Dialectical behavior therapy (DBT), adapted from a similar treatment modality known as cognitive-behavioral therapy (CBT), is one of the most effective techniques for addressing substance abuse and addiction. Originally used to treat borderline personality disorder, addiction treatment professionals have embraced the benefits of dialectical behavior therapy for substance abuse since the 1980s. Let’s take an in-depth look at DBT and how it can be beneficial for someone that is suffering from substance abuse and addiction.

What is the Background of Dialectical Behavioral Therapy?

Man Undergoing Dialectical Behavior Therapy for substance abuse

DBT is an outcropping of cognitive-behavioral therapy (CBT). In fact, in the 1980s, a psychologist recognized that an adjustment to CBT would better serve clients with a mental health disorder. Rather than tossing out the entire treatment model, dialectical behavioral therapy allows for updates to its protocol. Today, therapists rely on both forms of psychotherapy as appropriate for working with people struggling to overcome substance abuse.

Consider that two people might react differently to an emotionally charged situation. In CBT, a therapist would ask you to evaluate the patterns of your thoughts, feelings, and actions. When you see room for improvement, you work with the professional on making the changes. In DBT, however, you acknowledge that you might be reacting more strongly to the situation than someone else would.

Rather than merely evaluating patterns, you learn how to cope with the strong feelings you have. When you’re able to control your emotional response, it’s more likely for you to recognize patterns in need of change. In addition, you learn why you react the way you do. Clinicians refer to the treatment model as one that actively pursues change while encouraging acceptance.

What Does Dialectical Behavior Therapy Involve?

DBT’s basic premise is similar to CBT in that it changes faulty thinking, or at least one’s relationship to his or her thoughts, and leads to changes in behavior. Dr. Marsha Linehan was the first behavioral health expert to take CBT’s principles and add the concept of dialectics to the cognitive brew. As a result, the newly invented dialectical behavior therapy enabled practitioners and their clients to focus on behavioral change while still accepting themselves for who they are. The therapy works to change negative acts, thoughts, and feelings that can get in the way of progress.

What Are The Principles of DBT?

When dealing with an addict, it can be difficult to have them undergo even the most basic of therapy. In most cases, they are in denial that they either have a problem or that their problem is affecting those around them. If someone doesn’t think that there is anything wrong with them, they aren’t likely to just willingly go to therapy. While therapy is ultimately an excellent way to get them to open up and change their actions, attitude, and even the way they think, oftentimes it can lead to the person either getting combative or shutting the therapist out. DBT was created specifically for these types of patients.

DBT utilizes three mechanisms to assist clients in synthesizing their conflicting issues with changing certain behaviors and with the acceptance of reality.

  1. DBT embraces a supportive approach that can help clients identify their strengths and then approach that need to change certain aspects of their attitudes and behaviors. Because DBT is a form of Cognitive Behavioral Therapy, it focuses on the person’s cognitions or thinking processes, that play into the formation of belief systems, personal assumptions, and assumptions about the world. By assisting the client in changing certain irrational beliefs and assumptions that they may have about themselves, other people, and even their own future, DBT can effectively promote behavioral change.
  2. DBT stresses the use of the therapeutic alliance (the working bond between the client and therapist) in therapy. DBT also stresses the forming of an alliance between the patient, the therapist, and other people who are important in the patient’s life to assist said patient in making changes and to accept things that cannot be changed.
  3. The focus of change in DBT is done to attempt to change aspects of the patient, such as attitudes, expectations, and behaviors, that are actually changeable. DBT assumes that change is important for growth and establishes a focused approach to implementing change in addition to accepting that aspects of the world can’t be controlled or changed no matter what.

What Are the Four Components of DBT?

Dialectical behavior therapy consists of four main components. They include:

  • Therapist-led group life skills training for up to six months.
  • Individual and group therapy that establishes a forum to discuss ways to apply life skills to overcome daily challenges
  • Phone coaching that can occur outside of sessions if a client is in crisis, relapsing or having other serious difficulties.
  • Therapist consultation for dialectical behavioral therapy practitioners. This provides support and input from a team of consultants so that therapists can continue to provide the highest quality of support to their clients throughout the therapeutic process.

DBT and Addiction Treatment

Dialectical behavior therapy for substance abuse uses several approaches to address the challenges of addiction. These include:

  • Discontinuing the abuse of substances such as alcohol or drugs
  • Minimizing withdrawal symptoms
  • Diminishing a client’s cravings and temptations to abuse drugs or alcohol
  • Learning how to stay away from situations that trigger substance abuse
  • Encouraging the client to establish new, positive relationships and/or vocations

Why Does DBT Work for Addiction Treatment?

Specifically, substance abuse crowds your life. It shuts down relationships and pursuits of goals and dreams. In its wake, it leaves loneliness, pain, and disappointments over missed opportunities. However, when you decide that it’s time to quit using, rehab offers you the help you need to enter recovery.

Nonetheless, getting well doesn’t mean that you get everything back you lost. For example, relationships may not heal the way you want them to. There will be new challenges as you rebuild your life. Therapists understand this process and use dialectical behavioral therapy to prepare you for the road ahead. During counseling sessions, you learn to embrace where you’re at right now. Moreover, you learn to look at the positives even as it appears the negatives outweigh them.

During the treatment, you set goals for sobriety and life beyond the rehab facility. Next, you break down the steps you need to take to achieve the goals. Built into these processes is the ability to accept occasional setbacks and not see them as a final outcome. For this reason, you develop the ability to handle potential trigger situations in a positive way.

DBT Is Just One Component in a Broader Treatment Regimen

Of course, DBT is only one aspect of addiction therapy services. Furthermore, it can’t stand alone as the only form of treatment. Other modalities include:

  • Individual therapy program
  • Group therapy program
  • Family therapy program
  • Men’s rehab treatment and women’s rehab treatment
  • Holistic approach to addiction treatment

When you combine these treatments, you can see how they all connect in one way or another. Regulating your emotions and learning to deal with distress is another significant step toward disarming trigger events. Over a short period, you learn how to handle life without reaching for a mind or mood-altering substance.

How Can Dialectical Behavior Therapy for Substance Abuse Help You Recover?

If you or someone you love is struggling under the heavy burden of substance abuse, dialectical behavior therapy for substance abuse has proven to be one of the most effective ways to turn your life around in a positive, long-lasting way.

Located in the beautiful mountains near Asheville, NC, Crest View Recovery Center is one of the premier substance abuse programs in the country. Because we know that every person is unique, we tailor your therapy to suit your own particular needs. We use DBT in numerous addiction therapy settings, including:

Our individual and group therapists will partner with you to explore the origins of your destructive behaviors, identify the thoughts that cement them into habits, and then work to change your responses to those thoughts in a positive, self-affirming way. At Crest View, our substance abuse treatment programs can help you overcome dependence on alcohol, heroin, meth or opioids. We understand the heavy toll that drug or alcohol dependency takes on your life, your relationships, your finances, and your future, and we’re committed to helping you redefine your life as a sober, healthy person.

Many centers make wild claims of success, but we have the alumni to prove how effective our addiction treatment strategies are. You’ll never be alone on your journey. Your success is our success.

Are You Interested In Dialectical Behavior Therapy For Substance Abuse?

Are you ready to live without the need for a chemical crutch? The friendly therapists at Crest View Recovery Center are here to help provide dialectical behavior therapy for substance abuse. Call 866.327.2505 today and connect with an intake counselor to learn more about our addiction treatment programs.

Article Reviewed by Patrice Wishon, LCSW, LCAS, CCS

Patrice Wishon, LCSW, LCAS, CCSPatrice has over 30 years experience working in social work and mental health/substance abuse counseling. She received her Master’s degree from UNC-Chapel Hill and has worked in a variety of settings, including community-based outpatient, hospital and classroom settings. Patrice specializes in substance abuse treatment, trauma and women’s issues.