Dialectical behavior therapy (DBT) was initially developed as a method of treating individuals with severe mental illness, particularly people who were diagnosed with borderline personality disorder (BPD) who were chronically suicidal. It continues to be used to treat individuals with BPD and is now also used to treat a variety of other conditions including drug or alcohol abuse, also known as substance use disorders (SUDs).
It’s not unusual for SUDs to occur along with BPD. It can be challenging to successfully treat an individual who has more than one diagnosis, but DBT has been found to be an effective method of treating addiction and substance use disorder in people who have BPD along with a substance use disorder, as well as those who have SUDs but not BPD.
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How DBT Can Help in Recovery from Substance Abuse
The ultimate goal of DBT is to help you to build a life worth living, and it can be a very effective method of treatment if you have been struggling with substance abuse and haven’t responded to other forms of therapy. Using the components of DBT, you can learn to envision and pursue goals even though there is a history of out-of-control behavior.
DBT promotes the two seemingly opposing goals of change and acceptance. Using this approach, you can gradually learn to deal with everyday problems without the extreme emotional reactivity that so often leads to turning to substances.
The Emotional Challenges That Precede Addiction
A person who turns to alcohol or other substances typically does so as a way of soothing or altering volatile emotions. When emotions become intense and overwhelming, people may look for a way to calm or quiet these emotions, which can lead to addictive behavior.
DBT offers skills training that is very useful in managing intense emotions. Using DBT, substance use and addictive behaviors can be replaced with healthy coping skills, and emotions can be brought under control. It’s an intense, structured form of treatment that may work for individuals who haven’t been able to achieve recovery from SUDs using other methods.
Focusing on Substance Use
When DBT is used as a method of overcoming and treating addiction and substance use, there is a targeted focus on behavior that is related to reliance on substances, which is what is interfering with an individual’s quality of life. Goals of therapy will include:
- Decreasing use of mind-altering substances, including alcohol, illegal drugs or prescribed medications that aren’t taken as prescribed
- Relieving physical discomfort and painful withdrawal symptoms
- Reducing cravings and temptations to use substances
- Recognizing triggers and avoiding opportunities to turn to substances, which may include destroying drug paraphernalia or throwing away phone numbers of drug dealers
Social support is an important tool that is used as part of DBT to encourage abstinence from SUDs. You will be encouraged to engage in recreational activities that support abstinence, to develop new friendships and to seek environments that support abstinence from chemical addiction.
How DBT Therapy Works for SUDs
DBT consists of four components that are used together to help you recover from dependence on mind-altering substances. These components include:
- Skills training done in a group where you can begin to learn new life skills. Groups meet weekly.
- Individual therapy allows you to work one-on-one with a therapist, which will help you to stay motivated and work on applying the new skills you are learning.
- Phone coaching means you are able to call your DBT therapist when you are feeling vulnerable and need coaching.
- Therapist consultation is a way for therapists to remain motivated and able to provide the best possible treatment.
Effectiveness of DBT in Treating Drug Addiction and Alcohol Abuse
DBT is effective in reducing substance abuse as well as self-harming or suicidal behavior that often goes with BPD and may also accompany SUDs. Skills learned through DBT can help you learn to cope with difficult situations, regulate your emotions and improve your relationships with others. These skills are very beneficial in overcoming reliance on substances and will help you begin to build a life worth living.
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