Dialectical Behavior Therapy (DBT) Programs

Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan in the 1980s, is a comprehensive cognitive-behavioral treatment combining acceptance and change strategies. While originally designed for borderline personality disorder, DBT has proven highly effective for addiction treatment, particularly for individuals with emotional dysregulation, impulsive behaviors, and co-occurring mental health conditions.

The Four DBT Skill Modules

DBT teaches four essential skill sets directly applicable to addiction recovery:

• Mindfulness: Developing present-moment awareness without judgment; observing thoughts, emotions, and urges without automatically reacting
• Distress Tolerance: Surviving crises and tolerating difficult emotions without making situations worse through substance use or impulsive actions
• Emotion Regulation: Understanding, naming, and managing intense emotions; reducing emotional vulnerability
• Interpersonal Effectiveness: Asserting needs, maintaining self-respect, and strengthening relationships while managing conflicts

DBT Treatment Structure

Standard DBT includes four components: weekly individual therapy addressing specific issues and treatment targets, weekly skills training group (2-2.5 hours) teaching the four modules, phone coaching between sessions for applying skills during crises, and therapist consultation teams ensuring quality treatment. Adapted DBT models exist in addiction treatment settings, maintaining core principles while adjusting format.

Who Benefits from DBT

DBT is particularly effective for individuals with co-occurring depression, anxiety, PTSD, personality disorders, or those experiencing intense emotions, impulsive behaviors, self-harm, chronic suicidal ideation, relationship difficulties, or who haven't succeeded with other treatments. DBT addresses complex, chronic cases requiring comprehensive skills training.

Dialectics in Recovery

"Dialectical" refers to balancing opposites - acceptance AND change. DBT validates current struggles while promoting change. In addiction, this means accepting yourself while working toward sobriety, acknowledging difficulty while building skills, and recognizing both strengths and areas needing growth. This balanced approach reduces shame and resistance while supporting sustainable change.

Resources for DBT:

• Behavioral Tech - DBT Resources
• SAMHSA