Clinically Reviewed by Linda Whiteside, LPCC

Medically Reviewed by: Dr. Ryan Peterson, MD

What is Dialectical Behavior Therapy (DBT) for Drug and Alcohol Abuse Treatment

Table of Contents

Dialectical Behavioral Therapy (DBT) is a form of therapy used in drug and alcohol treatment programs to help clients deal with mental and emotional conflict. It is in ways similar to Cognitive Behavioral Therapy (CBT) which is often made part of an individual addiction treatment plan. While CBT can be of great help to many struggling with addiction, it may not be the answer for everyone. Each addict is unique in their needs and goals, and CBT may not adequately address the root causes of an addict’s addiction. If this is the case, other therapy options such as dialectical behavior therapy (DBT) may provide a better option for some individuals.

DBT is a relatively new therapy option that an increasing number of drug treatment facilities are offering in their treatment plans. An offshoot of CBT, dialectical behavioral therapy may provide the breakthrough addicts need to address the issues that are keeping them stuck in addiction. The following article will explain in greater detail what DBT is and how it can benefit your recovery.

Dialectical Behavioral Therapy (DBT)Defined

As stated in the introduction, DBT is a relatively new therapy. Developed by psychologist Marsha M. Linehan in the late 1980s, dialectical behavioral therapy was initially developed to help people suffering from borderline personality disorder. In the years following its development, DBT therapy is used to treat addiction and has been utilized in other treatments including drug and alcohol abuse.

DBT is a form of psychotherapy that operates on the belief that people are prone to react more intensely in more emotionally intense situations such as those involving family, friends, and intimate romantic relationships. When confronted with these feelings, people may experience more emotional volatility and may take longer to return to equilibrium. With this continual wide swings in emotion, people may turn to drugs and alcohol to feel normal or to “self-medicate”.
If the underlying emotions and impulsivity are not addressed, those who turn to substances to cope can easily become dependent then addicted to substances. Worse yet, the underlying psychological issues also escalate over time—and those afflicted can develop a dual diagnosis condition. To help client better deal with their underlying emotional and psychological issues, DBT may be of great benefit.

The Unique Nature of DBT

While DBT is considered an offshoot of psychotherapy, it is a unique therapy model onto itself. Whereas other psychotherapy models consist of one mode or aspect of treatment, dialectic behavioral therapy consists of five distinct components. Each component was created and intended to meet a specific need or function.

These components are as follows:

Skills Training

In the skills training component, therapists work with clients in a group setting to help acquire and hone healthy life and coping skills. These skills are reinforced through the assigning of homework and exercises by the therapist. In general, groups meet once weekly for approximately 2 ½ hours per session. The skills that are taught include mindfulness, regulating emotion, effective interpersonal skills, and distress tolerance.

Individual Therapy

In addition to group therapy, those in DBT programs also meet one-on-one with a therapist. The goal of individual therapy is to aid in helping clients apply the life, and coping skills learned in a group setting for their own unique and specific challenges. Clients meet with a therapist once a week and will run simultaneously with group skills training.


One unique aspect of DBT is the fact that clients can receive real-time coaching either in person or by telephone. The goal of coaching is to assist clients in using their newly acquired skills to effectively cope with the stressors they encounter in their daily lives.

Case Management

Clients learn case management strategies to help them manage their everyday lives. The goal of this component is to empower clients to take control of how they look at and manage their daily lives. Therapists will always be close by in case the client runs into trouble and is seeking additional support.

Support Therapists

Another unique feature of dialectical behavioral therapy is the presence of support therapists. These people are considered the “therapists for the therapists.” This team supports DBT providers in their work and helps DBT therapists stay motivated and competent so they can avoid burnout.

The 4 Stages of DBT Treatment

When people enter DBT treatment, there are four distinct stages that mark the treatment process. These stages are as follows:

Stage 1-Stabilization

With this stage, people may be dealing with major issues along with addiction like self-harm and even suicide. When entering therapy, people may feel that are at the lowest of the low. In this stage, the goals center on crisis intervention and getting the client to a safe space.

Stage 2-Experience

In this stage, people start feeling the weight of their emotional pain. While this may be scary, therapists provide a safe and secure environment for the client to explore these feelings. The primary goal is for clients to experience their emotional pain and not ignore, rationalize or bury their pain.

Stage 3-Goal Setting

Once clients can face and cope with the pain they are feeling, they can start setting goals to help them reach happiness and stability. During goal setting, therapists emphasize that goals should be reasonable and attainable. Additionally, clients should understand that if a goal is not met not to beat themselves up.

Stage 4-Moving Forward

In this fourth stage, therapists work with clients to get them to the next level in their recovery. During this stage, therapists work with clients in improving learned skills and/or work toward ways to achieve a significant sense of spiritual fulfillment. This stage focuses on strategies to maintain happiness and security.

How Long Does DBT Treatment Last?

For those considering DBT treatment, know right away the treatment process can be lengthy. Because of the “module” system and its comprehensive nature, those you choose DBT can expect to be in treatment for at least 6 months. Typically, each module in DBT can last anywhere between 8-10 weeks with a week or so in between modules.
The length of time dialectic behavioral treatment can last can turn people away. However, addicts will gain extensive tools and support that can increase their chances of long-term recovery. As with any treatment program, it is essential to do careful and thorough research. It is also crucial to get professional guidance and advice from experienced addiction treatment personnel.

If you are considering DBT for yourself or a loved one, contact NuView Integrated Recovery Center toll-free today. Our team of professionals will take the time to explain the benefits of DBT as well as other therapy options. Don’t second guess your recovery or that of someone you love; call NuView Integrative Recovery Center today.

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Written By: Linda Whiteside

Licensed Clinical Professional Counselor who has been providing mental health services for over 10 years.

Medically reviewed by: Dr. Ryan Peterson

Went to medical school at The George Washington University School of Medicine in Washington, D.C.

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