Dialectical Behavior Therapy (DBT) is a modified form of cognitive behavioral therapy that is used to treat individuals with severe and multiple psychosocial disorders and patients who are chronically suicidal. Because a high number of people with mental health disorders also suffer from a substance use disorder (SUD), DBT has been modified to treat patients with co-occurring disorders. In fact, 51 percent of people diagnosed with a mental illness also suffer from a substance use disorder. The 2014 National Survey on Drug Use and Health sponsored by SAMHSA identified 43.6 million people suffering from a mental illness and 20 million with a substance use disorder. Used in addiction treatment, DBT utilizes concepts that promote abstinence by both changing behavior patterns implementing reasonable timelines for achieving total abstinence. Originally developed to treat borderline personality disorder, a serious mood disorder, research shows DBT’s effectiveness in treating patients suffering from depression, PTSD, bipolar disorder and some eating disorders.

Dialectic by definition refers to the union of two opposing opinions. Therapists using DBT aim to promote two goals for patients: change and acceptance. Dr. Marsha M. Linehan, the coauthor of the groundbreaking therapy, developed it with an end goal in mind – for her patients to build a life worth living. This means having the ability to deal with life’s challenges in a healthy way and to envision and set goals for oneself that are not linked with destructive behavior.  DBT was the standard behavioral therapy of the 1970s in the treatment of chronically suicidal individuals. It was later adapted for therapists to use with patients with substance use disorders and borderline personality disorder.

How DBT Works

Addiction is closely linked with behavior because of the effect that drugs have on the brain. They hijack the brain’s communication system, interfering with messages it’s desperately trying to send to parts of the body. The brain is simultaneously developing a tolerance for the drug, needing more and more to produce the same high. When the euphoria doesn’t come at the same rate, many addicts end up feeling the exact opposite – depressed and lifeless.

When a therapist begins a behavioral therapy like DBT with a new patient, they begin to build a hierarchy of negative and destructive behaviors and begin targeting the most life-threatening behaviors first. These concerning behaviors could be suicidal or even homicidal thoughts; therefore, they will be at top of mind each session to ensure no harm is inflicted on the patient or others.

Through individual sessions with a trained therapist, patients will focus on four key areas:

  • Mindfulness – Encouraging patients to be in and live in the present moment and not to live in the past, perhaps reliving a personal trauma.
  • Distress tolerance – The therapist will help the client be more tolerant of negative emotions rather than running from them.
  • Emotion regulation – Therapist provides the tools to help the patient manage and change the emotions that are causing problems
  • Interpersonal effectiveness – Teaching the interpersonal skills needed for one to communicate with others in a healthy, yet assertive way that maintains self-respect and fosters positive relationships.

Why DBT Works in Addiction Treatment

In active addiction, the user’s thoughts and believes – everything they do is under the control of the drugs they are abusing.  Through DBT, a patient will learn acceptance and change through a number of sessions with their therapist. Throughout the process, patients are developing the motivation to change and structuring the environment to be successful in recovery outside of treatment. In teaching acceptance, the patient learns that any relapse they may experience is not a problem, or reflection on them, rather a problem that needs solving. The therapist encourages the patient not to feel negative emotions toward a relapse.

Goals of DBT in Addiction Treatment:

  • Decreasing/eliminating substance abuse
  • Reducing the physical discomfort that accompanies abstinence and/or withdrawal (urges, cravings, and temptations to use again)
  • Avoiding and completely cutting off opportunities for future abuse; e.g. destroying phone numbers to drug dealers, getting rid of paraphernalia, or changing your own personal phone number to begin fresh
  • Correcting behaviors that support and surround drug abuse. For example, fostering relationships with new friends, surrounding yourself with a positive community that promotes abstinence and pursuing new sober social activities.

Is DBT Right For You?

If you are seeking DBT for addiction treatment in Kentucky, look no further than JourneyPure Bowling Green. Our staff, many of whom are in recovery, are highly trained, compassionate and dedicated to seeing those who are living with addiction get the quality care they deserve. Call today to learn more about our treatment programs and how you can start living your best life.


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