It can be very difficult for young people to understand that the experience of distress and the behaviours that often result are not the same thing. This is particularly so where the experience of distress has persisted over time and the associated behaviours have become habituated. The following elements drawn from Dialectical Behaviour Therapy (DBT) and Adolescent Community Reinforcement Approach (ACRA) can be useful in helping a young person to gain a new understanding of their distress and how it is separate to but related with particular behaviours. This is the basis on which other interventions are introduced that can help a young person to better tolerate and deal with distressing feelings.

G5i. Recognising your emotions
This element from DBT can be used to help each young person to develop the ability to:

  • Be aware of how they are feeling at any given time
  • Understand the ways in which strong emotions are triggered
  • Understand how they are typically affected by strong emotions

G2ii. Chain analysis
An alternative form of behavioural analysis used in DBT is a chain analysis. Like a functional analysis, a chain analysis involves defining a problem and gathering evidence to determine what is causing it, what is preventing its resolution, and what tools might be available for solving it. Chain analysis can help the practitioner and client gain a perspective on several factors that may be working in specific contexts to maintain problem behaviours, or prevent the use of skill-based strategies.

D1. Functional analysis of problem behaviours
An alternative format, from the ACRA model, this approach uses questions about a particular behaviour, such as substance use or self-injury, to find out more about what might be behind it. This includes a response to overwhelming distress.