Dialectical Behavior Therapy (DBT) for Addiction Treatment

Dialectical behavioral therapy, commonly referred to as DBT is an evidence-based form of psychotherapy used to treat people with multiple mental health conditions.¹ Developed by psychologist Dr. Marsha Linehan and her colleagues in the 1980s, DBT, largely based on cognitive-behavioral therapy (CBT), was used to treat severe mental health conditions and high-risk behaviors, such as chronic suicidal ideation, specifically.² The main difference between CBT and DBT is that the latter focuses on validating and accepting uncomfortable feelings rather than avoiding or working around them.² Now, individual and group treatments commonly employ DBT for conditions such as borderline personality disorder (BPD), depression, anxiety disorders, and substance use disorders (SUD), a medical condition defined by an uncontrollable use of substances despite the negative consequences.¹

The Four Skills Taught in DBT

The DBT approach is multidimensional and comprehensive and relies on learning skills to change unhelpful thoughts and behaviors. This is especially useful in addressing some of the underlying factors that can contribute to substance use.

Therapists using DBT teach critical behavioral skills by modeling, providing instructions, telling stories, practicing, giving feedback, and coaching.¹ DBT uses a variety of strategies and techniques to do this including:¹

DBT Treatment Components

Dialectical behavioral therapy consists of four key components, including:^3,4

What Does DBT Treat?

Dialectical behavioral therapy was created with the intent to primarily treat women with suicidal tendencies.³ Since its development nearly 40 years ago, DBT has proven to be most effective for treating individuals with borderline personality disorder (BPD) when compared to other community-based behavioral therapy approaches.⁴ However, studies have shown that DBT is effective at treating other disorders, including substance use disorders. Researchers continue to investigate DBT’s effectiveness with other mental health conditions besides BPD. These include:^1,4-9

• Other personality disorders, such as antisocial personality disorder and narcissistic personality disorder.
• Anxiety disorders.
• Depression.
• Eating disorders.
• Bipolar disorder.
• Substance use disorders.
• Attention deficit hyperactivity disorder (ADHD).
• Post-traumatic stress disorder (PTSD).

Using Dialectical Behavioral Therapy For Addiction Treatment

Research indicates that dialectical behavioral therapy is effective in treating people with borderline personality disorder with co-occurring substance use disorders.¹ Several clinical trials suggest that DBT may also be effective in treating individuals with a substance use disorder and other co-occurring disorders, or individuals who have not responded to other evidence-based substance use disorder treatments.⁷

A substance use-focused DBT approach encourages individuals to commit to abstinence and work to bolster their motivation to change through the various activities and techniques.⁷ DBT for alcohol and drug addiction treats relapse as a problem to solve; therefore, therapists help the individual assess the events that led to the relapse and work to help them repair the harm they caused themselves and others as a result of the relapse.⁷ The idea is to increase the individual’s awareness surrounding the negative consequences associated with drug or alcohol use.⁷

How Long Does DBT Typically Take?

There’s no single answer to how long DBT takes, as it depends on your individual goals, the complexity of your challenges, and your commitment to the process. DBT often involves individual therapy, group skills training, and phone coaching, and your therapist will work with you to create a personalized treatment plan. While duration varies, the focus is always on equipping you with lifelong skills to manage emotions and navigate challenges effectively.

Benefits of DBT in Addiction Treatment

By taking an addiction-focused approach to DBT, many individuals can benefit from treatment. Some of the benefits might include:⁷

• A decrease in substance use.
• A decrease in the physical discomfort associated with withdrawal symptoms.
• A drop in substance-related impulsivity, cravings, and temptations.
• Creating and enforcing boundaries necessary for abstinence.
• Avoiding triggers and precipitating events that could lead to substance use.
• Reducing problematic behaviors that contribute to substance use.
• Increasing healthy interpersonal relationships through community and other environments that support the individual’s success.

How Effective is DBT for Addiction Treatment?

While there is no conclusive evidence that DBT helps to treat a stand-alone substance use disorder, studies indicate that DBT can be a helpful component in a comprehensive treatment plan for an individual with a SUD and co-occurring mental health disorders, such as depression or borderline personality disorder (BPD).¹² In one study of women with BPD and co-occurring substance use disorders, individuals who received DBT showed reductions in substance misuse during a year of treatment (and in the 4-month follow-up) and dropped out of treatment less often than individuals who did not receive DBT as part of their treatment plan.³

How to Find DBT Treatment

DBT can be an effective therapy for individuals. Therapists who facilitate DBT groups are specifically trained on providing this type of treatment. The first step in finding if dialectical behavioral therapy is right for you is to talk with your doctor and mental health provider, who can evaluate your symptoms, treatment history, and therapy goals.

American Addiction Centers (AAC) offers DBT at select treatment facilities. If you’re unsure whether DBT might be appropriate for you, you can talk with your mental health professional or talk with a knowledgeable admissions navigator at AAC to find a treatment facility where you can be evaluated.

Does Insurance Cover the Cost of Dialectical Behavioral Therapy?

DBT may be covered by your insurance provider in conjunction with your inpatient or outpatient treatment plan. This depends on your specific health insurance plan. To see if your insurance provider covers all or at least part of the cost of rehab treatment, call us or use our online verification form.

When you’re ready to begin your journey to recovery, American Addiction Centers is here to support you every step of the way. To learn more about your treatment options, get answers to your questions, and to get started on the path to healing you can reach out to us at . Our admissions navigators are on hand to help.

If you’re not ready to talk, but still need support, we offer a free no-obligation text support line. Get the help you deserve, when you need it, no strings attached.