In Treatment

“Acceptance doesn’t mean resignation;

it means understanding that something is what it is

and that there’s got to be a way through it.”

– Michael J. Fox



Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment developed by Marsha Linehan to treat individuals struggling with persistent emotional, behavioral and thought difficulties and dysregulation. DBT integrates dialectics, behaviorism and mindfulness to reduce dysfunctional behaviors and increase skillful coping. It has been found to be an evidence-based practice benefiting individuals struggling with addiction.

The dialectic of Acceptance and Change acts as a foundation for individuals struggling with addiction; understanding and accepting oneself and situation fully, while at the same time recognizing the need for change and transformation. Finding a balance, walking the middle path, is one that can be difficult when one’s mind has learned to operate and act in extremes. DBT teaches individuals to acknowledge both their emotional and psychological needs (Emotion Mind) AND their logical, intellectual thought process (Rational Mind), fusing each perspective together to live mindfully and act intuitively utilizing one’s Wise Mind.

DBT utilizes validation to motivate individuals, building assurance and strength in their ability to develop and thrive. It operates on the assumptions that individuals are doing the best they can and individuals want to improve.

DBT provides skill-based training modules focused on four areas:

  • Mindfulness
  • Distress Tolerance
  • Emotion Regulation
  • Interpersonal Effectiveness

Each module is broken down below:

Mindfulness: Core Mindfulness skills are used as a way for individuals to learn how to gain awareness of, and learn to accept, their emotions. These skills help individuals focus on the present and tackle what is happening in the here and now, slowing individuals down to utilize Wise Mind and act in less destructive, more skillful manners.

Distress Tolerance: Distress Tolerance helps individuals cope with difficult times, when emotions are intense. It teaches skills to respond in healthy ways, soothing oneself when emotions run high, rather than acting destructively or hiding from their feelings.

Emotion Regulation: Emotion Regulation skills assists individuals in understanding their emotions. It teaches individuals how to manage negative, overwhelming emotions while increasing positive experiences.

Interpersonal Effectiveness: Interpersonal Effectiveness teaches individuals how to attend to their relationships, communicate effectively while getting their needs met. It involves respecting oneself and others, listening and communicating effectively, dealing with difficult people, repairing relationships and being able to say no.

So, what does this all mean?

From my own experience and through the use of DBT with the individuals I work with, DBT has shown me that “pain is inevitable; suffering is optional.” Life happens…a continuum of good and bad, happy and sad, boring and exciting; individuals have the last say in how experiences affect them. DBT provides them with the skill set needed to regulate each area of their life (emotionally, logically, interpersonally), find a balance, dive in and nourish their inner strength, and empowers each of us to “build a life worth living.”


Author: Nicole Ehrhardt, LPC, LCADC, NCC – Footprints to Recovery – Clinical Director

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