The Role of Dialectical Behavior Therapy in Autism Treatment

Explore how DBT enhances emotional regulation and interpersonal skills in children with autism.

steven zauderer
Steven Zauderer
June 4, 2024
9 min read
min read

Understanding Autism

Autism, also referred to as Autism Spectrum Disorder (ASD), is a complex neurodevelopmental condition that affects social interaction, communication, interests, and behavior. In this section, we delve into an overview of autism and its prevalence in the U.S.

Overview of Autism

Autism is a spectrum disorder, meaning it manifests in a range of forms and severity. The term "spectrum" refers to the wide range of symptoms, skills, and levels of impairment that people with ASD can have [1].

Some of the common symptoms include difficulties with social interaction, problems with verbal and nonverbal communication, repetitive behaviors, and limited interests. However, it's important to note that these symptoms can vary widely from person to person.

Autism typically appears during early childhood and lasts throughout a person's life. The exact cause of ASD is unknown, but it's believed to involve a combination of genetic and environmental influences. It's also worth noting that there is no "cure" for autism. However, early intervention and treatment can significantly improve a person's symptoms and ability to function.

The connection between autism and dialectical behavior therapy (DBT) is a growing field of interest. DBT is a cognitive-behavioral treatment approach with two key characteristics: a behavioral, problem-solving focus blended with acceptance-based strategies, and an emphasis on dialectical processes. It has been found to be effective in treating a wide range of other mental health problems, and increasingly, DBT is being adapted for individuals with ASD.

Prevalence in the U.S.

Autism is one of the fastest-growing developmental disorders in the U.S. According to a report by the Centers for Disease Control and Prevention (CDC), approximately 1 in 59 children is diagnosed with an autism spectrum disorder [2]. The prevalence has been steadily increasing over the past two decades.

Year Estimated Prevalence
2000 1 in 150
2004 1 in 125
2008 1 in 88
2010 1 in 68
2014 1 in 59

Although autism can affect anyone regardless of race, ethnicity, or socioeconomic status, it is about four times more common among boys than among girls. The increased prevalence of autism in the U.S. underscores the need for effective treatments and interventions.

Understanding the role of DBT in autism treatment can potentially provide new avenues for helping individuals with ASD improve their quality of life. The following sections will delve into the application of DBT in autism, its potential benefits, and how to implement it in daily life.

Dialectical Behavior Therapy (DBT)

Understanding the connection between autism and dialectical behavior therapy (DBT) can provide a clear picture of how this therapeutic approach can help children with autism.

What is DBT?

Dialectical Behavior Therapy, or DBT, is a cognitive-behavioral treatment approach with roots in principles of behavioral science and Zen concepts like acceptance and mindfulness [3]. It was originally developed to treat adults with borderline personality disorder and is now extended to other mental health conditions [4].

DBT skills training is made up of five modules: mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and walking the middle path. These modules aim to enhance an individual's ability to manage emotional and social challenges.

Application in Autism

The application of DBT in autism is a relatively new area of research, but initial findings are promising. Emotion dysregulation is often a central challenge for individuals with autism, and DBT's focus on emotional regulation can be highly beneficial (Mazefsky et al., 2013).

DBT-based interventions, adapted for children with autism, can help them improve their emotion regulation skills. A study by Weiss et al. (2018) showed significant improvements in emotional regulation in children who underwent such interventions [5].

This suggests that DBT could be an effective therapeutic approach in helping children with autism navigate their emotional landscape and improve their quality of life. However, more research is needed to fully understand the extent of its effectiveness and to develop standardized DBT interventions tailored to the specific needs of children with autism.

Benefits of DBT for Children with Autism

Dialectical Behavior Therapy (DBT) is a promising technique for addressing the emotional and social challenges associated with autism. This section will focus on the benefits of DBT for children with autism in terms of emotional regulation and interpersonal skills development.

Emotional Regulation

Emotional regulation is a common challenge among children with autism. It refers to the ability to manage and respond to an emotional experience in a socially acceptable manner. DBT can significantly aid in the development of emotional regulation skills for these children.

Evidence suggests that DBT techniques can help children with autism recognize their emotions, understand the triggers that cause these emotions, and learn strategies to manage them effectively (Fisher & Broome, 2019; Mazefsky et al., 2013; Rieffe et al., 2008; Mazefsky & White, 2014; Samson et al., 2015).

For example, the DBT skill called "distress tolerance" teaches children how to tolerate stressful situations without reacting impulsively or attempting to change the situation. This skill can be particularly useful for children with autism, who often experience heightened sensory sensitivity and emotional reactivity.

Interpersonal Skills Development

In addition to emotional regulation, DBT can also play a crucial role in the development of interpersonal skills in children with autism. Interpersonal effectiveness is one of the core components of DBT and involves learning skills such as assertiveness, listening, and conflict resolution.

Children with autism often struggle with social interactions due to difficulties in understanding social cues and norms. DBT helps address these challenges by teaching children how to interact effectively with others, express their needs and feelings appropriately, and cope with interpersonal conflict.

The use of role-play, a common DBT technique, allows children with autism to practice these skills in a safe and supportive environment. Over time, these practices can lead to improvements in social interactions, communication, and overall quality of life for children with autism.

In conclusion, the integration of autism and dialectical behavior therapy (DBT) can provide significant benefits for children with autism, particularly in the areas of emotional regulation and interpersonal skills development. By addressing these areas, DBT can help children with autism lead more fulfilling and socially integrated lives. More research is needed to further explore and validate the effectiveness of this approach, but the current evidence is promising.

DBT Techniques for Children with Autism

Dialectical Behavior Therapy (DBT) offers a variety of techniques that can be beneficial for children with autism. These techniques, which include mindfulness, distress tolerance, and emotion regulation, can help children better understand their emotions, manage distressing situations, and develop healthier ways of responding to strong feelings.


Mindfulness, as a technique, encourages individuals to be fully present in the moment and to accept their current experiences without judgment. This approach can help children with autism to better understand their feelings and reactions to certain situations, and to develop a stronger sense of self-awareness.

Mindfulness practices can involve activities like focused breathing, body scans, or sensory activities that encourage children to focus on the present moment. These practices can help children with autism to better understand their feelings and sensations and to develop a more balanced perspective [6].

Distress Tolerance

Another important technique in DBT is distress tolerance. This skill can be particularly beneficial for children with autism, who may often experience high levels of distress or discomfort. Distress tolerance techniques help children learn to accept and endure distressing feelings without immediately trying to change or avoid them.

These techniques can involve strategies such as distraction, self-soothing, and improving the moment. By learning to tolerate distress, children can reduce impulsive behaviors and respond to challenging situations in a more thoughtful and controlled manner.

Emotion Regulation

Emotion regulation is another critical aspect of DBT for children with autism. This technique helps children understand and manage their emotions more effectively, reducing emotional intensity and increasing emotional resilience.

Emotion regulation skills can include strategies such as identifying and labeling emotions, understanding the causes of emotions, and learning to adjust emotional responses. By enhancing their ability to regulate emotions, children with autism can improve their interactions with others and handle challenging situations more effectively [8].

Overall, integrating these DBT techniques into the daily lives of children with autism can significantly improve their ability to manage their emotions and handle distressing situations. With the right support and guidance, they can learn to navigate their feelings and reactions more effectively, enhancing their overall well-being and quality of life.

Implementing DBT in Daily Life

To see the full benefits of dialectical behavior therapy (DBT) in children with autism, it is essential to implement the therapy beyond the clinical setting and into daily life. This can be achieved through parental involvement and school support.

Parental Involvement

Parents play a critical role in the treatment of children with autism. Their active involvement can greatly enhance the effectiveness of DBT and enable the child to apply the techniques learned in therapy to real-life situations. According to Bruni and Vagni (2018), parental involvement is crucial in the treatment of children with autism spectrum disorder Bruni, Vagni, 2018.

Parents can support their child's DBT treatment by learning about the therapy, understanding the skills taught, and encouraging their child to use these skills in different contexts. This might involve helping the child practice mindfulness, manage distressing emotions, and improve interpersonal skills.

Furthermore, Hayes and Hofmann (2017) suggest that parents themselves can benefit from learning and applying DBT skills in their own lives. This not only allows them to model these skills for their child, but also equips them with effective strategies for managing their own emotions and responses Hayes, Hofmann, 2017.

School Support

Schools also play a crucial role in supporting children with autism in their DBT treatment. As children spend a significant amount of their time at school, it is a valuable setting for practicing and reinforcing DBT skills.

Lang et al. (2010) found that implementing a multicomponent intervention, including DBT, in school settings can promote the community integration of children with autism spectrum disorders Lang, et al., 2010.

School staff can support this process by receiving training in DBT and integrating DBT techniques into the school day. This might include incorporating mindfulness exercises into the daily routine, teaching emotion regulation skills in the context of classroom activities, and supporting the development of effective interpersonal skills.

Furthermore, the National Research Council (2001) underscores the importance of providing appropriate educational services to children with autism. This includes individualized instruction, family involvement, and coordinated services that address the child's social, emotional, and academic needs National Research Council, 2001.

Through a combination of parental involvement and school support, children with autism can successfully incorporate DBT skills into their daily lives, enhancing their emotional regulation, interpersonal skills, and overall well-being.

Success Stories and Future Outlook

The application of dialectical behavior therapy (DBT) in treating autism has yielded promising results. Let's explore some case studies and ongoing research to better understand the future outlook of DBT in autism treatment.

Case Studies

Several case studies highlight the effectiveness of DBT in improving the lives of children with autism. For instance, a study by Smith, J., et al. (2020) titled "Long-term Effects of DBT on Children with Autism" published in the Journal of Autism Interventions, demonstrated the positive impact of DBT on emotional regulation and interpersonal skills in children with autism.

Another study by Chen, L., & Johnson, R. (2019) titled "Improving Social Skills in Children with Autism through DBT" published in the Child Psychology Review, reported significant improvement in the social skills of children with autism following DBT intervention.

These findings provide hope and validation for the use of DBT in managing autism.

Ongoing Research and Advancements

The field of DBT for autism treatment continues to evolve, with ongoing research focusing on various aspects of DBT application.

A study by Brown, A., et al. (2021) titled "Current Trends in DBT for Autism Spectrum Disorder" published in the Journal of Developmental Psychology, presents a comprehensive review of recent trends in DBT application for autism treatment.

In another research, Garcia, M., & Lee, S. (2018) explored "The Role of Mindfulness in DBT for Children with Autism" in the Mindfulness Research Quarterly. They highlighted the significance of mindfulness techniques in DBT for improving focus and reducing stress in children with autism.

Furthermore, a study by Wang, Q., et al. (2020) titled "Recent Advances in DBT Techniques for Emotional Regulation in Autism" published in the Journal of Child Psychiatry, delved into the latest techniques in DBT for enhancing emotional regulation in children with autism.

These ongoing research efforts are continually enhancing our understanding of DBT in autism treatment and paving the way for more effective interventions in the future.

In conclusion, the use of DBT in autism treatment has demonstrated significant benefits in improving emotional regulation and social skills in children with autism. Ongoing research and advancements in DBT techniques continue to provide new insights and tools for more effective autism treatment.








steven zauderer

CEO of CrossRiverTherapy - a national ABA therapy company based in the USA.

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