Dialectical behavior therapy (DBT) is often used in addiction treatment to teach skills for emotion regulation, distress tolerance, and behavior change. DBT is a form of cognitive behavioral therapy (CBT) that draws on mindfulness techniques. It encourages you to acknowledge unwanted thoughts and behaviors without judgement.
Dialectical behavior therapy can help with the underlying issues that fuel substance use disorders like mental illness symptoms and unhealthy thought patterns. In DBT for substance abuse, you’ll learn to identify the root causes of drug addiction or alcohol addiction. You’ll also develop specific ways to change destructive behaviors and cope with triggers.

How Dialectical Behavior Therapy (DBT) Works
DBT is based on the belief that individuals who struggle with mental health and emotional regulation may have difficulty managing strong emotions. DBT aims to teach individuals how to more effectively cope with these intense feelings, rather than trying to eliminate them entirely. To do so, therapists base treatment off of the Principles of DBT which include:
- Mindfulness
- Emotion regulation
- Interpersonal effectiveness
- Distress tolerance
Together, you and your therapist will work on learning and practicing DBT skills that can help you manage intense emotions and reduce impulsive behaviors, leading to improved relationships and overall well-being.
What To Expect In DBT Skills Training Groups?
During dialectical behavior therapy, your therapist provides a safe, controlled environment to practice healthy coping skills. Used both in individual therapy and group therapy, the ultimate goal of DBT is to help you build skills to self-manage in daily life.
DBT skills training can teach you to:
- Identify and name emotions.
- Recognize obstacles to changing emotions.
- Reduce vulnerability to emotional turmoil.
- Increase positive emotional events.
- Take actions to change destructive behaviors.
- Apply distress tolerance techniques.
Some DBT skills you may learn in therapy sessions:
- Paying attention to what is happening in the present moment through grounding and mindfulness practices.
- Increasing your tolerance for distress by learning to accept situations and feelings, acknowledge they’re difficult, and refrain from destructive coping mechanisms.
- Practicing more effective and healthy ways to interact with others.
- Developing self-confidence and setting boundaries.
- Learning ways to manage intense emotions so that they don’t feel so overwhelming.
What Can DBT Treat?
DBT was originally developed to treat borderline personality disorder or people who have ongoing thoughts of suicide. Dialectical behavior therapy is now shown to be helpful for other behavioral health conditions like:
People who have borderline personality disorder or eating disorders are at higher risk of having co-occurring substance use disorders. Using DBT alongside other substance abuse treatments can help a wider range of people who struggle with drugs or alcohol. Addressing all co-occurring disorders simultaneously is important for long-term recovery.
How DBT Helps Addiction
Dialectical behavior therapy is often used in addiction treatment to address co-occurring mental health disorders. It’s also helpful for developing more adaptive ways of thinking and coping with distress. Many clinicians use a form of DBT specifically for substance use disorders (SUD). This is known as DBT-SUD, and it adds addiction-centric components that help:
- Ease discomfort associated with drug withdrawal.
- Decrease urges and cravings.
- Establish new skills in addiction recovery.
- Address attachment issues, vulnerability, and accepting emotions.
If you’re recovering from substance abuse, dialectical behavior therapy for addiction can be useful in triggering situations. By reducing anxiety and managing emotions that can lead to alcohol and drug abuse, you are better able to resist substances. Additionally, DBT for substance abuse increases awareness of negative consequences from drug or alcohol abuse. It can also help you address feelings of guilt that come with an addiction relapse. DBT sessions encourage you to learn from the lapse rather than spiral back into an abusive cycle, known as the abstinence violation effect.
Dialectical behavior therapy for addiction can be adjusted depending on your physical needs during detox. For example, if you’re struggling with opioid addiction, you may take maintenance medications rather than adhere to complete abstinence from all substances.
How Do Substance Abuse Treatment Centers Use DBT for Addiction?
DBT is an evidence-based approach to treating addiction that focuses on building skills to cope with difficult emotions and situations, promoting self-acceptance and awareness, and involving loved ones in the recovery process. By incorporating these elements into a comprehensive treatment plan, individuals can increase their chances of overcoming addiction and maintaining long-term sobriety.
DBT Groups
Group therapy is a core component of substance abuse treatment, so dialectical behavior therapy for addiction often occurs in a setting with peers going through similar challenges.
A group therapy leader may use DBT techniques to develop interpersonal skills and help members manage distress. Group sessions can serve as a safe space to discuss problems and ways to deal with these challenges.
One-On-One DBT Sessions
During individual therapy, a trained therapist can provide personalized support and guidance in implementing DBT techniques in daily life. This one-on-one support can be especially beneficial for addressing specific triggers or challenges that may arise in an individual’s recovery journey.
DBT in Family Therapy
Family therapy can also incorporate elements of DBT for addiction, involving loved ones in the treatment process and creating a supportive and understanding environment at home. This can help improve communication and relationships, which are often strained by addiction.
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Benefits of DBT for Addiction
DBT for addiction emphasizes self-acceptance and non-judgmental awareness, promoting a sense of worthiness and reducing shame or guilt that may be associated with substance abuse. This can be particularly helpful for those struggling with co-occurring disorders or trauma.
When used in conjunction with other therapies, DBT for substance abuse can help address co-occurring disorders and underlying issues that lead you to cope with alcohol or drugs like:
- Post-traumatic stress disorder
- Mental health disorders
- Depression symptoms and thoughts of suicide
- Relationship and attachment issues
- Low self-worth
- Poor coping skills
For this reason, using DBT for addiction is often seen as a holistic approach to recovery, addressing not just the symptoms of addiction but also the root causes and underlying issues. By learning skills such as emotional regulation, distress tolerance, and mindfulness, individuals can better manage difficult emotions and situations without turning to addictive substances.
Need Help With Substance Abuse?
If you or a loved one is struggling with addiction, a drug rehab center that draws on several types of therapies can help. Footprints to Recovery’s addiction treatment centers use both traditional and alternative therapies so you can address substance abuse from all angles. In addition to dialectical behavior therapy for addiction, treatment specialists at our recovery centers use approaches like:
- Cognitive behavioral therapy (CBT)
- Acceptance and Commitment Therapy (ACT)
- Eye Movement Desensitization and Reprocessing (EMDR)
- Motivational Interviewing (MI)
- Individual therapy
- Group therapy
- Nutrition support
- Yoga and fitness
- Art therapy and music therapy
- Massage therapy and chiropractic services
Our treatment programs include medical detox, residential treatment, partial hospitalization, intensive outpatient programs, and sober-living residences. If you or a loved one is struggling with drugs and alcohol, contact us today to learn more.
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