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dialectical behavioral therapy
02.26.2021

How Does Dialectical Behavioral Therapy Help Addiction

Dialectical behavioral therapy (DBT) is a type of psychotherapy developed by Dr. Marsha Linehan in the late 1980’s. DBT is used to treat a variety of different mental illnesses, including substance abuse. One of the core objectives of DBT is to teach substance use disorder patients communication skills, coping techniques, self confidence and other life skills necessary to overcome addiction.

Since substance use disorder is often characterized by self-destructive behaviors and emotional instability, dialectical behavioral therapy focuses on mindfulness, tolerance for uncomfortable situations, interpersonal relationship building and emotional regulation.

What Does The Term “Dialectical” Mean?

The term “dialectical” refers to the balance between two opposing goals for patients; change and acceptance. This technique balances a patient’s desire to eliminate painful experiences. It does so by accepting that life is painful and changing one set of problems or issues at a time. The fundamental concept of DBT is that a person must accept that they will struggle in early recovery. Whether it is with facing consequences of their addiction, overcoming cravings or confronting emotions that they had previously dulled with alcohol or drugs. This acceptance must be accompanied by a willingness to change their behaviors. Also, their surroundings and their thinking in order to build a life in recovery.

How Does Dialectical Behavioral Therapy Work?

Dialectical behavioral therapy was initially established to treat chronically suicidal individuals. It was later adapted to treat individuals with substance use disorder and borderline personality disorder. DBT includes strategies that are designed to overcome these mental health conditions. It requires a collaborative and cooperative relationship between the patient and a therapist specializing in DBT. Treatment includes five essential functions:

  • Improving a patient’s motivation to change

DBT requires a patient to want to make positive behavioral changes in their life. In order to identify which behaviors threaten their sobriety and overall well being, the therapist relies on individual therapy sessions to determine what unresolved issues from a patient’s past needs to be tackled and what negative behaviors might need to change in order to achieve sobriety.

  • Reinforce patient capabilities

The purpose of this step is to teach a patient life skills. These skills being necessary to achieve sobriety or improve upon certain life skills.

  • Generalizing new behaviors

The purpose of this step is to help a person develop the coping skills necessary to “deal with life on life’s terms.” In other words, the goal of this therapy is to help a person hone their coping mechanisms under the guidance of a therapist.

  • Structuring the environment 

The purpose of this step is two-fold: first to establish the type of therapeutic environment that is conducive to healing and progress through recovery. Second, the therapist tries to identify and then eliminate aspects of a patient’s life that could be detrimental to their early recovery or jeopardize their long term sobriety (i.e. triggers, unhealthy people, lifestyle choices).

  • Enhancing therapist capability and motivation

The purpose of this function is to keep a therapist up to date on the best therapeutic options and practices so that they can continue building their skills and develop professionally.

This can be accomplished in an outpatient setting via four different treatment modes:

  • Individual therapy

This structured therapy helps guide a patient towards the balance between acceptance and change in recovery

  • Group skills training

Group therapy sessions where people are able to learn and hone the behavioral skills they will need to manage emotions and stress that they will encounter while developing the skills needed to have effective interpersonal relationships

  • Telephone consultation/skills coaching with a therapist

This mode of therapy is to help a person newly in recovery have access to their therapist when they are dealing with difficult situations so they can learn different coping skills as they experience life in sobriety.

  • Consultation for therapists

This is important for the therapists so they can seek support while treating patients and work on a team for collaborative consultations

DBT aims to make changes hierarchically based on behaviors that are more imminently life-threatening, then reducing behaviors that may interfere with success of therapy, then reducing behaviors with consequences that might impact overall quality of life and finally increasing behavioral skills that will enhance recovery. The ultimate goal is abstinence, which  is accomplished through DBT’s behavioral targets:

  • Decreasing abuse of substances
  • Alleviating the physical withdrawal symptoms 
  • Decreasing urges, cravings and other temptations to use or abuse,
  • Avoiding or eliminating possible triggers
  • Increasing behaviors that reinforce healthy behaviors and support abstinence

Rehab in Florida

If you or a loved one is struggling with substance or alcohol use, contact Genesis House. At Genesis House, addiction treatment specialists are able to work with you or your loved one to assess your situation and determine an individualized treatment plan that will suit your needs. A professional will be able to take a thorough substance use history. This will help them determine if drug or alcohol treatment is recommended. They will then advise how the best therapeutic course of action is warranted. 

Listen to Podcasts
Season 3, Episode 31: 29 Years of Recovery w/ Andy V.