Dialectical behavior therapy (DBT) is often used in addiction treatment to teach skills for emotion regulation, distress tolerance, and behavior change. DBT is a form of cognitive behavioral therapy (CBT) that draws on mindfulness techniques. It encourages you to acknowledge unwanted thoughts and behaviors without judgement.

Dialectical behavior therapy can help with the underlying issues that fuel substance use disorders like mental illness symptoms and unhealthy thought patterns. In DBT for substance abuse, you’ll learn to identify the root causes of drug addiction or alcohol addiction. You’ll also develop specific ways to change destructive behaviors and cope with triggers.

How Dialectical Behavior Therapy (DBT) Works

During dialectical behavior therapy, your therapist provides a safe, controlled environment to practice healthy coping skills. Used both in individual therapy and group therapy, the ultimate goal of DBT is to help you build skills to self-manage in daily life. Principles of DBT include:

• Distress tolerance
• Emotion regulation
• Mindfulness
• Interpersonal effectiveness

Some DBT skills you may learn in therapy sessions:

• Paying attention to what is happening in the present moment through grounding and mindfulness practices.
• Increasing your tolerance for distress by learning to accept situations and feelings, acknowledge they’re difficult, and refrain from destructive coping mechanisms.
• Practicing more effective and healthy ways to interact with others.
• Developing self-confidence and setting boundaries.
• Learning ways to manage intense emotions so that they don’t feel so overwhelming.

DBT can teach you to:

• Identify and name emotions.
• Recognize obstacles to changing emotions.
• Reduce vulnerability to emotional turmoil.
• Increase positive emotional events.
• Take actions to change destructive behaviors.
• Apply distress tolerance techniques.

How DBT Helps Addiction

Dialectical behavior therapy is often used in addiction treatment to address co-occurring mental health disorders. It’s also helpful for developing more adaptive ways of thinking and coping with distress. Many clinicians use a form of DBT specifically for substance use disorders (SUD). This is known as DBT-SUD, and it adds addiction-centric components that help:

• Ease discomfort associated with drug withdrawal.
• Decrease urges and cravings.
• Establish new skills in addiction recovery.
• Address attachment issues, vulnerability, and accepting emotions.

If you’re recovering from substance abuse, dialectical behavior therapy for addiction can be useful in triggering situations. By reducing anxiety and managing emotions that can lead to alcohol and drug abuse, you are better able to resist substances. Additionally, DBT for substance abuse increases awareness of negative consequences from drug or alcohol abuse. It can also help you address feelings of guilt that come with an addiction relapse. DBT sessions encourage you to learn from the lapse rather than spiral back into an abusive cycle, known as the abstinence violation effect.

Dialectical behavior therapy for addiction can be adjusted depending on your physical needs during detox. For example, if you’re struggling with opioid addiction, you may take maintenance medications rather than adhere to complete abstinence from all substances.

In conjunction with other therapies, DBT for substance abuse can help address co-occurring disorders and underlying issues that lead you to cope with alcohol or drugs like:

• Post-traumatic stress disorder
• Mental health disorders
• Depression symptoms and thoughts of suicide
• Relationship and attachment issues
• Low self-worth
• Poor coping skills

Group therapy is a core component of substance abuse treatment, so dialectical behavior therapy for addiction often occurs in a setting with peers going through similar challenges. A group therapy leader may use DBT techniques to develop interpersonal skills and help members manage distress. Group sessions can serve as a safe space to discuss problems and ways to deal with these challenges.

Applying DBT to Related Conditions

DBT was originally developed to treat borderline personality disorder or people who have ongoing thoughts of suicide. Dialectical behavior therapy is now shown to be helpful for other behavioral health conditions like:

• Depression
• Bipolar disorder
• Eating disorders
• Self-harming struggles
• Substance use disorders
• Trauma

People who have borderline personality disorder or eating disorders are at higher risk of having co-occurring substance use disorders. Using DBT alongside other substance abuse treatments can help a wider range of people who struggle with drugs or alcohol. Addressing all co-occurring disorders simultaneously is important for long-term recovery.

Need Help With Substance Abuse?

If you or a loved one is struggling with addiction, a drug rehab center that draws on several types of therapies can help. Footprints to Recovery’s addiction treatment centers use both traditional and alternative therapies so you can address substance abuse from all angles.

In addition to dialectical behavior therapy for addiction, treatment specialists at our recovery centers use approaches like:

• Cognitive behavioral therapy (CBT)
• Acceptance and Commitment Therapy (ACT)
• Eye Movement Desensitization and Reprocessing (EMDR)
• Motivational Interviewing (MI)
• Individual therapy
• Group therapy
• Nutrition support
• Yoga and fitness
• Art therapy and music therapy
• Massage therapy and chiropractic services

Our treatment programs include medical detox, residential treatment, partial hospitalization, intensive outpatient programs, and sober-living residences. If you or a loved one is struggling with drugs and alcohol, contact us today to learn more.

References

1. https://psycnet.apa.org/record/2018-39784-027
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797106/
3. https://www.researchgate.net/publication/296622665_Dialectical_behavior_therapy_as_treatment_for_borderline_personality_disorder
4. https://www.researchgate.net/publication/281298055_Abstinence_Violation_Effect
5. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2768029
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145450/
7. https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-020-00299-z
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304419/
9. https://pubmed.ncbi.nlm.nih.gov/20187169/
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304419/
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145127/
12. https://journals.sagepub.com/doi/abs/10.2478/v10199-012-0024-9