June 20, 2025
The Struggle of Parenting an Emotionally Dysregulated Child
Every parent knows the challenge of managing a child’s big emotions. But for some families, emotional outbursts aren’t just occasional tantrums — they’re daily crises that seem to come out of nowhere and disrupt home life, school performance, and social relationships. Children with severe emotion dysregulation may:
- Explode over minor frustrations
- Engage in self-harm or destructive behaviors
- Struggle with suicidal thoughts, even at young ages
- Experience intense, hours-long meltdowns
- Reject comfort or logical reasoning during emotional storms
Traditional parenting approaches often fail with these children. Time-outs lose effectiveness. Rewards systems collapse. Even standard therapy may not provide concrete enough tools. That’s where Dialectical Behavior Therapy for Children (DBT-C)—an adaptation of the evidence-based DBT model specifically designed for kids ages 6-12—comes in.
Trained by Dr. Francheska Perepletchikova the the original developer of DBT-C, Dr. Sylvia Gearing developed GearingUP’s DBT-C program utilizing her over 200 hours of DBT training, more than a decade of experience in DBT, and direct care of hundreds of DBT clients at GearingUP. Having spent more than a decade as a child psychologist specialist, Dr. Sylvia has extensive knowledge of how to best work with children to deliver excellent clinical care for our little ones.
Our clients have been shocked as they have seen firsthand how DBT-C’s innovative approach can transform families who felt hopeless after trying other interventions for years like “standard child therapy.”
What Makes DBT-C Different? The Science Behind the Approach
The Limitations of Standard Therapies
Most child therapies focus on either “Insight” (helping kids understand their feelings) or “Behavior modification” (reward/punishment systems). While these can help some children, those with severe emotion dysregulation often need more. Research shows that in standard therapy:
- Only 45% of children show meaningful improvement in standard therapy
- Gains often don’t persist after traditional child treatment ends
- Parents frequently feel unprepared to handle crises with standard child therapies
The DBT-C Difference: A Three-Pronged Solution
DBT-C addresses these gaps through:
1. Developmentally Adapted Skills Training
Unlike adult DBT, DBT-C presents coping skills in child-friendly formats such as:
- Visual emotion thermometers
- Comic strip conversations
- Interactive games teaching distress tolerance
- Walking through books and worksheets in session
- “Superhero” metaphors for emotional control
2. Intensive Parent Coaching
DBT-C recognizes that parents are the real change agents. The program teaches caregivers new ways to work with their child including:
- Validate emotions without reinforcing negative behaviors
- Implement effective consequences (not punishments)
- Model emotional regulation skills themselves
- Create a consistent, structured home environment
3. Therapist Consultation Teams
GearingUP’s clinicians participate in weekly DBT consultation teams ensuring:
- Adherence to the treatment model
- Consultation from many seasoned DBT and child clinicians
- Quality assurance overseen by Dr. Sylvia Gearing
- Support for therapists working with complex cases
- Continuous skill refinement and updated training
The results speak for themselves:
- 90% of children show improvement by the conclusion of DBT-C treatment
- 95% maintain or continue improving after completing DBT-C therapy
- Families report significant reductions in hospitalizations, school suspensions, and ER trips both during and after DBT-C
What DBT-C Treatment Actually Looks Like
Phase 1: Assessment and Stabilization
Before diving into skill-building, our team begins with a comprehensive evaluation of your child’s emotional patterns, treatment history, and more. We also work with parents to establish safety plans for self-harm, outburts, or aggression with themselves, peers, or adults. Parents will also start working with a DBT-C clinician to learn more about emotion dysregulation and understanding how life at home may be contributing to their child’s dysregulation.
Here’s an example case: 8-year-old “Mia” would have violent outbursts when asked to turn off screens. Her parents alternated between giving in (reinforcing the behavior) and harsh punishments (increasing Mia’s shame). In Phase 1, our DBT-C clinicians would have worked with parents on multiple issues to prepare them for the weeks ahead as well as provide immediately actionable insights. Here is a sample of common Phase 1 topics:
- Identified Mia’s emotional triggers and vulnerabilities (e.g., transitions, hunger, fatigue)
- Taught parents basic antecedent strategies (preparing Mia before asking)
- Created additional aids such as a visual “cool down” routine
Phase 2: Skill Acquisition
Children and parents participate in parallel programs in DBT-C to acquire and reinforce skills at home for immediate and long term change. DBT-C teaches children and parents many fo the four core skills of classic DBT including:
1. Mindfulness – Noticing emotions without judgment while cultivating awareness of thoughts, emotions, and more. An example skill specific to DBT-C would be The “Turtle Technique” for teaching your child how to pause before reacting.
2. Distress Tolerance – Learning how to tolerate and work with our intense emotions utilizing skills and tools. Children and parents will learn how to prepare for inevitable waves of strong emotions with both physical tools (for example, “self-soothe kits” with sensory tools to engage children) and behavioral skills (like the “TIPP” skill to learn how to use our breath, the environment, activity, etc. to calm down) to be ready for emotional dysregulation whenever or wherever it may arise.
3. Emotion Regulation – Implementing skills everyday to maintain regulation of our emotions and keep our minds clear and our emotions in balance. Activities for children in this section include “Emotion Detectives” so they can learn how to identify physical cues of emotions, and parents will learn how to implement proven behavioral skills like “Opposite Action” to help their child upregulate their mood when necessary.
4. Interpersonal Effectiveness – Finding ways to work with those around us in an effective, skills-based way to make friends and improve relationships with our community. Children will learn skills such as “DEAR MAN” to learn how to ask for what they need calmly, and parents will learn how to mentor their children in relationships with skills like how to repair a friendship after conflict.
Phase 3: Generalization and Maintenance
The final phase ensures skills transfer to real-world settings:
- Specialized coaching and practice to prepare for use in the moment
- Real world attempts and reporting back to the therapist
- Refinement of skills practice and ensuring proper usage
- Additional reinforcement and refreshing of skills lessons
- Connection with community resources and additional programs
- Exploration of continued coaching or other useful therapy possibilities
Who Benefits Most from DBT-C?
While DBT-C helps any child who may be struggling, it’s particularly effective for those with:
1. Depressed and Anxious Children – Rates of depression and anxiety in children are growing every year, but children and preteens may experience them in very different ways. Common signs include: persistent sadness, irritability or outbursts, more extreme emotions, losing friends, quitting activities, changing sleeping or eating patterns, inability to concentrate, restlessness, withdrawal, headaches, or gastrointestinal issues like stomach aches or digestive issues.
2. ADHD with Emotional Impulsivity – These children often struggle with issues like rejection-sensitive dysphoria, rapid escalation from calm to rage, and poor frustration tolerance which often escalates into full tantrums.
3. Disruptive Mood Dysregulation Disorder (DMDD) – Usually characterized by severe, chronic irritability, frequent temper outbursts (3+ times weekly), trouble recovering from emotional arousal, and more.
4. Oppositional Defiant Disorder (ODD) – Often described as children who are persistently defiant, hostile, or disobedient towards parents or authority figures. They frequently argue, refuse to comply with simple requests, and may even intentionally annoy those around them.
5. Autism Spectrum Disorder (Level 1) – DBT-C can be implemented to help children on the spectrum who may struggle with intense emotional reactions, lack flexibility, or experience “shutdowns” after meltdowns.
6. Early-Onset Bipolar Disorder – DBT-C provides crucial emotion tracking to identify mood shifts, preventive strategies for manic/depressive episodes, and more to help manage and treat Early-Onset Bipolar Disorder.
Common Parent Questions About DBT-C
“How is this different from regular therapy?”
Traditional therapies for children such as play therapy can help children process emotions but often lacks concrete skill-building and are considered “non-directive therapies.” That means that they are entirely reactive to the client and what they bring to their session instead of implementing a proven treatment program backed by research. CBT teaches coping strategies but may not address parent-child interactions. DBT-C combines the best of both while adding family systems work.
“What if my child refuses to participate?”
It’s not uncommon for children to be resistant to therapy, particularly if they have had less than positive experiences in the past with a therapist. However, DBT-C is built to specifically engage resistant child and preteen clients utilizing a number of techniques and engagement strategies like:
- Letting kids choose skill practice activities to feel ownership of their therapy
- Mixing up session activities with including games, toys, exercises, and more
- Incorporating their special interests into the therapy (e.g., Minecraft-themed lessons)
- Starting with brief, successful experiences and celebrating wins
- Working with parents to create incentives at home to successfully engage in therapy
“Can we do this alongside medication?”
Absolutely! We are happy to collaborate with psychiatrists, pediatricians, and other medical professionals to ensure coordinated care. While medication can be an important part of treatment for multiple issues, many families find they can reduce medication usage after DBT-C skills take effect.
“Does DBT-C have homework?”
Yes, but the homework is designed to be manageable and rewarding. No busy work or wasted time – homework relates to direct practice of skills at home or tracking information to share with your therapist. Here are some examples of DBT-C homework in between sessions:
- Kids might track their moods, emotions, and thoughts in between sessions
- A mindfulness exercise to practice together for five minutes
- Parents practice one new skill daily with their child to reinforce usage at home
- Implementing rewards and incentive systems to reinforce skills practice and usage
The Long-Term Impact: Beyond Symptom Reduction
While decreased meltdowns and self-harm are immediate goals, DBT-C’s true value lies in its longterm rewards and preventing future struggles. Without intervention, research shows these children with behavioral, emotional, or mental health issues are at a higher risk than neurotypical peers for:
- Teen depression and substance use
- Relationship difficulties in adulthood
- Employment challenges
Dozens of studies have shown that early interventions that teach children skills based curriculums like DBT-C can have an “inoculation effect” that makes those same children more resistant to mental health issues for years and even decades to come. By learning regulation skills before adolescence, DBT-C graduates often:
- Form healthier friendships and relationships
- Perform better academically
- Transition more smoothly to adulthood
Getting Started with DBT-C at GearingUP
GearingUP’s DBT-C program is ready to work with you and your child. Developed personally by Dr. Sylvia Gearing after years of training and decades of treatment experience, our DBT-C program includes:
- Comprehensive intake assessments, testing, and diagnostics
- Weekly individual child sessions
- Weekly parent coaching and skills training
- Recommendations for implementation at home and other places
- Ongoing coaching and troubleshooting
- Resources for the entire family including other children and caregivers
If you are ready to get started, contact us today to get started:
1. Schedule an initial parent consultation to discuss if our program fits your needs
2. Complete our initial diagnostic and testing screenings to measure levels of emotional dysregulation and more
3. Finalize the treatment plan and begin working with your DBT-C team
Hope for Overwhelmed Families
Parenting an emotionally intense child can feel isolating. Well-meaning friends, teachers, or other parents may say, “they’ll grow out of it,” or they may give unsolicited advice implying that you’re “not disciplining enough at home.” DBT-C offers a research-based, science-backed path forward that:
- Respects your child’s needs and potential neurological differences
- Equips your entire family with practical tools to implement at home
- Delivers measurable, lasting change for school, relationships, and more
If you’re tired of “walking on eggshells,” done with ineffective therapies, or simply dreading the next meltdown, DBT-C might be the solution you’ve been searching for.
Take the first step today: Contact GearingUP to learn more about our DBT-C program.
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