Hope, Backed by Practice: What We Learned About Skills Coaching for Teens

If you’re the parent or caregiver of a teen who has struggled with suicidal thoughts or self-harm, you already know how frightening and exhausting it can be — and how badly you want something that actually helps. We want to share some encouraging news from our own program, along with an honest look at what it does and doesn’t tell us.

What we looked at

Compass is a DBT-LBC™ certified program, which means we deliver Dialectical Behavior Therapy the way the research says it should be delivered. DBT for adolescents (“DBT-A”) teaches young people practical skills: how to get through an emotional crisis without making things worse, how to manage intense feelings, and how to handle relationships and conflict. A complete program includes individual therapy, a skills-training group, phone coaching between sessions, and a team of therapists who support one another’s work.

We wanted to test an idea. Learning a skill in a group is helpful — but using that skill in a real, overwhelming moment is much harder. So we added something we call Individualized Skills Coaching: short, one-on-one sessions focused entirely on practicing the skills until they feel usable in everyday life. We followed 47 teens and young adults in our program over their first year of treatment to see how they were doing.

What “skills coaching” actually looks like

These coaching sessions aren’t extra therapy where your child talks through everything that’s wrong. They’re focused practice. A skills coach — usually someone other than your child’s main therapist — zeroes in on a specific skill your child is struggling to use, then helps them rehearse it: role-playing, troubleshooting what gets in the way, and sometimes practicing in low-pressure ways like tossing a ball back and forth while they talk it through. The goal is simple: make the skill feel automatic enough to reach for when it matters most.

What we found

Over the first year, the young people in our program showed real, measurable improvement:

• Their suicidal thinking decreased significantly.
• Their “reasons for living” — the things that anchor a young person to life — grew stronger.
• Their depression symptoms eased.

Most of this progress happened in the first six months. And here’s the part that gave us hope: the teens who attended more skills-coaching sessions tended to show greater early reductions in suicidal thinking. In other words, more focused practice seemed to go hand in hand with more improvement.

What this might mean for your family

If your teen is in DBT, ask their treatment team how they build in repeated, real-world practice of the skills — not just learning them, but rehearsing them until they stick. That kind of practice is the heart of what we studied. And whatever path you’re on, remember that progress in DBT usually builds steadily over months. A hard week doesn’t erase the work; recovery rarely moves in a straight line.

You don’t have to do this alone

Watching your child struggle is one of the hardest things a parent can face. Please know that support exists, that improvement is possible, and that reaching out is a sign of strength, not failure.

This article describes preliminary findings from a pilot study and is for general education. It is not medical advice and does not describe guaranteed outcomes. Please consult a qualified clinician about your family’s specific situation.