Dialectical Behavior Therapy, also known as DBT, encourages people to examine their opinions, thoughts, and reactions.
This type of therapy works towards achieving a balance between acceptance and change, empowering people with substance use disorders towards the steps they need to take to live a life free of drugs and alcohol.
A Brief History of Dialectical Behavior Therapy
Developed in the late 1980s and early 1990s by psychologist Dr. Marsha M. Linehan Ph.D, ABPP, the specific purpose of dialectical behavior therapy, according to an article in Psychiatry MMC, was to help in the treatment of multi-problematic, suicidal women. DBT treatment became very popular and was found to be significant in the treatment of borderline personality disorder and severe personality disorder.
Research has shown that dialectical behavior therapy is often an effective and successful treatment for a wide array of other disorders. Several of these conditions include:
- Substance abuse
- Post-traumatic stress (PTSD)
- Depression
- Eating disorders
- Anxiety
- Non-suicidal self-injuries
What Is Dialectical Behavior Therapy?
A branch of psychotherapy, dialectical behavior therapy is based on the principles of cognitive behavioral therapy, also known as CBT. By making several additions and modifications to CBT, clients using DBT learn new skills and strategies that they need to decrease relationship conflicts and manage their painful emotions. By emphasizing both individual psychotherapy and group skills training classes, DBT helps people learn and use their new skills to build a life that they feel is worth living.
Dialectics is the idea that change is constant, everything is connected, and opposing forces can be brought together to find balance. According to ResearchGate, “The word dialectic refers to the synthesis of two opposites. The fundamental principle of DBT is to create a dynamic that promotes two opposed goals for patients: change and acceptance.”
Dialectical Behavior Therapy and Recovery from Substance Abuse
For individuals who suffer from an addiction to drugs or alcohol, there are specific behavioral targets within the guidelines of dialectical behavior therapy. These targets are stated by Linda A. Dimeff in an article in ResearchGate titled Dialectical Behavior Therapy for Substance Abusers and include:
- Decreasing the instances of substance abuse, including both illegal drugs and legally prescribed drugs that are used in a way not prescribed
- Alleviating physical discomfort associated with withdrawal or abstinence
- Diminishing cravings, temptations, and urges to abuse
- Avoiding opportunities and cues suggestive of substance abuse, such as getting a new telephone number and making the decision to throw away drug paraphernalia
- Reducing behaviors conducive to drug abuse
- Increasing community reinforcement of healthy behaviors such as rekindling old friendships or pursuing social/vocational activities that support abstinence
The Five Essential Functions of Dialectical Behavior Therapy
According to an article in The US National Library of Medicine, there are five essential modes, or components, of treatment in dialectical behavior therapy. These components work together to make up a standard dialectical behavior therapy program. Each component of treatment is intended to meet a specific function, or objective.
The following are the five functions and their components:
- Improving patient motivation to change – individual psychotherapy
- Enhancing patient capabilities – dialectical behavior therapy skills training
- Generalizing new behaviors – in the moment coaching
- Structuring the environment – case management
- Enhancing therapist capability and motivation – DBT consultation team
The Four Modules of Skills Training
DBT’s four modules of skills training include: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation.
- Mindfulness is being fully aware of and immersed in the present. When a person is mindful, they are engaged in their current setting and their current experience. Often people that suffer with substance abuse problems are distracted from the here and now by worrying about the future or thinking about the past.
- Distress tolerance helps individuals learn how to deal with negative emotion. Generally, when people experience feelings of distress, they have an urge to change or reduce it immediately. An unhealthy example of a way to try to escape from it, is using drugs or alcohol. Distress tolerance teaches people how to tolerate and accept distress and negative emotions, instead of trying to escape from it.
- Interpersonal effectiveness is learning techniques and skills that allow a person to communicate and interact with others in a way that maintains self-respect, is assertive, and strengthens relationships. This helps people to have effective and happier interactions and relationships with others. Individuals learn how to say no and ask for what they want while maintaining self-respect and relationships with others.
- Emotional regulation provides methods and strategies that teach ways of communication and conflict resolution to manage and change strong intense emotions that are causing problems in an individual’s life. Emotional regulation works to identify feelings that are unwanted and explore different ways to change them while distress tolerance moves towards acceptance.
A Final Thought on Dialectical Behavior Therapy
The words of Linda Dimeff sum up DBT this way: “When dialectical behavior therapy is successful, the client learns to envision, articulate, pursue, and sustain goals that are independent of his or her history of out-of-control behavior, including substance abuse, and is better able to grapple with life’s ordinary problems.”
If you or a loved one is suffering with substance addiction, there is help available. Finding the right place for treatment is essential. At Canyon Vista Recovery Center in Mesa, Arizona, clients are provided with a full continuum of care that combines traditional and holistic therapies.
