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An Overview of Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is a type of cognitive behavioral psychotherapy that aims to identify and change negative thinking patterns and pushes for positive behavioral changes. Developed in the late 1980s by psychologist Marsha Linehan, it was originally designed to help in the treatment of borderline personality disorder. Today, DBT is utilized in the treatment if alcoholism and drug addiction, and other kinds of mental health disorders.

DBT Components

Standard comprehensive DBT has four parts: individual therapy, skills training group, phone coaching, and therapist consultation.

  1. Skills training group includes sessions that enhance patients’ ability to change negative behaviors. The group leader teaches these skills and assigns homework for clients to practice the skills in their everyday life. The group meets weekly for about 2.5 hours and it take 24 weeks to get through the full skills curriculum.
  2. Individual therapy focuses on enhancing patients’ motivation and encouraging them to stay in treatment. It teaches them to apply the skills to certain challenges and events in their lives. This therapy takes place once a week.
  3. Phone coaching offers patients live coaching when they are facing a difficult situation, such as a relapse. They are coached on how to use skills to effectively cope with these situations by the help of a therapist outside of normal session time.
  4. Therapist consultation is a platform for the therapist who are offering DBT. The consultation team is intended to be therapy for the therapists and to support DBT providers in their work with people who suffer from difficult-to-treat disorders.

DBT Skills

DBT process involves four sets of behavioral skills, including:

  1. Mindfulness: mindfulness is the practice of being fully aware and present in this one moment. By practicing mindfulness, patients become aware of their thoughts, feelings, actions, and reactions. DBT patients often live in the past, preventing them to enjoy a happy life. Mindfulness can relieve those traumatic experiences that cause emotional distress and outs them in control of their own minds.
  2. Distress Tolerance: this type of therapy is used to help individuals cope and survive during a crisis, and helps them tolerate short term or long term pain (physical or emotional). It teaches clients that there will be times when pain is unavoidable and the best course is to learn to accept and tolerate distress.
  3. Emotion Regulation: Many patients experience explosive emotions and they enter therapy with the inability to control their emotions in provocative situations. By learning the skill of emotional regulation, patients learn how to control their emotions and reduce emotional vulnerability.
  4. Interpersonal Effectiveness: the way patients communicate with others has an important impact on the quality of their relationships. In order to communicate more effectively, DBT patients learn how to approach conversations in a more thoughtful and deliberate manner, maintain their self-respect, and be respectful of others.


Stages of DBT Treatment

DBT systematically and comprehensively treats issues in order of severity. Treatment happens in four stages and all concerns are addressed.

Stage 1: the focus of this stage is stabilization and eliminating life-threatening behaviors such as suicide attempts, suicidal thinking, self-injury, and aggressive behaviors. This stage also strives to decrease therapy-interfering behaviors such as missing sessions and it doing homework, and reduce behaviors that interfere with the quality of life including not going to work or school, anger outbursts, skin picking and the likes. It increases behaviors that will enable a happy and fulfilled life, and encourage skills that help build meaningful relationships, manage emotions, and deal effectively with life problems.

Stage 2: in this stage of treatment behaviors are more stable but mental health issues are still present. The goal here is to patients fully experience their emotional pain and explore their traumatic experiences.

Stage 3: this stage puts an emphasis in enhancing the quality of life through maintenance of progress and reasonable goal-setting. It promotes happiness and stability, respect for self and others, and solving ordinary life problems.

Stage 4: during the course of this stage, therapists support patients in improving their learned skills and working towards spiritual fulfillment. The main goal is to help patients achieve and maintain a life worth living.

Addictions and Mental Health Disorders Treated by DBT

Today, DBT is widely utilized and offered through a wide range of mental health programs, community treatment centers, inpatient rehab facilities, hospitals, and school systems and some workplaces. Studies show that this type of therapy greatly helps in treating addictions and mental health disorders such as:

  • Alcohol
  • Tobacco or nicotine
  • Prescription pain medication
  • Opiates
  • Stimulants
  • Depressants
  • Antidepressants
  • Hallucinogens
  • Illegal drug addiction
  • Eating disorders
  • Recreational drug addiction
  • Depression
  • Post-traumatic stress disorder

DBT in the Treatment of Addiction

The term “dialectical” means a synthesis or integration of opposites. It comes from the idea that bringing together two opposites in therapy, acceptance and change, brings better results than either one alone. DBT focuses on encouraging patients to accept themselves as they are and to make positive changes in their life. DBT therapists accept clients as they are while also acknowledging that they need to change in order to reach their goals. Moreover, the four skills modules include two sets of acceptance-oriented skills, mindfulness and distress tolerance, and two sets of change-oriented skills, emotion regulation and interpersonal effectiveness.

When DBT is applied to addiction, it aims to restore balance to a patient’s emotional instability and eliminate their dependency. It pushes for immediate and permanent cessation of drug abuse, while also instilling the fact that a relapse does not mean that the patient cannot achieve the desired result. It applies nonjudgmental, problem-solving responses to relapse and incudes techniques to reduce the dangers of overdose, infection, and other harmful consequences.

A typical DBT program focuses on:

  • Carefully decreasing drug abuse
  • Lowering withdrawal symptoms
  • Eliminating cravings and relapse urges
  • Teaching coping behaviors
  • Increasing emotional connections and communication skills
  • Restoring emotional balance
  • Encouraging participation in recreation or vocational activities that support abstinence

The Effectiveness of DBT

Findings from multiple studies confirm the efficacy of DBT, particularly in the treatment of borderline personality, addiction, suicidality, and post-traumatic stress. Patients who received DBT significantly lowered their drug use and had an easier time adjusting to emotional difficulties and interacting with people socially.

DBT effectiveness lies in the way that it helps deal with emotional dysfunction. This therapy understands that most addictions stem from a deeply rooted emotional problem. DBT identifies with these disorders and helps patients find active and diverse methods for healing. Patients are taught how to implement coping methods that will positively change their addictive behaviors that have caused them difficulties for their whole life.

Research shows that DBT is effective at:

  • Reducing substance abuse
  • Treatment dropout rates
  • Depression
  • Anger
  • Suicidal behavior
  • Psychiatric hospitalizations
  • Non-suicidal self-injuries
  • Improving social functioning

The cost for DBT varies, depending on the treatment facility and whether your insurance will cover this form of treatment. Generally, the cost of one-year DBT program costs $6,000, with individual sessions costing roughly $4,800 and skills group sessions costing about $1,900.

For more information please call our Addiction Treatment Helpline at (844) 439-4765. This is a Free and completely confidential call. We are available 24/7. In many cases, your health insurance company will cover 100% of the treatment cost. So please call now.

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