DBT for Teens in Surrey BC

When Your Teen’s Emotions Are Running the House

Maybe it is the door slamming that ends every hard conversation. The meltdowns over things that seem small from the outside. The scary moments, skipped school, friendships that implode, marks on their arm you were not supposed to see. Living with a teen who feels everything at full volume is exhausting, and most parents have already tried reasoning, consequences, and backing off entirely by the time they look for help.

None of that means your teen is broken, or that you have failed. It usually means their emotional intensity has outgrown the skills they have for managing it. That is exactly the gap Dialectical Behaviour Therapy was designed to fill. At Sojourn in Cloverdale, Surrey, DBT informed counselling for teens is led by Katherine Ouano, MEd RCC, who has formal DBT training (Levels 1 and 2) and 25 years of experience with youth in schools and community mental health.

Why Teens Struggle With Emotional Regulation

The parts of the brain that generate strong emotion mature years before the parts that regulate it. Add school pressure, social media, shifting friendships, and identity questions, and many teens are running powerful emotions through unfinished wiring. For some, especially sensitive teens, neurodivergent teens, or those who have been through hard things, the result is a pattern: feelings arrive fast and huge, coping happens on impulse, and shame follows afterward.

DBT skills training speaks directly to that pattern. It does not ask teens to feel less; it teaches them what to do when they feel a lot.

Signs DBT Informed Counselling May Be a Fit

• Explosive anger or meltdowns, followed by remorse
• Self harm, or talk of wanting to hurt themselves
• Intense mood swings within a day, not just across weeks
• Friendships and relationships that are intense, then blow up
• School refusal, shutdown, or panic around school
• Impulsive risk taking, substance use, or disordered eating used to cope
• Family conflict that keeps repeating the same script
• Anxiety or low mood where the feeling, not the thinking, seems to be the problem

What Your Teen Learns in DBT Informed Counselling

DBT for adolescents (DBT-A) was adapted from adult DBT specifically for teens and families. It teaches the same four skill areas, plus a fifth that only exists in the teen version.

• Mindfulness: noticing emotions as they build instead of being ambushed by them; finding Wise Mind, where feeling and thinking meet.
• Distress tolerance: getting through overwhelming moments, urges to self harm, rage, panic, without doing something that makes life worse. Skills like TIPP (cold water, movement, paced breathing) and STOP are concrete enough to use in a bathroom stall at school.
• Emotion regulation: naming feelings, checking whether the intensity fits the facts, using opposite action when it does not, and looking after sleep, food, and movement so the fuse is longer to begin with.
• Interpersonal effectiveness: handling conflict with friends and family, asking for what they need (DEAR MAN), and holding boundaries without blowing up relationships.
• Walking the Middle Path: the teen specific module. It helps teens and parents move out of black and white thinking, validate each other, and find the middle ground between “you never let me” and “you can’t be trusted.”

Sessions are built around your teen’s actual life, the group chat drama, the exam week spiral, the fight about the phone, so skills get practised where they are needed. Teens tend to engage when they feel understood rather than lectured, and that relationship comes first.

Where Parents Fit

You are not sent to the waiting room and left to guess. With your teen’s knowledge, parents are usually included through check ins and practical coaching, so the language and skills your teen is learning show up at home too. Many parents find that learning to validate first and problem solve second changes the temperature of the whole house. Family sessions can be added when the pattern between people, not just inside one person, is the thing that needs care.

Parents also learn a few skills of their own: how to stay regulated when your teen is not, how to hold a limit without a lecture, and how to repair after things go badly. Those are the moments the Middle Path module was written for.

DBT, Anxiety, and School

A great deal of teen emotional dysregulation is anxiety wearing a different coat: the Sunday night stomach ache, the exam week meltdown, the refusal that is really fear. DBT skills give anxious teens something to do with the wave rather than only avoiding it, and because Katherine spent 25 years working inside schools, she understands the school side of the problem, from accommodations to what a counsellor can and cannot do from within the system. See also our anxiety counselling and child and youth counselling pages.

DBT and Neurodivergent Teens

For teens with ADHD or Autism Spectrum Disorder, emotional regulation challenges are often part of the picture, not a character flaw. DBT skills can be adapted to fit how a neurodivergent teen actually processes the world, more concrete, more visual, more rehearsal, fewer abstractions. Katherine’s long background with ASD and developmental disabilities means this adaptation is familiar ground, and autism funding may apply for eligible families. Some teens also benefit from pairing skills work with neurofeedback, which Katherine also provides.

DBT and Teens Who Have Been Through Hard Things

When a teen has experienced trauma, bullying, loss, or a chaotic home, emotional dysregulation is often the nervous system doing its job too well. DBT skills help a teen steady themselves first; when they are ready, trauma focused work such as EMDR can follow, and our PTSD therapy and complex trauma pages describe how we approach that. Stabilizing before processing is a core principle of trauma informed care, and it is exactly where DBT skills fit.

Who Provides DBT for Teens at Sojourn

Katherine Ouano

MEd, RCC · Formal DBT training (Levels 1 and 2) · Neurofeedback provider · Evenings and weekends

Katherine leads DBT informed counselling for teens at Sojourn. She has completed formal DBT training (Levels 1 and 2) and has spent over 25 years supporting children, youth, and families in school and community settings, so she knows the school side of teen stress from the inside. Teens tend to feel understood rather than lectured with her, and parents are kept in the loop. Evening and weekend appointments mean counselling does not have to compete with class time, in person in Cloverdale or online across BC.

Book with Katherine   View profile

Tarnia Pickard, RCC, also integrates DBT informed skills with EMDR and expressive approaches in her work with youth.

Not sure who fits? Answer 5 questions and we will suggest counsellors who fit.

What a First Session Looks Like

Usually parents and teen meet the counsellor together briefly, then the teen has time on their own. The first goal is not to fix anything; it is for your teen to decide whether this is someone they could talk to. From there, sessions settle into a rhythm: what happened this week, what skill might have helped, practise it, try it before next time. Sessions are 50 minutes, usually weekly to start.

A Word About Safety

If your teen talks about suicide, or you are worried about their immediate safety, please do not wait for a counselling appointment. Call or text 988, call 911, or go to your nearest emergency room. Counselling can then be part of what comes next.

Fees and Coverage

Sessions with a Registered Clinical Counsellor are $160 to $175 for 50 minutes. Direct billing to many insurers is available through TELUS eClaims, and though we cannot direct bill every insurer, plans that cover RCC services may still reimburse you; receipts are provided. See fees and insurance, or low cost counselling if budget is a barrier.

Frequently Asked Questions

My teen refuses to go to counselling. Now what?

This is common, and it is workable. Many reluctant teens will agree to one low pressure first session, especially online, where the only goal is to see whether the counsellor is someone they could talk to. Parents can also start on their own; changing how the household responds to big emotions often shifts things even before a teen engages.

Is this a full DBT program with a skills group?

No. We offer DBT informed individual counselling, where skills are taught within one to one sessions and adapted to your teen. If a comprehensive full model DBT program is what your teen’s situation calls for, we will say so and help you find one.

Will I know what happens in my teen’s sessions?

Teens need privacy to speak honestly, and parents need to know their child is safe. Your counsellor will be clear at the start about what stays confidential and what you would always be told, and will help your teen share what is useful for home.

How is DBT different from regular talk therapy for teens?

DBT informed work is skills forward: alongside being heard and understood, your teen leaves with specific things to try when emotions surge. For teens who find open ended talking awkward, the structure often helps.

Can sessions happen outside school hours?

Yes. Katherine offers evening and weekend appointments, in person and online, so counselling does not have to mean missed classes.

Does DBT help with self harm?

DBT was developed with self harm and crisis coping at its centre, and distress tolerance skills give teens real alternatives in the moments that matter. If self harm is active, your counsellor will also talk openly with you and your teen about safety planning.

What age is DBT for teens appropriate for?

DBT informed skills work is generally a fit from about age 12 or 13 through the late teens, adapted to maturity. For younger children we more often use play based and family approaches, sometimes with simplified regulation skills; see our child and youth counselling page.

Can DBT help a teen with ADHD or autism?

Often, yes. Emotional dysregulation is common in both, and DBT skills adapt well when they are made concrete and rehearsed. Katherine’s background with ASD and developmental disabilities means this is familiar work, and autism funding may apply.