balls in the air.

Again thank you so much. You all have such a great wealth of information and experience that is so helpful and the support you offer is so awesome.

Research supports DBT as the best option. Teens can indeed be diagnosed. Sure some normal range teen behavior can be symptoms of BPD, BUT it is more extreme and impairing in a teen with BPD. I think it's great you plan to go this route OP!

Anonymous wrote:

Anonymous wrote:There is no cure or quick fix for personality disorders. I'd be weird of a program offering a and that sounds very high.

It is NOT weird.
DBT is very very effective in treating Borderline, and the younger you start THE BETTER the future outcome is for your son.
Please, get on the waitlist for the one covered by insurance. You can also purchase workbooks on amazon for DBT supplemental exercises.

DONT let this go. Untreated, it can get SOOO much wore into the teen years and adulthood.

+1 The prognosis for borderline with DBT treatment is much better than for other personality disorders. Without treatment, it's just as bad as the others.

Anonymous wrote:I would be very cautious about putting a 16 year old into a group of adults with borderline personality disorder. You need to find a youth orientated group.

Call INOVA Keller. They do this for teens.

Anonymous wrote:Borderline personality disorder has a reputation as a dump-all diagnosis for people with unpleasant personality traits. I would be very wary of how this diagnosis was reached, especially if your child is under 18.

If your child is annoying, neurotic, etc. that doesn't mean he has BPD.

This is absolutely not true or accurate in the least.

Anonymous wrote:There is no cure or quick fix for personality disorders. I'd be weird of a program offering a and that sounds very high.

It is NOT weird.
DBT is very very effective in treating Borderline, and the younger you start THE BETTER the future outcome is for your son.
Please, get on the waitlist for the one covered by insurance. You can also purchase workbooks on amazon for DBT supplemental exercises.

DONT let this go. Untreated, it can get SOOO much wore into the teen years and adulthood.

Anonymous wrote:Is “suffering through their own mistakes” and “making things worse” Boarderlime or can it be ODD or just emotional regulation ?

In my nephew's case, the symptoms very clearly matched up with borderline personality disorder. Emotional regulation and defiance are part of the mix, but borderline involves a lot of extremes from defiance to perfect compliance, from exstatic to suicidal (not explained by bipolar, which he also has and successfully managed with medication), and near total lack of awareness of how these extremes are self-generated and impacts other people's perception of him. Also there is an element of unstable relationships - people go from saints to sinners in an instant with very unrealistic expectations that the other person will always be 100% available and if they are not, they are 100% terrible. This will obvioiusly turn people off, and creates the rejection he so desperately wants to avoid. I think with just ODD or emotional regulation alone, the person is aware of how their behavior impacts others, the just have trouble controlling it, or maybe they just prefer the negative attention.

DBT helped him identify the extremes in his thinking and to recognize the impact it was having on his life.