Dialectical Behavior Therapy for Addiction Treatment

Addiction treatment may involve a variety of therapeutic interventions, depending on a person’s needs. Dialectical behavior therapy (DBT) is a type of therapy that has been found useful in treating substance use disorders and other co-occurring mental health disorders.¹

This page will explain what DBT is, how it works, and what to expect when DBT is used as part of a comprehensive addiction treatment program.

What Is Dialectical Behavior Therapy?

Dialectical behavior therapy is an evidence-based treatment that unites 2 opposing principles—acceptance and change—with the goal of reducing emotion dysregulation and helping a person build a life worth living.^1,2

Originally developed by Dr. Marsha Linehan to treat chronically suicidal patients, DBT was later adapted for use in treating other severe mental health conditions, including substance use disorders.¹

As an addiction treatment therapy, DBT may be employed during:¹

• Individual therapy.
• Group therapy.
• Teletherapy.
• Therapy for the therapist.

While dialectical behavior therapy is a type of cognitive behavioral therapy (CBT), there are particular differences between the 2 therapies.³

CBT primarily focuses on identifying unhealthy thoughts and working to challenge or restructure them to change behaviors. Alternatively, dialectical behavior therapy emphasizes the acceptance and validation of some uncomfortable thoughts or feelings.^1,3

This acceptance allows a person to come to terms with or tolerate certain problems so they can work on changing other problematic aspects of their life.^1,3

Therapists conducting DBT help a person strike a balance between acceptance and change.³

How Does Dialectical Behavior Therapy (DBT) Work?

Dialectical behavior therapy works by allowing patients to feel validated in their struggle with life’s difficulties, while also bringing hope that things can change, even if they encounter setbacks along the way.¹

There are 5 specific functions of DBT treatment:^1,4

Function 1: Enhancing capabilities. It is assumed that individuals with substance use disorder, or another severe mental health disorder, lack or need to strengthen certain important life skills. Such skills may include regulating emotions, mindfulness, interpersonal effectiveness, and distress tolerance. Improving these skills can involve lessons, active practice, discussions, or homework assignments so patients can practice new skills outside of therapy sessions.

Function 2: Generalizing capabilities. Applying newly learned or improved skills to a person’s daily life is another function of DBT. The therapist works with an individual to help them practice applying these life skills in their day-to-day lives.

Function 3: Improving motivation and reducing dysfunctional behaviors. Therapists work with each person to identify and track problematic behaviors. During a therapy session, time spent on understanding and finding ways to improve specific behaviors is prioritized with life-threatening behaviors being given the highest priority.

Function 4: Enhancing and maintaining therapist capabilities and motivation. Therapists can find working with individuals who have severe mental health disorders highly rewarding. However, it can also place a strain on them. This function of DBT provides therapists with encouragement and support by having a therapist consultation-team meeting. During this time therapists can work together to problem-solve specific challenges they face in their DBT practice.

Function 5: Structuring the environment. Another function of DBT involves structuring the environment in a way that does not reinforce problematic behavior but instead supports progress. This can apply to the environment a therapist creates during treatment as well as helping a person discover ways to modify their environment outside of treatment.

In each session, a DBT therapist will help the patient target unhealthy and life-threatening behaviors. Behaviors are addressed in a hierarchical order as follows:¹

• Diminishing life-threatening behaviors, such as suicidal or homicidal behaviors
• Reducing behaviors that interfere with therapy, such as attending while intoxicated or dissociation during therapy
• Minimizing behaviors that interfere with quality of life through their consequences, such as domestic violence, homelessness, substance use, or probation violations
• Increasing behavioral skills

What Does DBT Treat?

DBT was first introduced for chronically suicidal patients and those with borderline personality disorder (BPD). Since then, DBT has been found useful for the treatment of various mental health conditions, including:^1,4,5

• Depression.
• Anxiety.
• Eating disorders.
• Substance use disorders.

Dialectical Behavior Therapy for Addiction Treatment

In addiction treatment, DBT addresses substance use as a behavior of the highest order that interferes with a person’s quality of life.¹ Specific substance use behaviors that are addressed during DBT therapy include:¹

• Minimizing drug and alcohol use.
• Reducing physical symptoms associated with withdrawal or abstinence.
• Diminishing of cravings or temptations for substance use.
• Avoiding or reducing opportunities or triggers to use drugs or alcohol.
• Minimizing behaviors that encourage or allow substance use.
• Increasing interaction with healthy relationships and community reinforcement of substance avoidance.

Central to healing is the achievement of abstinence. A patient is encouraged to immediately stop using substances, and the expectation of abstinence (of change) is implemented.¹

However, a complete, undefined period of abstinence may feel impossible. So, an achievable goal is established. Abstinence for a day, a month, or a matter of minutes becomes the goal.¹

And, when it is achieved, the patient renews their commitment for another clearly defined period.¹ After some time, this promotion of small, recurring changes adds up to long periods of abstinence.¹ Additional methods may be used to cope with potential temptations before they occur, thus preparing a person to maintain abstinence in the future.¹

Acceptance is encouraged if a person experiences relapse and the focus shifts to helping the person “fail well.” Rather than feeling inadequate or as if treatment has failed, a DBT therapist will help a patient analyze the situation and learn from it. Thus, allowing acceptance while still encouraging change.¹

DBT for drug and alcohol addiction is typically employed in combination with other behavioral therapies such as cognitive behavioral therapy, motivational interviewing, and others.

Find a Dialectical Behavior Therapy Program in Florida

If you or a loved one are struggling with addiction, help is available. River Oaks Treatment Center offers comprehensive evidence-based treatment, including DBT, for drug and alcohol addiction. Our Florida rehab provides outpatient and inpatient addiction treatment near Tampa.

Expert licensed clinicians customize each individual’s treatment plan to ensure they receive the right amount of support. To learn more about our levels of addiction treatment and what makes River Oaks the ideal place to start your recovery, call .

Admissions navigators are available 24/7 to tell you more about the various ways to pay for rehab, how easy using insurance to pay for rehab can be, and how you or your loved one might benefit from care at River Oaks.

Unsure of what your health insurance covers? You can quickly and confidentially .

Please don’t wait to get the help you deserve. Call today and start the admissions process.