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DBT Therapy

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Behavioral therapies aim to alter a person’s addictive behaviors, in part through educating patients on how to deal with situations that could trigger substance abuse and relapse. Many behavioral therapies have been useful in treating substance use disorders (SUDs), and some are more appropriate for certain substances than others.

At Legends Recovery Services of Ohio, our facilities offer types of psychotherapy such as DBT for substance abuse to help teach people to identify problem behaviors and triggers for addiction and to develop coping strategies.

Let’s find out more about DBT’s applications, functioning, and how to get started if you believe it could be of assistance to you.

dbt for substance abuse

What is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy (CBT). It was created by psychologist Dr. Marsha Linehan in the late 1980s. DBT is based on CBT but has more of an emphasis on emotional and social factors.

DBT is a method that’s been proven to be effective in treating many conditions related to substance abuse and mental health and helping people control their emotions. Current research suggests it may be helpful for a variety of mental diseases or issues, notably self-harm, but it was originally developed as a treatment for borderline personality disorder (BPD).

However, it also teaches individuals how to tolerate suffering and identify the potential for change within themselves. It is very beneficial for treating mental illnesses such as personality disorders, depression, anxiety, and others.

Similar to CBT, DBT emphasizes the development and maintenance of strong connections, mindfulness, and remaining in the present moment, as well as emotional regulation. It’s intended to be for those who have trouble controlling their strong emotional reactions and unhealthy coping mechanisms.

The Cognitive Triangle

The link between thoughts, emotions, and behavior is depicted in a graphic called the cognitive triangle. It illustrates how our thoughts alter how we feel, which in turn affects how we act, which affects how our thoughts, and so on. Without assistance, it is impossible to break this cycle.

It’s one of the most well-liked and successful techniques used by cognitive behavioral therapists to treat mental health illnesses. Patients who suffer from anxiety, sadness, or other common stressors can benefit from it.

DBT was created to target the emotional component of the CBT triangle to identify, accept, and regulate unstable emotions and destructive behaviors, as well as teach us the interpersonal skills required to form trusting supportive relationships.

The purpose of the cognitive triangle is to explain how feelings, thoughts, and behaviors are related. Understanding the connections between these three aids in altering some of our actions and attitudes. Let’s explore the 3 sides of the cognitive triangle.


Every day, people experience transitory thoughts that come and go, some of which are more persistent than others. Self-critical thoughts tend to be common, and without awareness of how frequently they come up, it is impossible to stop them. The significance of these thoughts on your emotions is highlighted in therapy.


Unlike thoughts, feelings can be summed up in a single word. Simple fear is the feeling that comes to mind while thinking about this. In therapy, emotions can occasionally be recognized readily and they have an impact on your behavior.


Thoughts and sentiments have an impact on actions. In this case, becoming an overly watchful or helicopter parent and keeping tabs on your child’s every step would be a comparable action.​​

What is Dialectical Thinking?

Dialectical thinking is the capacity to recognize that it’s alright for two opposites to coexist. For instance, when a roommate leaves when they get married, you could experience mixed emotions.

The dialectic between acceptance and change forms the basis of DBT. It teaches people how to balance these opposing forces: You can strive for change while accepting who you are and everything in your life.

The cognitive triangle is a tool that helps therapists help their clients uncover underlying emotions and change their thoughts, so their actions follow suit. When thoughts are feelings are influenced, behavioral changes can be made. Just as the shape of a triangle demonstrates, thoughts, feelings, and behavior are all connected and each side influences the other.

Benefits of DBT for Substance Abuse

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Many people can gain therapeutic benefits from DBT when it is applied with an addiction-focused strategy. The advantages could include:

  • Learn how to stop drug abuse.
  • Reduced intensity and discomfort from withdrawal symptoms.
  • A reduction in impulsivity, desires, and temptations connected to substance use.
  • Establishing and upholding the boundaries required for abstinence.
  • Avoiding negative situations and behaviors that could act as catalysts for substance use (Triggers).
  • Assist in managing stress, dealing with even the strongest emotions, establishing and maintaining stronger relationships, and living in the now.
  • Fostering more wholesome interpersonal connections in a community and other settings that promote the achievement of the individual.
  • Teaches how to deal with strong emotions, challenging circumstances, and unhealthy relationships.

What Conditions Does DBT Help Treat?

DBT was initially created to treat self-harm, suicidal thoughts and actions, and borderline personality disorder (BPD). Since then, it has also been demonstrated scientifically to benefit individuals with additional mental health disorders, such as:

  • Borderline personality disorder (BPD)
  • Substance use disorders (SUDs)
  • A range of mental health issues
  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Substance use disorders
  • Eating disorders
  • Attention deficit hyperactivity disorder (ADHD)
  • Major depressive disorder
  • Bipolar disorder

DBT can be useful for treating other problems like anger management and binge drinking, according to other studies.

DBT's Core Principles and Goals

DBT for substance abuse consists of four behavioral skill modules. Two of them, mindfulness and distress tolerance, emphasize acceptance. The other two courses, on interpersonal effectiveness and emotion management, are all about change. Let’s find out more about them all.

Mindfulness Skills

Focusing on the present moment is the practice of mindfulness. It’s a technique for clearing your mind so you can concentrate on what’s going on in front of you. DBT teaches you how to utilize mindfulness to manage your emotions and experiences. Additionally, mindfulness enables you to absorb your surroundings without judgment.

Distress tolerance skills

When you’re in a crisis or your emotions are running high, having the ability to tolerate stress can help you deal. You can accept and deal with these overwhelming feelings healthily by using distress tolerance techniques including timed breathing, vigorous exercise, self-soothing, and diversion.

Interpersonal Effectiveness Skills

Learning how to enhance your relationships is a necessary component of interpersonal competence. You’ll pick up the skills necessary to express your needs, interact with others, and grow in self-respect. These abilities are intended to support you in upholding healthy relationships and boundaries with others.

Emotion Regulation Skills

You can effectively shift tough emotions with the aid of emotion regulation abilities. This offers resources for problem-solving, wise decision-making, and moving forward with your plans. Additionally, you discover how self-care affects (and can be utilized to alter) how you feel and respond in stressful circumstances.

Alternative DBT Treatment Components

Dialectical behavioral therapy includes other components to treat disorders. They include:

  1. Individual Therapy: People learn to apply their DBT abilities to real-life issues in these weekly, one-on-one sessions. Utilizing these newly acquired skills in real-world settings is encouraged in individual therapy.
  2. Group Therapy: In group therapy sessions, people actively practice new, healthy coping mechanisms as they work on building them. The atmosphere in DBT groups is encouraging and rewards good conduct. Outside of the group, the person attempts to organize their surroundings to create a favorable environment for achievement.

How Does DBT for Substance Abuse Work?

Dialectical behavior therapy for substance abuse was created as an extensive, multi-part treatment. This is referred to as complete, standard, or comprehensive DBT. It involves phone coaching, DBT skills training, and individual therapy.

In one-on-one DBT treatment, you and your therapist discuss your issues and experiences. You then acquire skills from each of the four modules in a weekly group setting. To put those skills into practice in your everyday life, you will complete homework assignments.

Between sessions, your therapist is available for as-needed guidance, and to assist you in using your abilities in challenging circumstances. Utilizing coaching and practicing what you learn in treatment sessions are proven to be linked to successful recovery outcomes. The average person will undergo DBT for around a year. Someone may require more based on their specific needs.

Difference Between CBT for Substance Abuse and DBT for Substance Abuse

substance addiction DBT ohio

Dialectical behavior therapy (DBT) and cognitive-behavioral therapy (CBT) are two types of psychotherapy or “talk therapy.” In both situations, you collaborate with a mental health expert to gain knowledge about the difficulties you have and develop the skills you need to deal with them on your own.

The two main distinctions between CBT and DBT are relationships and validation. DBT encourages you to accept who you are, despite difficulties or challenging situations, and that your experiences are true. Relationships, especially the ones you have with your DBT practitioner, are crucial in DBT.

A combination of one-on-one and group sessions may be used during treatment. Along with learning CBT techniques, you’ll also develop your emotional management, interpersonal communication, problem-solving, acceptance, coping/life skills, and mindfulness abilities.

DBT for substance abuse is typically structured and goal-oriented but unlike CBT’s general focus on changing thoughts and behaviors, DBT was designed to target the emotional part of the CBT triangle. This therapy aims to identify, accept, and regulate unstable emotions as well as teach us the interpersonal skills required to form strong supportive relationships.

It also assists people in discovering strategies to accept themselves, feel comfortable, and control their emotions to control potentially harmful or destructive behaviors.

Addiction is a disease of the mind, which makes it harder and harder to “break” out of automatic negative thought patterns and try to make adjustments for a better quality of life. By examining and altering our actions and thought patterns, CBT for substance abuse helps people manage their ideas and teaches strategies to identify when they may become problematic.

The main goal of psychotherapy is to acknowledge how your current actions and beliefs affect people’s emotions and worldviews. It takes time and commitment to reap the rewards of CBT and DBT skills, just like with many talk therapies.

Does Insurance Cover DBT for Substance Abuse?

The Affordable Care Act (ACA) has made it eligible for millions of people who need behavioral health treatment such as counseling, mental and behavioral health services, and substance use disorders receive the treatment they need through insurance coverage benefits.

Your insurance company might pay for DBT as part of your inpatient/residential program or outpatient treatment program. This depends on the particulars of your health insurance policy. Our admissions team can verify whether your insurance company will pay the entire cost of rehab therapy or at least a portion of it.

Finding a Facility Offering DBT for Substance Abuse

DBT for substance abuse groups is led by therapists who have received specialized training in treating patients successfully. Speaking with a medical professional and mental health professional who can evaluate to assess your symptoms, provide a diagnosis, and create a treatment/recovery plan. We will determine whether dialectical behavioral therapy is the best option for you.

If you have questions about whether this type of therapy is a good fit for you, speak with your mental health physician to locate a facility where you can have an evaluation.

Learn if DBT for Substance Abuse is Right for You

If you think DBT for substance abuse may be helpful for you or a loved one, there are several ways to search for therapists and facilities that offer it in your area. Contact our admissions team at Legends Recovery to learn more about the services and resources we offer.