Dialectical Behavioral Therapy: Effective Addiction Treatment for Drug and Alcohol Abuse
Dialectical behavioral therapy (DBT) is a specialized psychotherapy that is mainly used to treat mental health conditions. However, it has been adapted for substance use disorders and addiction treatment. DBT is very effective in teaching healthy coping skills and the ability to avoid actions that reinforce drug use. Dialectical behavioral therapy helps reduce cravings for drugs and alcohol. It also helps recovering addicts avoid situations that can lead to relapse.
At this point, you might wonder if there is truly a need for dialectical behavioral therapy in addiction treatment? It may surprise you to learn that an estimated 20 million Americans are battling alcohol and drug abuse, yet only 2.5 million receive the specialized addiction treatment they need.1 One of the key elements of specialized addiction treatment is psychotherapy. Psychotherapy provides the necessary support system for people recovering from substance abuse. Counselors and therapists build a relationship of trust with recovering addicts and provide them with judgment-free guidance and the resources to overcome their addictions. An individualized treatment plan is typically needed to achieve lasting recovery from drug abuse and alcoholism. This includes focusing on various areas of an individual’s life that serve as triggers and led to addiction in the first place. Therapy also helps improve a person’s mental and physical health and addresses professional, financial, and legal issues. Addiction treatment includes a combination of group and individual therapy sessions and various effective therapy techniques, one of which is dialectical behavioral therapy.
What is dialectical behavioral therapy?
Dialectical behavioral therapy is a type of psychotherapy (talking therapy) that is frequently utilized in people with a variety of emotional difficulties and mental illnesses. It is practiced in schools, community centers, hospitals, and specialized inpatient and outpatient addiction treatment facilities. It was developed by Marsha M. Linehan, a well-known psychologist, several decades ago. DBT is particularly useful in addiction treatment because it helps recovering addicts learn skills to cope with strong emotions and cravings for alcohol and drugs.
DBT was initially developed for individuals with suicidal ideation and borderline personality disorder. It was later discovered that DBT is effective in treating a variety of mental illnesses, such as depression and PTSD, as well as substance use disorders. Dialectical behavioral therapy is now a well-established evidence-based treatment in alcohol and drug rehab. It is used to treat a range of addictions, including alcohol, marijuana, methamphetamines, cocaine, heroin, and prescription painkillers. DBT is effective in reducing substance use, encouraging abstinence, and preventing relapse.
The word dialectical means two opposing things can be simultaneously true. Dialectical behavioral therapy encourages recovering addicts to strike a balance between two opposites – change and acceptance. Acceptance refers to making peace with the current circumstances and doing the best one can. Change refers to working toward goals and altering behaviors to overcome addiction.
What happens during a DBT session?
During a dialectical behavioral therapy session, the therapist helps a recovering addict understand the behaviors that lead to substance abuse. A back-and-forth debate (dialectics) takes place between patient and therapist. This helps to identify false beliefs and arrive at the truth. The idea is to help recovering addicts understand three fundamental concepts:
- Thoughts, emotions, and behaviors are interconnected
- Change is inevitable
- Acceptance and change, although opposites, can exist in balance
Individuals receiving dialectical behavioral therapy learn to accept the things they cannot change and the courage to change the things that can improve their lives. The emphasis is on the psychosocial aspects of addiction treatment. Four techniques are used to achieve this – individual therapy, weekly group therapy, skills coaching, and interdisciplinary consultations.
How is DBT different from CBT?
Dialectical behavioral therapy originated from the principles of another type of psychotherapy called cognitive-behavioral therapy (CBT).2 Both types of therapy have the same underlying principle, i.e., addiction is the result of emotional vulnerability and a triggering environment. People who suffer from substance use disorders are emotionally vulnerable and react rapidly and strongly to intense situations. However, CBT is different from DBT in that it places an emphasis on change. DBT, on the other hand, helps recovering addicts understand why they behave in a certain way.
What dialectical behavioral therapy does is introduce validation and optimism to addiction treatment. Recovering addicts are encouraged to accept their current circumstances and develop the desire to change in order to overcome their addiction. DBT is more flexible than CBT and has relatively lower dropout rates. Moreover, CBT is usually offered through individual therapy sessions, whereas DBT can be provided through group therapy and phone consultations as well.
Goals of dialectical behavioral therapy
The primary goal of dialectical behavioral therapy is to reward and reinforce healthy behaviors and move recovering addicts closer to their goal of a sober life. Therapists work with the individual to identify target behaviors that need to be increased or enhanced. For instance, someone with an alcohol use disorder is encouraged to reduce thoughts about drinking or avoid situations where drinking is common. The goal is to keep the person safe while on the road to recovery by reducing reckless behaviors. Also, recovering addicts learn to manage stress through positive emotions. This helps reduce the risk of relapse once addiction treatment is completed. The effects of dialectical behavioral therapy last well beyond the course of treatment.
DBT for Substance Use Disorders
Dialectical behavioral therapy is a useful addiction treatment modality that helps recovering addicts move toward a healthy, happy, drug-free future. DBT is particularly effective in people who experience extreme emotions and mood swings and who always seem to be in some crisis or the other. Such individuals tend to see the world in black-and-white and don’t have the skills to cope with sudden, intense emotions. Dialectical behavioral therapy helps such people react less intensely to emotional situations. The DBT therapist guides recovering addicts to develop the skills to handle strong emotions without relying on alcohol or drug use.
Choosing a dialectical behavioral therapist
If you or a loved one is struggling with alcoholism or drug abuse, dialectical behavioral therapy could help. Addiction treatment is one of the biggest challenges an individual will face in their lifetime. A good DBT therapist can help recovering addicts attain the goals that often appear unattainable at the start of addiction treatment. Therapists who provide dialectical behavioral therapy undergo a considerable amount of specialized training. This enables them to understand the person’s unique circumstances as they relate to alcohol or drug use. Highly experienced DBT therapists guide recovering addicts toward the changes necessary to ensure lasting recovery from substance abuse. The relationship between a good DBT therapist and the client is one of equals and both work in collaboration.