DBT Drug Addiction Treatment

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DBT drug addiction treatment is a popular method used to help substance use abusers recover from addiction. In the following article we will define DBT, explore Dialectical Behavior Therapy techniques and explain how they are used to aid in recovery for drug users and alcoholics in inpatient and outpatient rehabs.

What is Dialectical Thinking?

Dialectical thinking is one’s ability to view potentially contradictory information from multiple different perspectives in order to reconcile a reasonable and economic outcome. In the simplest of terms, it is the ability to look at all sides of the story, especially when the story triggers irregular emotional responses. Therefore, Dialectical Behavior Therapy (DBT) teaches one to master the skill of thinking cognitively before reacting emotionally. It is a scientifically proven method of therapy for those with suicidal behaviors, borderline personality disorder, and other serious mental and emotional disorders, as well as addiction treatment

What Is Dialectical Behavior Therapy?

DBT (Dialectical Behavior Therapy) combines the efforts of cognitive and scientific behavior therapy with the teachings of acceptance and mindfulness to – essentially – help people regulate their emotional responses to situations. DBT was developed by American psychiatrist Dr. Marsha M. Linehan [1] in the 1970s.  It’s proven to be especially beneficial to those whose minds tend to take things to the extreme when they hear something mildly discomforting or obstructive. 

Why these emotional responses happen can vary from childhood trauma to addictive tendencies, but almost everyone that partakes in this therapy has some sort of emotional sensitivity that leads to emotion dysregulation. Since the 70s, Dr. Linehan has helped countless patients learn how to master their self-defeating thoughts by increasing self-awareness and modifying their thinking habits in order to better handle conflict and stress.

DBT Treatment Guidelines

She also developed a set of four core principles that are standard during all DBT sessions. Think of this as a set of guidelines one can trust the therapist will always adhere to. 

They include: 

  1. The primacy of the therapeutic relationship 
  2. A non-judgmental approach 
  3. The ability to differentiate between effective and ineffective behaviors
  4. Obtaining the skill of dialectical thinking 

It is through these four principles that patients progress through the following five main DBT therapy steps to achieve the ability of emotional regulation and dialectical thinking. 

DBT Therapy Steps

These five stages include: 

  • Precontemplation 
  • Contemplation 
  • Preparation 
  • Action 
  • Maintenance 

These five stages are something that tends to happen naturally as the therapy progresses and are oftentimes unnoticed by the patient themselves. The goal is simply to unlock a level of emotional intelligence within the person that they haven’t had the chance to achieve on their own. 

DBT Therapy Techniques

During Dialectical Behavior Therapy, therapists are adamant about the patients completing each of the four modules of the treatment. The order in which the modules are completed is also crucial to the success of the overall treatment. Regardless of a person’s background, it seems that all patients naturally gravitate toward this module order, so it only seems fitting. 

Below are the four modules and a description of each of the DBT therapy techniques: 


1. Mindfulness

Mindfulness is basically the foundation of DBT. It’s the skill that, once learned, helps patients with the rest of the therapy. It is the same concept found in Buddhist practices, one that teaches the student to remain in the present moment. Learning mindfulness allows the patient to pay attention to and embrace the present moment as well as feeling all emotions fully in each moment and with perspective. In other words, when a patient’s emotions have them thinking too far in the past or future, the reminder of mindfulness helps to bring them back to the present. In turn, this helps them see the situation and their emotions for what they truly are. 

It teaches the mantra of “radical acceptance” or “reality acceptance,” which are the ideas that both positive and negative situations should be faced without judgment. 

Mindfulness in Action

Below are some different mindfulness skills that are practiced: 

  • Observation: Observe one’s inner and outer worlds objectively/without judgment

  • Base thoughts on facts rather than what is “good,” “bad,” “right,” or “wrong.”
  • Description: The Allowance of full expression of what the patient has observed
    • Focus on one thing or one moment at a time to better understand what each emotion is and where it derives from. 
  • Present Participation: When a person focuses fully on what they are doing
    • Allows one to effectively do what they intend to do. 

2. Distress Tolerance

In the words of Dr. Linehan herself, “Distress tolerance skills [2] allow a person to survive an immediate emotional crisis without making it worse.” Patients are also reminded of the acceptance and mindful module, in which they can better accept their current reality, even when they feel out of control and desperately want to change the situation. 

Furthermore, this acceptance helps patients to even accept the emotions they don’t quite understand or cannot label at the moment. 

12 Crisis Survival Skills

During this module, patients are taught crisis survival skills that help them achieve the above-stated mental states. The most common skills include: 

  • Self-Soothing Techniques: Based on their five senses
  • The Stop Skill: To stop them from impulsive behaviors
  • Pros and Cons: Gets them to think cognitively during crisis mode
  • Radical Acceptance: Realizing they cannot change the situation and learning to accept it for what it is
  • Distraction: Help in situations when a person feels particularly overwhelmed 
  • Improving the Moment: Imagery 
  • Meaning 
  • Prayer 
  • Relaxation 
  • One thing in the moment
  • Vacation 
  • Encouragement 


All of these dialectical behavior therapy techniques are short-term coping strategies. They help to mentally slow the person down when they are in emotionally painful situations in order to prevent self-harming behaviors, running away or avoiding the situation, denying the reality of the situation, and even using drugs. The only way a patient can attempt to one day regulate their emotions is if they first learn proper distress tolerance techniques.

3. Emotional Regulation

In this module of DBT, the patient learns to identify their emotions. It doesn’t stop there, though. Once the emotion is identified, the person learns to be mindful of how that emotion impacts their behavior. From there, the patient can apply their distress tolerance techniques to pull the gas from the fire and regulate the situation in a cognitive manner. 

Perhaps the hardest part for someone with intense emotional responses is the ability to label their emotions. Oftentimes, they don’t know what they are feeling. All they know is that it causes immense pain and distress and potentially sends them into their fight or flight mode of survival. Therefore, this module teaches how to first identify and label emotions. 

Then, patients are taught how to be mindful and present with their emotions. This helps the patient identify why their instinctive yet impulsive reaction occurs and how to use their distress tolerance skills to better monitor that initial reaction and remain present. 

The Story of Emotion

The main skill taught during this module is called the “Story of Emotion,” in which the patient describes: 

  • The event that occurred
  • Their interpretation of it
  • The sensations felt in the body
  • The body language that ensued 
  • Which action they were urged to do
  • The action that ensued
  • Naming the emotion-based from this list

This DBT therapy step tends to be the longest because therapists want the patient to really get in the habit of completing the first three modules in every stressful situation, so they can then achieve Interpersonal Effectiveness.

4.Interpersonal Effectiveness

Interpersonal Effectiveness essentially teaches the patients how to maintain relationships after stressful or crisis situations occur. Simply put, this module focuses on the patient’s ability to effectively communicate their needs, how to cope with conflict, and the importance of setting boundaries. By implementing the other modules, the patient learns to be mindful in communicating their needs, how to identify and control their emotions when communicating those needs, as well as how to control their distress in the event of relationship conflicts.

Interpersonal Effectiveness Skills

Some of the skills taught in this module include: 

  • Dear Man: Teaches how to convey one’s personal needs to another in an effective manner
  • Give: Teaches how to better maintain all relationships
  • Fast: Teaches how to maintain one’s relationship with themselves and their self-respect 
  • Problem Solving: Puts the patient in real-life scenarios during group therapy sessions to practice putting their skills to use. 

This DBT therapy step really helps to put the other modules to use so patients feel confident they can continue these dialectical responses when they aren’t in a therapeutic setting. 

DBT for Addiction

When someone chooses to remove drugs or alcohol from their life after a dependency, it can present similar feelings to those experienced by someone with a personality or mood disorder. Their fight or flight kicks in, and they are forced to deal with emotions they haven’t dealt with. This can cause an influx of emotion dysregulation that becomes nearly impossible to manage on one’s own volition. 

DBT drug addiction treatment provides that sense of regulation and confidence the person needs during the most vulnerable stages of their recovery, so they can then apply this to their life and change their surroundings for the better. 

Dialectical Behavior Therapy Techniques for Addiction

Typical DBT drug addiction and substance abuse treatment techniques used include: 

  • Skills Training: Participants are taught all of the skills from the traditional four modules.
  • Individual Therapy: Gives those in recovery the respect and boundaries they haven’t given themselves and allows them to learn at their own pace without outside pressure. 
  • Phone Coaching: Allows the patient to call their therapist when difficult situations happen outside of their therapy sessions. This provides an added layer of assistance so the person can begin learning how to apply their skills in the real world from very early stages in their treatment. 
  • Group Therapy: This is important for the relationship building and maintenance part of the treatment, as well as providing a safe space to run through real-life scenarios. 


Benefits of DBT Drug Addiction & Substance Abuse Treatment

Dialectical Behavior Therapy techniques provide countless benefits for those in recovery, including a higher chance of maintaining their path of recovery long after they leave a rehabilitation center. It teaches them life skills and emotional intelligence that will allow them to accomplish their dreams while maintaining their self-respect and the health of their relationships with others. 

For example, using mindfulness in recovery from addiction can promote healthier thought patterns by altering the brain’s pathways. DBT for substance abuse and drug addiction continues to prove itself in its effectiveness for anyone that undergoes this form of addiction treatment. 

Do you or a loved one suffer from addiction? Reach out to Avenues Recovery for guidance on how DBT drug addiction and substance abuse treatment can aid in recovery. One of our friendly motivational coaches can support you in choosing the treatment method that’s right for you.


[1] en.wikipedia.org

[2] positivepsychology.com

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