Dialectical Behavior Therapy (DBT)
Overdosing on alcohol is a common problem that occurs when people attend parties, cheer for their favorite teams, or enjoy breaks from work. Binge drinking is a common cause of alcohol poisoning. The Centers for Disease Control and Prevention (CDC) note that in the United States, excess alcohol use caused about 88,000 deaths every year from 2006 to 2010. It also caused a loss of 2.5 million years of possible life during that time. Excess alcohol use also reduced the lives of individuals by about thirty years.
A form of cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) is an established treatment for people with severe or multiple psychological disorders. The treatment approach encourages people to build lives worth living.
While participating in DBT treatment programs, people learn to envision, pursue, articulate, and sustain goals independent of their history of uncontrolled behavior or substance use. The individuals are in better positions to deal with the ordinary problems of life.
Psychologist Dr. Marsha Linehan developed dialectical behavior therapy. It is a technique used to treat mental illnesses besides addiction and substance abuse. It has helped treat people with borderline personality disorders and suicidal thoughts.
Since many people who have psychosocial disorders such as borderline personality disorder also have substance use disorders or addictions, Dr. Linehan developed DBT to help people with drug use or addiction. The treatment program incorporates modalities and concepts designed to promote abstinence from substances while also reducing the adverse impact and length of relapses.
Two main goals of DBT are to help clients build their confidence and develop strategies to cope with stressful situations. Clients who have mental illnesses may be susceptible to intense emotional outbursts and engage in substance abuse. They may use substances to self-medicate themselves to numb the painful, emotionally overwhelming effects of their mental illnesses.
Mental Illnesses and Substance Use Disorders
When an individual has two or more disorders occurring at the same time (concurrently) or one after another, it is called a comorbidity. People who have mental illnesses and substance use disorders or drug abuse have a condition known as a comorbidity, a co-occurring disorder, or a dual diagnosis.
The term comorbidity also describes interactions between the disorders or illnesses that may make each other worse. Many people with substance use disorders (SUDs) also have some form of mental illness, and vice versa. About 50 percent of individuals who experience severe mental illnesses also experience SUDs at some point in their lives.
Unfortunately, comorbidities may start young. Youths who have substance use disorders also show increased rates of having co-occurring mental illnesses such as anxiety and depression.
When people have drug or alcohol abuse problems and mental illnesses, it may be impossible to determine if one caused the other. It may be hard to see if one of the problems came first, which may make it difficult to treat the problems. Common risk factors may lead to both substance use disorders and mental illness.
Comorbidities between mental illnesses and substance use disorders require comprehensive approaches to help identify and evaluate them both. People seeking help for substance abuse or addiction and other mental illnesses should be examined for both and offered treatment simultaneously.
Various behavioral therapies show promise to treat comorbid conditions. They include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), contingency management (CM), assertive community treatment, and therapeutic communities.
For example, addiction treatment centers sometimes use DBT in their treatment programs. Many tenets of dialectical behavioral therapy, such as improving self-image, communication skills, and coping tools, may be helpful to help people stay away alcohol and drugs.
DBT and Addiction Treatment
Recovering addicts may benefit from dialectical behavior therapy because it teaches them several skills. It helps people be mindful and become more aware of themselves. They begin to realize why they used drugs and alcohol and why they are the way they are. Accepting one’s thoughts, feelings, and bodily sensations may help when a person is dealing with a mental disorder or substance abuse.
Dialectical behavioral therapy may help people achieve distress tolerance. This means that they learn coping skills for enduring stressful situations, which are often culprits behind their drug or alcohol use. Some people use drugs or alcohol because they do not want to face particular life situations.
When they develop distress tolerance, people face difficult moments by holding on, tolerating, persevering, and enduring while they seek solutions. This way, they are more likely to stay away from drugs and alcohol, substances that they used in the past to mask their emotions and painful feelings.
DBT helps individuals develop interpersonal effectiveness. In dialectical behavior therapy, interpersonal effectiveness means that people have the skills to balance demands and priories, foster relationships, build a sense of self-respect and mastery, and create a balance between wants and shoulds.
Finally, DBT helps people learn emotional regulation, which is important to help them stop abusing drugs and alcohol. When overwhelmed by emotions, people with substance use disorders consume drugs and alcohol to cope with situations. But if they regulate and control their emotions in healthy ways, they may be better able to maintain their sobriety.
People who use dialectical behavioral therapy focus on modifying their behaviors and surroundings. Common strategies used in DBT are:
- Encouraging people eliminate triggers for drug use, such as unhealthy relationships and drug paraphernalia, from their day-to-day lives.
- Helping people find environments, surroundings, and peer groups that discourage the use of drugs and alcohol.
- Nurturing and bolstering the self-esteem and confidence needed to help people remain sober even in stressful periods.
Dialectical Behavior Therapy Techniques
Major components of dialectical behavioral therapy include:
- Skills training: Addicts recovering from drug abuse learn communication and coping skills. They learn how to apply mindfulness, distress tolerance, and emotional regulation to their daily interactions and routines during and after recovery. Training sessions typically last about two hours and occur once a week over several weeks.
- Individual therapy: Recovering addicts learn how to apply the techniques and skills they learned in skills training classes to help with real-life situations. During DBT programs, people participate in individual therapy sessions. The sessions are tailored to align with the personality characteristics of recovering addicts. Therapists help their clients decide how to apply their new skills to gain the most from them.
- Phone coaching: People who are recovering from addictions may want to reach out to therapists to discuss how to overcome certain problems or situations. Therapists may coach their clients about distress tolerance and emotional regulation to help manage their feelings and cope with difficult situations.
- Team consultation: While this does not directly involve clients, team consultation helps therapists and other medical professionals remain focused. Team consultation allows therapists to be motivated and offer the best assistance, especially for clients who are difficult to treat.
Besides these components, DBT requires people to complete assignments and tasks at home. Such tasks may include journaling, or writing about the behaviors, emotions, and urges they experience every day.
Assignments help therapists learn how the recovering addicts are progressing and if there are any signs of relapse. Jotting down daily experiences and writing about the application of techniques and skills may help individuals recall things about their lives.
Writing may help people determine the types of techniques that have been helpful in overcoming particular types of distress or difficult moments. Journaling illustrates which strategies or techniques are yielding better results in recovery and sobriety.
DBT and Other Treatment Therapies
Several addiction treatment centers use DBT in their recovery programs. This therapy helps teach recovering addicts important techniques and skills to overcome drug addiction. Addicts learn about building self-confidence, coping with distressing moments, communicating with other people, relating with other people, and realizing their inner selves.
Outpatient and inpatient rehabs have medical professionals adequately trained to treat different people with different conditions. Residential centers offer 24-hour medical care that may help emotionally distressed persons complete the detox process and manage withdrawal symptoms.
Writing in the journal Psychiatry, Dr. Alexander L. Chapman stated that dialectical behavior therapy may benefit people with substance abuse disorder and borderline personality disorder. Dialectical behavior therapy may also be effective if it is combined with other kinds of motivational and behavioral therapies such as:
- Cognitive behavior therapy (CBT)
- Contingency management (CM)
- Motivational enhancement therapy (MET)
- Community reinforcement approach (CRA)
In addition, support groups such as Alcoholics Anonymous and Narcotics Anonymous may also be helpful in recovery. The groups help recovering addicts integrate into alcohol-free and drug-free peer groups after they exit treatment.
Find Comprehensive Treatment for Alcohol or Drug Addiction
Treating addiction require qualified medical and therapeutic expertise. Staying sober also requires stress management skills. Rehab centers provide therapies such as dialectical behavior therapy to help support a healthy mind during recovery and help prevent relapse. A treatment center that uses DBT may help if you or your loved one is struggling with substance abuse disorder or addiction.
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