What is DBT?
DBT stands for “Dialectical Behavior Therapy.” It is a type of psychotherapy designed to treat individuals with borderline personality disorder (BPD) and other related mental health conditions. Therapy is based on the idea that people with BPD have difficulty regulating their emotions, thoughts, and behaviors, and that these difficulties stem from a lack of skills in these areas. DBT aims to teach these skills and help individuals improve their ability to cope with difficult situations and emotions. It combines elements of cognitive-behavioral therapy with mindfulness and acceptance-based techniques. Read on to learn how DBT is used to treat addictions.
Purpose of DBT
The goal of DBT is to help individuals with BPD and other related mental health conditions improve their ability to regulate their emotions, thoughts, and behaviors. This is achieved by teaching a range of skills that fall into four main categories: mindfulness, resilience, emotion regulation and interpersonal effectiveness. These skills are taught through both individual therapy sessions and group skills training.
DBT for Mental Health Disorders
The goal of DBT is to help individuals reduce symptoms of BPD and other related conditions such as self-harm, suicidal behavior, and strained and unstable relationships. In addition, it aims to improve overall functioning, including the ability to build healthy relationships, stop work, and manage symptoms of depression and anxiety. DBT has also been adapted to treat other mental health conditions such as substance use disorders, eating disorders, Post Traumatic Stress Disorder (PTSD), and other conditions.
DBT for addiction
DBT has been adapted for the treatment of addiction and substance use disorders. It is based on the idea that individuals with addiction have difficulty regulating their emotions, thoughts, and behaviors, and that these difficulties stem from a lack of skills in these areas. DBT for addiction is similar to traditional DBT, but focuses on addressing specific issues that individuals with addictions face, such as triggers, cravings, and the emotional pain that often underlies the addiction.
In DBT for addiction, individuals learn skills to cope with distress and cravings, manage negative emotions, improve interpersonal relationships, and increase motivation to change their behavior. Therapy also includes strategies to manage triggers and reduce the risk of relapse, such as learning to identify high-risk situations, developing a plan to cope with cravings, and learning to recognize and change maladaptive thoughts.
DBT for Dual Diagnoses
DBT for addiction is usually done in an outpatient setting, but it can also be used in an inpatient or residential setting. Studies have found that DBT for addiction can be effective in reducing substance use, improving overall functioning, and reducing the risk of relapse. It is especially beneficial for people with co-morbid conditions such as PTSD, depression and anxiety. Co-occurring disorders are also known as dual diagnosis.
In DBT for dual diagnosis, the therapist addresses both the substance use disorder and the co-occurring mental health condition. Therapy includes training in standard DBT skills such as mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, as well as strategies to manage triggers and reduce the risk of relapse. In addition, the therapist may incorporate specific techniques to address the co-occurring mental health condition, such as cognitive-behavioral therapy (CBT) for PTSD or schema-focused therapy for BPD.
DBT for dual diagnosis can be effective in reducing substance use and improving overall functioning. It also addresses the underlying emotional pain and maladaptive coping mechanisms that often lead to addiction, which can increase the chances of long-term recovery. It is important to note that DBT for dual diagnosis is usually conducted in a team-based approach, with a therapist trained in DBT and often a psychiatrist who can handle the medication management aspect of treatment.
How is DBT performed?
DBT is usually performed in an outpatient setting, although it can also be used in an inpatient or residential setting. This usually involves both individual therapy sessions and group skills training.
Individual therapy
Individual therapy sessions are usually held once a week and are focused on addressing specific issues and problems the individual is facing. The therapist and client work together to develop a treatment plan and set goals for therapy. The therapist uses a combination of cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) techniques to teach the client new skills and help them apply them in their daily lives.
Group therapy
Group skills training typically occurs once a week and focuses on teaching the client DBT skills that fall into four main categories: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills are taught through a combination of didactic instruction, role play, and homework. Group skills training sessions allow clients to practice and receive feedback on the skills they learn.
Virtual Therapy Sessions
In addition to individual therapy and group skills training, DBT also includes virtual coaching. Virtual therapy sessions it can also be done via phone, tablet, laptop or iPad. Virtual training is an opportunity for clients to connect with their therapists between therapy sessions to receive support and help apply the skills they have learned to real-life situations. This can be particularly helpful for clients who have difficulty managing intense emotions or are at risk of self-harm or suicide.
In general, DBT is a structured, evidence-based treatment that requires significant commitment from both therapist and client. It is usually administered over several months, and the therapist and client work together to monitor progress and adjust the treatment plan as needed.
DBT: What to expect from a DBT session
During a DBT session, the therapist and client will work together to address specific problems and issues the client is facing. A session can include a variety of different activities, such as:
Client diary review: The client may be asked to keep a diary that records their daily moods, behaviors and skills they use. The therapist will review the diary card with the client to identify patterns and problem areas to be addressed in the session.
Skills training: The therapist will teach the client new skills and strategies to help them cope with difficult emotions, manage impulsive behaviors, and improve relationships. The therapist will also help the client practice these skills and receive feedback.
Problem Solving: The therapist will work with the client to identify specific problems and develop a plan to solve them. The therapist will help the client identify the underlying causes of the problem, discuss potential solutions, and develop a plan of action.
Emotion regulation: The therapist will help the client learn how to identify and label their emotions and develop strategies to manage strong emotions in a healthy way.
Mindfulness: The therapist will teach the client mindfulness techniques, such as meditation and breathing exercises, to help them stay in the moment and reduce stress.
Interpersonal effectiveness: The therapist will teach the client skills to improve their relationships, such as assertiveness, effective communication, and setting boundaries.
Progress Review: The therapist will review the client’s progress and adjust the treatment plan as needed.
In general, DBT sessions are a combination of teaching, coaching, and problem solving and are tailored to the specific needs and goals of the individual client. The therapist will use a supportive and collaborative approach and the client will be encouraged to take an active role in their treatment.
Advantages of DBT
DBT is a well-established and effective treatment for individuals with borderline personality disorder (BPD), addiction, and other related mental health conditions. Some of the benefits of DBT include:
Reducing BPD symptoms
DBT has been shown to significantly reduce symptoms of these problems, such as self-harm, suicidal behavior, and intense and unstable relationships.
Improving overall performance
DBT can improve general functioning, including the ability to form healthy relationships, hold down work, and manage symptoms of depression and anxiety.
Reducing substance use
DBT has been adapted for the treatment of addiction and substance use disorders and has been found to be effective in reducing substance use and reducing the risk of relapse.
Address the underlying emotional pain
DBT addresses the underlying emotional pain and maladaptive coping mechanisms that often lead to addiction and mental health conditions, which can increase the chances of long-term recovery.
Skill training
DBT teaches a set of skills that can be used to improve the ability to regulate emotions, thoughts, and behaviors, not only for the specific condition being treated, but can be beneficial in other areas of life.
A team-based approach
DBT is usually administered in a team-based approach, with a therapist trained in DBT and often a psychiatrist who can handle the medication management aspect of treatment.
Adaptation
DBT has been adapted to treat other mental health conditions such as substance use disorders, eating disorders, Post Traumatic Stress Disorder (PTSD), and other conditions.
Final Thoughts on DBT for Addiction Treatment
Thank you for reading our resource on DBT for addiction treatment. It is important to note that DBT requires a significant commitment from both therapist and client and is usually administered over several months. But with consistent effort and dedication, DBT can provide a powerful tool for individuals to manage their symptoms, improve overall functioning, and achieve lasting changes in their lives.
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