Author: James Anderson

Dialectical Behavior Therapy DBT and Substance Abuse Treatment Behavioral Health Community

dbt for substance abuse

DBT provides clients with structure and skills to better tolerate distress and the guidance on how to apply these skills to the unique situations in their lives. This is where the emotional regulation skills of DBT are invaluable in teaching us how not to re-trigger the emotion so that we can “sober up” and make decisions that lead to a worthwhile life. It’s not an option for you to “abstain” from feeling (nor is it recommended, as other serious mental health issues arise), so we must learn how to live with our emotions, and more importantly, how to limit the distress that painful emotions bring into our lives. 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.

  1. Dialectical behavior therapy for addiction can be adjusted depending on your physical needs during detox.
  2. Programs teaching this skill educate people to label their feelings accurately, which can be particularly helpful for those with borderline personality disorder.
  3. Dialectical behavioral therapy is also offered in a group-based format, such as in drug rehab programs and some community support groups.
  4. Dialectical behavioral therapy can be helpful for people who have issues surrounding control, negative emotions, or self-destructive actions.
  5. This study found that ACT and DBT treatments had positive effects on substance use disorders.

DBT, which was originally created to help individuals with Borderline Personality Disorder — a pervasive disorder of emotion regulation — excels at assisting patients in learning healthy and effective emotional regulation skills. Once the addict and alcoholic surrenders the use of the drug, the patient is left without many useful ways to manage his or her emotions, and it is here that DBT provides needed relief. Dialectical behavior therapy can help with the underlying issues that fuel substance use disorders like mental illness symptoms and unhealthy thought patterns.

Emotionally unavailable to emotionally engaged

All subjects took levomethadyl (ORLAAM, which is no longer available in Europe or the United States), an opiate replacement medication, throughout the treatment year and continued to receive it post-treatment. DBT treats a lapse into substance abuse as a problem to solve, rather than as evidence of patient inadequacy or treatment failure. When a patient does slip, the therapist shifts rapidly to helping the patient fail well—that is, the therapist guides the patient in making a behavioral analysis of the events that led to and followed drug use, and gleaning all that can be learned and applied to future situations. Dr. Linehan’s basic premise for DBT was that people who wanted to be dead did not have the requisite skills to solve the problems that were causing their profound suffering and build a life worth living.

dbt for substance abuse

This modality can be delivered in various settings, including group therapy settings, over the phone, and in individual counseling settings with a clinician. Each group session lasts around two hours, and groups usually meet weekly for about six months. People use these breathing techniques to slow down the situation and separate their thoughts from their emotions. We are here to provide assistance in locating an Ark Behavioral Health treatment center that may meet your treatment needs. You nor your loved one are under any obligation to commit to an Ark Behavioral Health treatment program when calling our helpline.

Supporting Abstinence by Encouraging Acceptance

Emotions are intended to organize and focus our behavior in moments when we may need to react quickly, sometimes even before thinking about it. In this stage, people practice experiencing emotions fully without using substances to cope. Programs teaching this skill educate people to label their feelings accurately, which can be particularly helpful for those with borderline personality disorder. Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available. It was originally developed to treat suicidal ideation in women with borderline personality disorder, or BPD.

dbt for substance abuse

This helpline is answered by Ark Behavioral Health, an addiction treatment provider with treatment facilities in Massachusetts and Ohio. Dialectical behavioral therapy is a type of therapy that was developed by Dr. Marsha Linehan in the 1980’s. James wrote, “My theory … is that the bodily changes follow directly the perception of the exciting fact, and that our feeling of the same changes as they occur is the emotion.”  In short, emotions are changes in bodily states. Emotions are designed to primarily warn us of possible danger and to prompt a change in behavior, just like the pain from the kidney stone forced me to stop what I was doing and to ultimately have surgery to remove them.

How Dialectical Behavior Therapy (DBT) Works

In addition to meeting criteria for opiate dependence, Lucy has had multiple episodes of major depression and is currently living with an abusive partner who is not interested in quitting his own use of drugs. A careful behavioral analysis highlights the central role of emotional dyscontrol resulting in her frequent use of drugs (often before having sex with her boyfriend; after an argument with him; or as a way to escape negative emotions, including sadness). Although Lucy does not meet the full criteria for treatment with BPD, the intervention may still be warranted because many of her problems are rooted in emotional dyscontrol. Patients with SUD typically begin DBT in a mental and behavioral state that we call “addict mind.” Their thoughts, beliefs, actions, and emotions are under the control of drugs. As they achieve increasingly lengthy abstinence, they typically develop an outlook that we call “clean mind.” In this state, they are off drugs but seemingly feel immune from future problems—a lack of vigilance that can set the stage for lapses.

Contact us today online or by phone to find effective substance abuse that offers dialectical behavioral therapy along with other evidence-based treatment services. As with NSSI and suicide, substance-related targets are understood as efforts to emotionally regulate in the face of challenging circumstances and experiences, with similar learning histories related to benefits such as emotional relief, numbness, or pleasant emotions — at least in the short term. As with standard DBT, clients are oriented to the option of developing new capabilities through DBT for responding to problems in ways that are consistent with their values and with moving towards lives that they would experience as worth living.

Sometimes people use substances to get through distressing situations or emotions rather than less destructive coping mechanisms. DBT can help clients learn to concentrate on the present moment, modify ineffective behaviors, and reduce the triggers leading to substance abuse. DBT support for these symptoms extends beyond the therapy session through phone coaching as a crisis intervention tool in addition to individual weekly psychotherapy and skills groups.

Features of the adapted intervention include drug-specific behavioral targets for treatment of problem drug use, a set of attachment strategies for fostering and building a strong therapeutic relationship, and dialectical abstinence—a synthesis of two polar opposite methods for addressing drug abuse. DBT and its adaptation may also be effective for SUD patients with multiple, complex problems rooted in emotional dyscontrol who have not responded to other evidence-based approaches. 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. If you’re recovering from substance abuse, dialectical behavior therapy for addiction can be useful in triggering situations.

Dialectical Behavior Therapy for Substance Abusers

These include five videos/DVDs featuring Dr. Linehan teaching DBT skills to patients, as well as more than 25 hours of in-depth online training in the core DBT curriculum, including DBT skills, behavioral chain analysis, and validation. Information about workshops, intensive training, online training, and other educational products for patients and therapists can be obtained through Behavioral Tech, LLC (). The adaptation of DBT to patients with SUD and BPD represents a natural extension of the therapy, in light of the comorbidity’s frequent and often synergistic threat to life (see Prevalence and Consequences of SUD-BPD Comorbidity). The adaptation was designed for a population of individuals with SUD that is largely heterogeneous across drugs of abuse and demographic variables.

DBT is an effective approach for treating substance abuse and related issues such as emotion regulation. 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.

Dialectical Behavior Therapy — or as it is most commonly known, DBT — has become an acclaimed, evidence-based therapy for individuals struggling with a co-occurring disorders. DBT therapy, as a form of addiction treatment, usually involves individual therapy sessions and skills groups. Individual therapy meetings involve one-on-one contact with a professionally trained therapist to address your therapeutic needs. Emotional dysregulation is the inability to control one’s emotions and can contribute to substance abuse. It prevents painful emotions from bubbling up, unlike distress tolerance and mindfulness. Because dialectical behavioral therapy can be helpful for a variety of psychiatric conditions, it is often offered as a component of dual diagnosis programs.