Dialectical Behavior Therapy and Treating Addiction

Written by Journey Pure Staff

What is Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is a type of cognitive behavioral treatment used to treat addiction that was developed by Marsha Linehan in the 1980s. DBT was initially developed to treat borderline personality disorder and has proven to be successful in helping clients to manage emotions, regulate suicidal thoughts and ultimately turn destructive behavior into something more positive for better outcomes. Because of the success of DBT in treating personality disorders, it is now being used to treat other psychosocial disorders including Substance Use Disorder.

DBT focuses on getting the patient to move past destructive, out-of-control behaviors like abusing substances and learning to envision and articulate goals then moving toward pursuing and sustaining those goals. In DBT,  the patient and the therapist will work together to set goals that are important to the patient. The patient will learn coping skills and ways to decrease harmful behaviors like “using” and learn to replace the destructive behavior with effective, life-enhancing behaviors that ultimately creates a life worth living. It is not simply abstinence from substances, but rather a life free of other destructive behaviors that often go along with substance abuse.

Hierarchy of DBT

In behavioral therapy treatments, there is often a hierarchy structure that dictates how therapy progresses. In DBT, the first step is to decrease behavior that is imminently life-threatening. For Substance Use Disorder patients, this means decreasing or ceasing abuse of substances that cause physical harm or even possibly death. Next is to reduce behaviors that interfere with therapy. In the addiction space, therapists will work to alleviate the patient’s physical discomfort associated with withdrawal from substances so that they can be present for the therapy sessions. The next step is to reduce behaviors that degrade the quality of life. For addiction patients, this may mean diminishing temptations to abuse substances or it could be more extreme like finding housing to prevent homelessness. The final step centers around increasing patients’ behavioral skill set to help patients create a better life for themselves. In addicted patients, this means reducing behaviors conducive to drug abuse and instead of teaching them to foster new relationships, pursue healthy activities, and find new environments that support abstinence.

A differentiating factor of Dialectical Behavioral Therapy compared to other traditional psychotherapies is that DBT has five components that work together. Most other traditional therapies are just one modality or approach. Each component of DBT is set to a corresponding, specific function or benefit. The different modes and corresponding functions are as follows:

  • DBT Skills Training to enhance a patient’s capabilities
  • Individual Psychotherapy to improve patient’s motivation
  • Real-time coaching to help patients cope with difficult situations that arise in their everyday lives.
  • Case Management to structure the patient’s environment for better success
  • Support Therapists with the DBT Consultation Team

Building a Better Life with DBT

In Dialectical Behavioral Therapy, therapists believe that destructive behaviors come about as a way to cope with a situation or feeling. These destructive behaviors may provide some short-term relief; however, they are often extremely toxic for the patient in the long-term. DBT believes that patients need to learn new behaviors and coping skills in relevant situations. By teaching behavioral skills like mindfulness, distress tolerance emotion regulation and interpersonal effectiveness, they are helping patients better navigate everyday life and challenges that they once turned to destructive behavior to manage.

Treatment at JourneyPure at the River

If you or a loved one suffers from a chronic substance abuse problem, please contact us today. We offer medically-assisted detox services, individual and group counseling and experiential therapies. Our friendly and knowledgeable staff is ready for you to get healthy and stay healthy.