DBT vs. 12-Step Programs: Which Is Better for Addiction Treatment?

12-step dbtWhen it comes to recovering from your drug or alcohol addiction and preventing relapse, 12-step programs aren’t the only way to sustain your recovery. Dialectical Behavior Therapy (DBT) is becoming an increasingly useful method for maintaining recovery from your addiction, and even has many similarities with traditional 12-step programs.

Below is a look at these two methods and how they compare when it comes to treating your addiction.

12-Step Programs for Addiction Treatment

Alcoholics Anonymous (AA) first developed a 12-step program to help recovering alcoholics maintain sobriety. Now, many addiction treatment centers use 12-step programs as part of their addiction treatment programs and aftercare plans.

A 12-step program teaches several tenets to follow to maintain sobriety and prevent relapse, including the following:

  • Learning to admit that you can’t control your addiction
  • Examining past mistakes
  • Making amends
  • Helping others who suffer from the same addictions
  • Recognizing a higher power to give you strength

Twelve-step programs consist of regular meetings with peers. Interacting with people who have shared a similar experience and listening to their stories give people in recovery a lot of courage to stay sober. When you participate in a 12-step program, you will pair with a mentor who will help you maintain your recovery and provide needed support.

DBT for Addiction Treatment

Pioneered by Marsha Linehan, Dialectical Behavior Therapy (DBT) was developed to treat Borderline Personality Disorder (BPD). However, it is growing in popularity as a treatment for substance abuse.

DBT teaches four main skills: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. These DBT skills are used in addiction treatment to help maintain recovery and prevent relapse in the following ways:  

  • Mindfulness techniques help you learn to live in the moment and acknowledge that “urges” to use will eventually pass.
  • Distress tolerance skills can help you effectively deal with situations that trigger relapse.
  • Emotional regulation will help you channel emotional energy proactively.
  • Interpersonal effectiveness skills can help improve your important relationships.

DBT skills, which are taught through individual and group therapy, aim to promote abstinence by promoting change in your behaviors. You will work with a trained DBT therapist to learn and practice these skills to change how you handle your day-to-day life. 

Similarities between 12-Step and DBT

Dialectical Behavior Therapy and 12-step programs have marked similarities. The primary goal of each method is to change behaviors, emotions, and thinking patterns that cause problems or relapse. Here are some other similarities between DBT and 12-step programs:

  • Both methods strongly emphasize improving interpersonal relationships, and learning to get your needs and wants met.
  • Mindfulness is encouraged as a practice in both 12-step programs and DBT.
  • Gaining acceptance of yourself and your actions.
  • The skills learned through both methods require continual practice – they can’t just be learned once and forgotten.
  • Learning to let go of emotional suffering and take care of yourself.
  • Surrendering your old beliefs and ways of doing things and trusting you will find a new way to live your life.
  • Honesty with yourself and others.
  • Learning to be nonjudgmental of yourself and others.
  • Reducing your vulnerability to relapse.

Which Is Right for You?

Both 12-step programs and Dialectical Behavior Therapy have proven effective in maintaining recovery from addiction and preventing relapse. A good addiction treatment center will incorporate both DBT skills and 12-step principles to give you the best chance at finding the skills and support you need to make a lasting recovery from your addiction.

Tags: 12-step program, addiction treatment, dbt, dialectical behavior therapy

3 Responses to “DBT vs. 12-Step Programs: Which Is Better for Addiction Treatment?”

  1. Joanna Wagner Feb, 21 2012 at 11:59 am #

    I see my substance abuse problem as part of my overriding major depressive disorder. It’s part of a long-term practice of self-harm and suicidal behaviors. I recently went through an intensive program of DBT through which I’ve learned skills for emotional regulation, acceptance and understanding.

    I’ve devised a three-tier program of recovery for myself that includes regular therapy sessions, antidepressants and AA to provide a social structure for my life. It’s only been 6 months, but this combination is working amazingly well. Not only am I not depressed, I’m actually happy.

    I’m participating in Alcoholics Anonymous and working the 12 steps with a sponser. For the most part, I find the two complimentary, but I’m encountering some difficulty with the 4th step, listing my resentments. I’ve learned to accept the past as it is and not to ruminate. This process seems to ask me to dredge up the past and my emotons about those events and people. It seems to me to conflict with the practice of radical acceptance. Is there something I’m missing?

    • Yitzchok May, 07 2013 at 7:26 am #

      I would suggest you speak to your sponsor (if you haven’t).
      I experienced the same thing. I would think about the resentments and cry.
      Then I found a sponsor who worked the steps with me very quickly. Step 4 took 5 days. (This isn’t commonly done though.) I didn’t need to get every resentment. The point was the concept. That I had resentments and now I had to learn my part. Then I moved on.
      By the way, I have bipolar depression, OCD, anxiety so I understand.
      Good luck,

  2. Liz May, 05 2014 at 6:59 am #

    Hi – I have been in recovery for over 26 years. During that time I have participated in dbt and found it extremely helpful . I am now working with a new sponsor who suggests the 12 steps will”cure” or work better than all my therapy and perhaps alleviate my anxiety and depression. I had come to peace with accepting my bipolar diagnosis and feel strong in my sobriety. I am having trouble with the concept of “character defects” especially because it has taken so long learning to accept myself, be in the moment, etc. it seems contradictory to dbt ‘a concepts to look backwards. There are other concerns too. In any case my anxiety and depression seem to be back since I have been working with her. Have I picked the wrong sponsor or am I issuing something?

Leave a Reply