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Dialectical Behavioral Therapy (DBT) in Addiction

Dialectical behavioral therapy, or DBT, is a style of therapy used to treat certain mental health disorders.1 While DBT was first developed to help treat highly suicidal patients with borderline personality disorder (BPD), it has since been adapted to help manage a range of other mental health conditions, including substance use disorder. 1, 2 Today, one may undergo DBT in combination with other evidence-based addiction treatments, usually as part of a broader behavioral therapy program.2 Understanding what DBT and what to expect from it can help you navigate the many treatment options that promote recovery.

What is Dialectical Behavioral Therapy (DBT)?

The main focus of DBT is to help a patient recognize a set of goals and achieve them through the synthesis of two core concepts: change and acceptance.2 DBT will often utilize the idea of a “dialectic” to help patients recognize and accept two somewhat opposing concepts, and then to synthesize a way forward to make positive changes in the future.2 This allows patients to both understand and accept aspects of their behaviors (including harmful behaviors driven by addiction) and to commit to a long-term change in those behaviors.

While many studies regarding the effectiveness of DBT have focused on patients with suicidal ideation in connection with bipolar personality disorder or other severe psychosocial disorders, evidence for the program’s effectiveness for those struggling with substance used disorders (also known as addiction) has emerged in the years since its development.3

As a component of drug and alcohol rehabilitation, dialectical behavioral therapy helps to perform 5 essential functions: 2

  • To improve patient motivation to change.
  • To enhance patient capabilities.
  • To generalize new behaviors.
  • To structure the environment.
  • To enhance the therapist’s capability and motivation.

DBT can be provided in various treatment settings, such as inpatient, outpatient, or telehealth treatment. Due to the versatility of the program, DBT may be done on an individual or a group basis. 2

Does Dialectical Behavioral Therapy Help in Addiction Treatment?

When used as a component of evidence-based addiction treatment, DBT can help people achieve and maintain abstinence.2 Oftentimes DBT programs will emphasize the need for a prompt cessation of substance use while also reinforcing that a failure to achieve immediate abstinence or relapsing does not constitute a permanent failure of recovery.2 Therapies in DBT programs will often promote this view in a nonjudgmental way, offering constructive feedback to the patient in their quest to reduce substance dependence.

For people living with a substance use disorder, dialectical behavioral therapy for addiction treatment can help them identify the behaviors that are counteractive to recovery and detrimental to their overall quality of life. 2 Some of the goals of DBT for SUD treatment include helping people in recovery to: 2

  • Decrease substance misuse of illicit or legally prescribed drugs.
  • Lessen the physical discomfort accompanying abstinence or withdrawal.
  • Decrease urges, cravings, and temptations to substance use.
  • Avoid situations and other cues that promote substance use, which includes:
    • Staying away from people and places associated with drug use.
    • Deleting the phone numbers of contacts who are associated with drug use.
    • Having the patient change their phone number to break contact with connections associated with drug use.
    • Trashing all paraphernalia.
  • Reduce behaviors contributing to drug misuse.
  • Increase community reinforcement of healthy behaviors, such as developing new friendships, participating in social and vocational activities, and seeking environments that support abstinence and punish behaviors related to drug misuse.

The use of dialectical behavioral therapy for addiction treatment is also beneficial to the patient because it can be administered in an individual, group, or virtual setting. 2

Benefits of DBT for Drug & Alcohol Addiction Recovery

While the effectiveness of DBT for those struggling with an SUD may not currently be exhaustively investigated, there have been promising findings in studies on the therapy’s effectiveness in people who struggle with borderline personality disorder and co-occurring substance use disorder.3

One study found that individuals struggling with BPD and an SUD experienced greater reductions in suicidal behaviors and alcohol use.3  In particular, women who struggle with BPD and an SUD may benefit from DBT at greater rates than other groups. 3 A study found that, when compared to standard treatment, women who met the diagnostic criteria for BPD and SUD and underwent a DBT program experienced a greater reduction in drug use over the course of 12 months and were more likely to remain in treatment. 3

While research into the effectiveness of DBT for addiction treatment continues, it is possible that certain groups may benefit from this type of therapeutic intervention.2

Does Insurance Cover Dialectical Behavioral Therapy in Rehab?

The Affordable Care Act (ACA) requires health insurance plans have been required to provide customers with coverage for necessary medical treatments, including mental health disorders and addiction.4 Coverage may pay all or a portion of the treatment, including DBT. Coverage may vary depending on your specific plan, so it is important to contact us to help determine the cost your insurance will cover before committing to treatment.

Find DBT Addiction Treatment Near You

If you or a loved one is interested in DBT for addiction treatment, you’ll first need to locate a facility that provides it. The recovery.org directory is a powerful online tool that can allow you to search through thousands of rehab centers across the country.

Additionally, you may consider calling the American Addiction Centers (AAC) addiction helpline. This 24/7 resource can connect you to knowledgeable staff who can help answer your questions about DBT, connect you with suitable rehab centers, and help you to verify your insurance coverage. Don’t delay, call us today at to get started.

Other Proven Addiction Therapy Methods

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