What Is DBT for Substance Abuse?

Dialectical behavior therapy (DBT) was developed by psychologist Dr. Marsha M. Linehan to assist in the treatment of individuals struggling with extreme suicidal thoughts. The method of DBT was designed specifically for tough patients to address their contradictory reactions to standard forms of intervention. It is recommended that treatment be followed for borderline personality disorder. DBT for substance abuse is essential to an everlasting recovery. It was created for hard-to-treat individuals.

The main focus of change in DBT is to strive to change the following aspects of oneself:

  • Expectations
  • Behaviors
  • Attitudes

It is essential to be able to accept qualities that cannot be altered. DBT presumes that change is vital for a person’s growth. Therefore, an established focused approach is instilled to implement change.

What Does DBT for Addiction Treat?

The principles for DBT were applied to other psychological disorders and behaviors that are difficult to treat in therapy. Individuals with severe personality disorders and who are suicidal are often extremely tough cases to treat in therapy. These sufferers will become reactive to attempts aimed to assist them in changing the following attributes to the following:

  • Attitudes
  • Actions
  • Thinking
  • Borderline personality disorder
  • Severe personality disorders

What Are The Basic Principles and Different Modules Of DBT?

Therapists attempt to alter the individual struggling attitude and behavior that causes them distress. The sufferer normally shuts down emotionally and offers minimal effort in the therapeutic process. Therapists will also attempt to help the people struggling to accept different facets of the world they feel they are powerless to change. As this process continues, aggression is normally portrayed to the therapist.

DBT is comprised of four modules:

  • Distress tolerance
  • Mindfulness
  • Interpersonal effectiveness
  • Emotional regulation

Each module’s focal point is on selected skills that assist in modifying a person’s behavior to ensure greater personal relationships and improve quality of life.

What Are The Components of DBT?

DBT for substance abuse is not a single approach. As mentioned previously, it employs multiple components to supplement one another. Individual therapy sessions are typically held weekly for a client with the therapist. Individual sessions will continue for the duration of therapy.

In the sessions, the therapist and client work together to expand the individual’s motivation to change certain features of the following:

  • Features of behavior and thinking
  • Develop and learn new skills to address particular client challenges

Group Therapy Sessions

Dialectical behavior therapy for substance use disorder also utilizes group therapy sessions that are usually training skills groups. In the groups, individuals with similar diagnoses and problems will meet with a therapist who will educate them on skills to accept specific aspects of the world. The groups normally meet for periods of 90 minutes to three hours, depending on the size of the group, and the subject matter.


The curriculum followed for DBT is fully psychoeducational and will take 20-24 weeks to complete. From there, the curriculum is repeated to provide individuals with the opportunity to attend specific areas that can be particularly troublesome for the patient. The educational facets of the group are targeted toward the following:

  • The symptoms and problems of a psychological disorder being treated such as:
    • Relaxation techniques
    • Conflict resolution
    • Coping skills
    • Substance abuse issues
    • Anger management

Phone Coaching

This coaching is designed to provide clients with instant assistance and solutions to specific difficult problems that can arise on the spot. Individuals can phone their therapist or another therapist who is readily available and able to discuss the issue. This service has the potential to be misused by clients and needs to be used with discretion.

Consultation Teams

This component of DBT for substance abuse is designed to update the therapist on the following aspects:

  • The implementation of new approaches and techniques
  • Research findings
  • Sharpen their skills

The consultation teams specialize in the following areas:

  • Increasing motivation especially for therapists with trying caseloads
  • Allow therapists a setting to discuss tough cases
  • Gain support from one another
  • Compare methods
  • Learn from one another

By engaging in multilevel, focused, and supportive approaches as well as requiring therapists to receive continuous education, DBT provides a comprehensive treatment package. Therapists remain encouraged to help patients and are updated regarding the latest strategies and techniques.

How Do DBT Sessions Usually Work?

The session typically results in individuals remaining in therapy sessions for a short period before becoming hostile and aggressive towards their counselor. From there, they drop out of therapy altogether or find another therapist hoping the process will somehow be different. This approach became a frustrating circumstance for the counselor and the sufferer.

DBT attempts to synthesize two opposite states of the therapeutic process and environment by combining them. Dialectic means a synthesis of two points of view. Dialectical behavior therapy for substance use disorder achieves this step by engaging in the three following mechanisms:

Supportive Approach

This supportive approach helps individuals identify what their strengths are. From that step, they can sense the need to change certain features of their behaviors and attitudes. Overall, the person suffering will be able to accept alternative aspects of their world based on their strengths.

Focus On Individual Cognitions

DBT is a form of cognitive behavioral therapy, so it focuses on the following aspects of an individual. By aiding the person in modifying unquestionable assumptions and beliefs about oneself, people, or one’s future, behavioral change can be effectively promoted.

  • Thinking processes that play into belief system formation
  • World assumptions
  • Personal assumptions

Stress The Use Of Therapeutic Alliance

The therapeutic alliance is the working bond between the therapist and individual during the session. DBT for addiction also stresses establishing an alliance between therapist, individual, and other people who are significant in the sufferer’s life. The primary goal is to assist the individual in constructing changes and accepting things that cannot be altered.

What Is The Approach of DBT?

The approach of dialectical behavior therapy for substance use disorder is comprehensive and multidimensional. There are several therapeutic intervention mechanisms intersected to produce acceptance and change in an individual by engaging in the following:

  • Since many individuals are reluctant to change, it is consequential to aid them in the development of being capable of changing certain aspects of themselves. While engaging in this process, the individual can identify facets of themselves and other people that cannot be changed.
  • DBT helps encourage individuals to alter features of their life that can be modified.
  • An environment is provided by therapists that inspire self-confidence and give people tools to assist in effective change and prepare individuals for real-world situations that can occur in life.
  • Therapists ensure that individuals remain component and stimulated in the delivery of therapy with continual consultation and training with other therapists.
  • DBT assists individuals in functional behavior development and helps them apply this approach in real-life situations.

Who Is A Good Candidate For DBT?

A good candidate for DBT is a person who possesses the following attributes:

  • A strong fear of abandonment
  • Regulates their emotions
  • Takes drastic actions to prevent others from leaving them
  • Has difficulty understanding that nothing is all “good” or “bad”

How Does DBT Help In Treating Addiction?

DBT specializes in several delivery methods to meet each goal. Individuals will participate in the following therapy options:

  • Group therapy
  • Individual therapy
  • On the spot consultation with therapists to address real-world situations that occur
  • Therapists continue to sharpen the individual’s abilities and skills via skills training and motivation therapy

How Does DBT for Substance Abuse Differ From CBT?

CBT focuses on feelings, and how thought and behavior impact one another. DBT is a form of does work on the previous items, but more emphasis is given to the following items:

  • Being mindful
  • Learning to accept pain
  • Regulating emotions

CBT seeks to provide patients the capability to acknowledge when their thoughts become exasperating. From there, techniques are provided to redirect thoughts. DBT assists patients in searching for ways to do the following:

  • Feel safe
  • Manage emotions
  • Find ways to accept self
  • Regulate damaging behaviors

When clients engage in DBT therapy, training session skills are usually instructed in a group setting in the four modules previously described. Many patients meet with a DBT coach or therapist weekly to receive DBT phone coaching as needed when help is desired the most. Oftentimes, once individuals can utilize DBT skills such as practicing mindfulness, regulating emotions, and improving relationships with others, they can transition to more standard CBT groups, certain recurring harmful behaviors and negative thought patterns.

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