Most insurance plans will cover either all or a portion of the treatment.
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SUD treatment executive, national news contributor & keynote speaker.
Navigation:
- Overview
- Who Is Dialectical Behavior Therapy For?
- What Does the DBT Process Look Like?
- How Long Does the DBT Process Last?
- Does Dialectical Behavior Therapy Work?
- DBT and SUD: What’s the Connection?
- DBT and Post-Treatment Relapse Prevention
- Find Rehabs That Offer DBT
Overview
Dialectical behavior therapy (DBT) is among the most common types of talk therapy in mental health treatment. It was first developed to treat borderline personality disorder (BPD), but has since been found to be effective in a wide range of mental health conditions, including but not limited to depression, anxiety, post-traumatic stress disorder (PTSD) and substance use disorder (SUD).
Who Is Dialectical Behavior Therapy For?
The people who benefit most from DBT are those who feel negative emotions more frequently, intensely, and acutely than others, and have had their lives impacted as a result. This type of emotional dysregulation can manifest itself in a variety of mental health challenges and can lead to self-harm or harm to other people.
Some of the issues commonly covered in DBT treatment may include, but are not limited to:
- Anger management and temper regulation
- Different types of anxiety
- Suicidal urges and ideations
- Alcohol and drug addiction
DBT is an evidence-based therapy that’s rooted in the greater cognitive-behavioral paradigm. It’s specifically adapted for individuals who require assistance with emotional regulation. Its root word, “dialectical”, means opposing ideas or forces, which is indicative of the actual methodology of the technique. The primary objective of this technique is to raise awareness and mindfulness of the intensity of one’s emotions and to provide individuals with the behavioral tools to manage them effectively.
What Does the DBT Process Look Like?
Dialectical behavior therapy is usually applied in both individual and small-group settings. It’s usually most effective when patients and practitioners work one-on-one and then continue to work in group settings to apply insights from those sessions.
The process focuses on teaching and promoting three core coping skills for healthy emotional processing:
- The ability to practice distress tolerance to manage distress as it emerges
- Emotion regulation to help recognize, accept, and manage intense feelings
- Interpersonal effectiveness to establish dialogue, improve communication, and strengthen relationships
Patients engage in regular individual sessions with their practitioner, followed by weekly or multiple times-per-week group sessions during which their practitioner acts as the group leader or moderator. Group sessions often build on the themes explored and addressed during individual sessions. Patients are usually assigned independent homework to help better reinforce the insights and substance of therapy sessions. Participants are encouraged to keep a journal chronicling their treatment experience, including the progress they’ve made and the challenges they’ve faced during the process.
In a departure from basic cognitive behavioral therapy, which generally characterizes negative thoughts and emotions as those that need to be corrected or reframed, dialectical behavior therapy recognizes these emotions as valid while helping guide patients toward the healthiest ways to contextualize, process, and express them.
How Long Does the DBT Process Last?
The DBT process generally lasts anywhere from six months to a year, depending on participants’ progress and ongoing care needs.
Some of the factors that can dictate duration include, but are not limited to:
- The complexity of the issues being addressed and explored
- Their relationships to patients’ overall mental health
- Their role in severe co-occurring disorders, such as substance use or post-traumatic stress disorder
For example, a person experiencing mild to moderate anger management issues in adulthood may not require the same level of care as a teenager or young adult who has contemplated or attempted suicide or self-harm. Dialectical behavior therapy is a valid form of therapy for both of these cases, but the patient with the more severe symptoms may need to be in therapy longer in order to keep them from hurting themselves or others.
For patients battling substance use disorder, DBT may be recommended on an ongoing basis to help with long-term relapse prevention and the development of coping mechanisms. Therapy often begins
Does Dialectical Behavior Therapy Work?
An established and growing body of research points to the long-term success of dialectical behavior therapy in multiple conditions beyond its initial application in the treatment of bipolar disorder. This includes helping to manage PTSD in multiple clinical settings, alleviating depression and anxiety in patients with COVID-19, and much more.
Although dialectical behavior therapy may not be clinically appropriate for every patient, it’s one of the most universally embraced talk therapy techniques because it allows us to recognize that we are human and acknowledge the difficult thoughts and feelings that are embedded in all of our natures. It helps reduce the fear, shame, and stigma around these feelings and provides a healthy way to address and reframe them.
DBT and SUD: What’s the Connection?
Simply put, there might be less for people to self-medicate if they could access DBT prior to turning to drugs or alcohol. When we consider the factors that lead to and sustain substance abuse, we usually find that they’re the product of emotional dysregulation that often stems from the inability to process intense feelings. Whether it’s broken familial relationships, acute traumatic experiences, issues of identity and self-worth or anything else, substance use often starts because people don’t feel they have anywhere to go to deal with these issues.
To that end, dialectical behavior therapy can help individuals struggling with SUD pinpoint and address the root psychological causes and triggers of their addiction, so they know how to deal with them without drinking or using drugs. Most alcohol and drug rehab centers offer DBT as part of their programming, and many provide references to post-treatment resources as part of patients’ aftercare plans so they can continue to work on the progress they made during their initial treatment experience.
DBT and Post-Treatment Relapse Prevention
The initial period after treatment is often emotionally challenging, with plenty of triggers for intense feelings and emotional dysregulation. These issues are among the most common causes of relapse. As integral to the treatment process as DBT is, there’s only so much that can be covered in a traditional 30-day inpatient program. This is why therapy must continue after patients complete their programs.
Although treatment centers often provide outgoing patients with referral information for DBT practitioners in their area, it’s important to ensure these providers are equipped to deal with your or your loved one’s unique emotional needs.
Some helpful questions to ask your prospective DBT practitioner include:
- How familiar are you with the types of challenges I face?
- How can you assess my candidacy for the ongoing DBT?
- What is your plan for treatment?
- How do you track progress?
- Do you provide a comprehensive DBT or a modification?
- What is your policy on phone calls and emails during the week?
- What length of time do you initially ask a client to commit to?
It’s also entirely appropriate to ask them about their background, including their education, years of experience, and if they belong to any professional organizations. You should also ask them if they consult with other therapists during your care.
Find Rehabs That Offer DBT
DBT is just one component of a comprehensive substance abuse treatment plan. Find rehab centers that offer DBT as part of their addiction treatment program.
