Dialectical Behavior Therapy

Understanding Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is a psychotherapy method developed by psychologist Marsha M. Linehan in the late 1980s.

"Dialectical behavior therapy is used to treat several mental illnesses in addition to substance abuse and addiction."

DBT was initially developed to treat patients with borderline personality disorder and suicidal thoughts. One of the core goals of DBT is to help patients build the confidence and coping abilities to effectively handle stressful situations.

Patients suffering from mental illness, such as those prone to intense emotional outbursts, are more likely to engage in substance abuse as a form of self-medication. Addiction treatment centers are increasingly utilizing DBT in their treatment programs. Some of the core tenets of DBT—such as improving communication skills, coping skills and self-image—are critical to helping those suffering from addiction move away from drug use.

DBT and Addiction Treatment

Dialectical behavior therapy helps recovering addicts learn several skills—mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation—that are effective at helping addicted people stop using drugs and alcohol.

DBT also focuses on changing the recovering addict’s behavior and surroundings to make sobriety easier.

Common DBT strategies include:

• Helping patients seek out environments and peer groups that discourage drug use
• Encouraging addicts to remove triggers such as drug paraphernalia or unhealthy relationships from their daily lives
• Bolstering self-esteem and confidence to help patients stay sober through stressful periods

DBT Therapies and Techniques

Dialectical behavior therapy generally includes four core components, including:

• Skills Training

  Group leaders teach communication and coping skills — such as how to use mindfulness, emotional regulation, or distress tolerance — which patients can apply to their daily routines and interactions. Skills training classes last roughly two hours, meeting once per week for about 24 weeks.

• Individual Therapy

  Individual therapy helps recovering addicts learn to apply techniques learned during skills training classes in real-life situations.

  Individual therapy is held weekly for the entire DBT program. Therapy sessions are tailored to a recovering addict’s personality. Therapists can then help the addict decide how to best apply his or her new skills.

• Phone Coaching

  Recovering addicts can call their therapists when difficult situations occur outside of individual therapy or skills training classes. The therapist will coach the recovering addict to use emotional regulation and distress tolerance techniques to manage feelings and cope with stress.

• Team Consultation

  Team consultation focuses not on patients, but on therapists and other healthcare providers. Team consultation helps therapists to stay motivated to provide the best care possible for patients that can be difficult to treat.

In addition to these components, recovering addicts will also complete homework assignments. These may include journaling the behaviors, urges and emotions they experience throughout the day.

DBT and Other Treatments

Many addiction treatment centers include DBT in their recovery programs. DBT can teach recovering addicts communication skills, coping techniques, self-confidence and other qualities important to overcoming drug addiction.

Inpatient and outpatient drug rehabs are staffed with medical professionals trained to treat all kinds of patients. The 24-hour medical care provided at residential centers can help emotionally distressed individuals complete detox and manage withdrawal.

DBT is also effective when combined with other behavioral, motivational therapies, including:

• Cognitive behavioral therapy
• Motivational enhancement therapy
• Contingency management therapy
• Community reinforcement therapy

Support groups like Narcotics Anonymous and Alcoholics Anonymous can also help those in recovery integrate into new, drug-free peer groups upon exiting treatment.

Find Complete Treatment for Drug or Alcohol Addiction

Beating drug addiction requires medical expertise, but staying sober requires stress management skills. Addiction treatment centers offer therapy like DBT to support a healthy mind in recovery and prevent relapse. If you or someone you care about is struggling with an addiction, a treatment center specializing in DBT may be able to help you.

• Sources

  National Institutes of Health. (2006). Dialectical Behavior Therapy: Current Indications and Unique Elements. Retrieved on August 17, 2015 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/

  The Linehan Institute. (2001). What is DBT? Retrieved on August 17, 2015 http://behavioraltech.org/resources/whatisdbt.cfm