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 Dialectical behavior therapy (DBT) is one of the treatment approaches rooted from cognitive-behavioral therapy (CBT). This therapeutic technique was developed by Dr. Marsha Linehan in the late 1980s when she was working with patients who were having serious suicidal thoughts and she found CBT to be limiting. While DBT was originally intended to assist clients with a borderline personality disorder, research revealed that DBT has also been used to successfully treat substance abuse disorder, depression, bipolar disorder, and other mental health issues. This piece will focus on DBT and addiction, so you can learn more and appreciate how this therapeutic tool can help you or your loved one win the battle against substance abuse disorder.

 What is the Main Goal of DBT?

 The primary goal of DBT is to teach the patient essential skills that will help him cope with stress. Through DBT, the patient is expected to learn effective tools that can help him change his existing negative coping mechanisms into positive ones. In the case of substance abuse disorder or addiction, the reliance on drugs is the negative coping mechanism. 

 People abuse drugs for a variety of reasons but all of them essentially boil down to the need to cope with something and the need to find relief. When you go through DBT, you will learn healthy ways to cope with what you are going through so that you will no longer have to depend on drugs, among other things. 

How can DBT Help Address Addiction?

 DBT help people suffering from substance use disorder by focusing on the attainment of the following behavioral targets:

  •  Lessening the dependence or abuse of different kinds of substances (e.g. drugs and alcohol)
  •  Decreasing the painful and discomforting symptoms of withdrawal.
  •  Diminishing the urges and cravings to use/abuse drugs and other substances.
  •  Avoiding tempting situations and other occasions that may cause one to take and abuse substances.
  •  Improving and increasing the support of one’s environment, apart from family, by helping the patient form new and healthy friendships.
  •  Encouraging the patient to be involved in recreational activities and wholesome hobbies that will support long-term sobriety or abstinence.

What is the DBT Method?

 Unlike other therapeutic techniques that only focus on one facet of the problem, the DBT approach is multidimensional and comprehensive. DBT and addiction treatment work by utilizing various treatment mechanisms and strategies to bring positive change and acceptance to the person suffering from substance abuse disorder. Specifically, the DBT approach

  •  … helps to encourage patients to change parts of their life that they can change.
  •  … assists patients in developing their capability to improve and change certain aspects of themselves and to determine which parts of themselves and others that they cannot change.
  •  … helps patients to develop more healthy and functional behaviors that they can apply in real life.
  •  … provides patients with tools that will help them change for the better and positive coping mechanisms that will help them deal with difficulties and challenges in the real world.
  •  … ensures continuous improvement and development by the patient through continued training and consultation with therapists after the required formal DBT sessions are over.

What are the 5 Functions of DBT?

 As mentioned above, DBT is a comprehensive program of treatment which is why other clinicians find DBT overwhelming. While techniques may vary, you can tell that a program is truly committed to the DBT approach if it addresses the following five main functions of the treatment method:

 Enhancing Capabilities

 DBT assumes that the patient either lacks or need to improve essential life skills to address their addiction, which is why improving skills is one of the major functions of DBT. 

 Generalizing Capabilities

 The skills acquired in the sessions should be applied in real life and not just left within the confines of the therapy room. This is the reason why the second critical function of DBT involves providing treatment gains to assist in the patient’s daily life and natural environment.

 Improving Patients Motivation and Reducing Behaviors Considered Dysfunctional

 The third function of DBT is focused on ensuring that the patient is continuously motivated and exerting effort to diminishing certain dysfunctional behaviors that will not contribute to a life that is worth living.

 Enhancing and Maintaining Therapist Capabilities and Motivation

 Considering that the role of the therapist is critical in DBT and addiction, another important function of DBT is to maintain the motivations, focus, and skills of the therapists who are treating the patients.

 Structuring the Environment

 The last important function of DBT involves helping the patient restructure his environment in a way that will reinforce his behavioral progress and deter problematic behavior. For instance, drug dependent patients would learn how to avoid hanging out with friends who promote drug use.

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What are the Capabilities or Skills Developed and Improved in DBT?

 In connection with the first function of DBT discussed above, here are the skills that patients must learn and develop while undergoing DBT treatment:

  •  Mindfulness skills – paying attention to the experience of the present moment and controlling attention. People usually abuse drugs because they are preoccupied with distracting themselves to avoid worries about the past or the future. By learning this skill, one gets to be fully immersed in the here and now. 
  • Distress tolerance skills – the ability to tolerate stress and hardships and surviving crises without making the situation worse. Abusing drugs is one of the most destructive ways to cope with stress and difficulties. By learning this skill, one can learn positive ways to manage distress.
  •  Interpersonal effectiveness – the ability to effectively go through interpersonal situations. DBT teaches the patient how to effectively deal with other people and to have meaningful interactions with others.
  •  Emotional regulation skills – ability to identify unwanted feelings and finding ways to control or change them. When people abuse drugs, they try to deny or run away from what they are feeling. DBT and addiction treatment will teach them how to address these emotions head on. 

What Can You Expect During DBT and Addiction Treatment?

 To attain the goals and functions of DBT, this treatment method involves the following strategies that complement and support each other:

 Individual Therapy Sessions

 DBT and addiction treatment require individual therapy sessions or one-on-one contact with a trained and experienced therapist who will ensure that all treatment requirements of the patients are being addressed. The therapist will ensure that patients stay motivated all throughout the treatment, that they will apply the DBT skills they have learned in their daily life, and that they will be able to overcome whatever challenges will arise during treatment. 

 Group Therapy Sessions

 DBT also make use of group therapy sessions wherein patients practice DBT skills together. During these sessions, the members of the group are encouraged to share their experiences and to offer support to each other. During group therapy sessions, the patients are taught coping skills, relaxation techniques, anger management, and conflict resolution, among many others.

 Phone Coaching

 There are times wherein patients need immediate solutions to pressing problems outside the therapy schedule. When this happens, patients can call their therapist who will then provide guidance and coaching. This strategy is used with discretion especially since this service can be abused by patients.

What are the Advantages of Utilizing DBT as Treatment for Addiction?

 DBT is very different from the many addiction treatments available primarily because it looks at the patient’s mental health condition and how it affects his addiction, and vice versa. Specifically, DBT offers the following benefits:

 It does not punish the patient for taking drugs since DBT assumes that drug dependents do the best they can under the situation.

  • It allows the therapist to determine the level of abstinence suited for the patient’s condition.
  •  It addresses the most serious problems first before moving on to the less serious ones, rather than trying to solve all problems at once.
  •  It encourages the patient to transition from an “addict mind” to a “clear mind” which is crucial in achieving long-term sobriety. 
  •  It uses several techniques that help patients stay and actively participate in treatment. 
  •  It helps patients learn essential skills needed to help them accept themselves and realize their need to change.

 Is DBT for Everybody?

 Yes. DBT has been thoroughly assessed and found to be suited and effective for individuals regardless of race, age, gender, and sexual orientation. DBT and addiction treatment is one of the few evidence-based psychological treatments approaches widely-used all over the world. 


What are the Factors that You Need to Consider When Looking for a DBT Therapist?


Considering that DBT is unlike other ordinary addiction treatments, it is critical that you find a reputable, experienced, and highly-skilled therapist to assist you. Below are the critical factors that you need to consider when searching for a DBT therapist for your addiction problem:

  •  Educational Background: Make sure that the therapist you are considering has completed a master’s or doctoral degree in counseling or clinical psychology from an accredited college or university.  
  •  Training: A good DBT therapist had clocked in hundreds of hours working with individuals and groups with substance abuse disorders and those with other psychological health issues.
  •  License: Check whether the therapist you are considering had passed the required state exam in the area where he or she is practicing.
  •  DBT Experience: Confirm the number of years the therapist had been practicing DBT as this is a good indication of how adept he is on DBT. You can also ask for his or her client list so you can check with his clients personally on how good the therapist is. 

How to Find DBT-Trained Therapist in Your Area?

 To find a DBT-trained therapist in your area you may ask referrals from your doctor or other trusted medical professionals. You may also check out DBT Clinical Resource Directory to find therapists who have completed the Dialectical Behavior Therapy Intensive Training or the Dialectical Behavior Therapy Foundational Training. 

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