Dialectical Behavior Therapy and Substance Dependency

You have many options when it comes to treating substance dependency. One of these options is Dialectical Behavior Therapy (DBT). DBT falls under the broader category of Cognitive Behavioral Therapy (CBT). This category of therapy focuses on changing how we act and feel by changing how we think. It helps us change our perspective and therefore our beliefs about ourselves and the world around us. Dialectical Behavior Theory uses certain theories and practices to help people become more aware and react more appropriately.

DBT began as a treatment option for bipolar disorder. According to Psych Central[1], “Some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships. DBT theory suggests that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation, and take a significant amount of time to return to baseline arousal levels.” DBT helped, and continues to help, many people with bipolar disorder find greater balance. As DBT found success in study and practice, therapists began to apply this treatment approach in more settings. These settings include substance dependency and addiction treatment.

Does DBT Work for Substance Dependency?

Dialectical Behavior Therapy can treat substance dependency and addiction. As with all treatment options, its effectiveness depends on your unique situation and personal recovery needs. DBT is evidence-based and supported by studies and statistics. Facing Addiction in America[2] considers it particularly effective and appropriate for both white and racial minority groups needing recovery support. DBT is a culturally sensitive treatment option, and cultural awareness is essential for effective treatment. Facing Addiction explains, “Cultural factors, including discrimination, acculturation, ethnic pride, and cultural mistrust, were associated with the pre-intervention levels of alcohol and drug use…Accounting for these factors when tailoring a substance use disorder intervention is critical to meeting the needs of the community it is aiming to serve.”

DBT is rooted in Buddhist practices but uniquely able to serve a broad range of cultures and perspectives. Facing Addiction, the Surgeon General’s report on alcohol and drug abuse, explains: “A study examining patients in a substance use disorder residential treatment center that incorporated DBT with specific cultural, traditional, and spiritual practices for American Indian or Alaska Native adolescents found that 96 percent of the adolescents in their sample either recovered or improved.” DBT is an effective treatment option. Your unique personal strengths and recovery challenges may be rooted in race, socioeconomic status, environment and more. DBT takes these factors into account to provide a holistic, appropriate approach to substance abuse treatment for anyone.

How Does DBT Work?

DBT focuses on managing emotions through meditative and culturally sensitive practices. Psychiatry[3] explains that DBT differs from other forms of CBT in that it is based in, “the biosocial theory and focusing on emotions in treatment, a consistent dialectical philosophy, and mindfulness and acceptance-oriented interventions.” DBT also serves “the five functions of treatment.” These functions of treatment are the goal of any comprehensive treatment approach.

The first function involves enhancing life skills. These skills may include the following:

  • Emotional regulation
  • Mindful awareness of the present moment
  • Interpersonal effectiveness
  • Distress tolerance

These skills let you balance your thoughts and feelings and see your circumstances and situation accurately. Life skills help you build healthy relationships and navigate interactions with others. They help you react to negative situations in healthy ways and to move forward rather than backward.

The next function of treatment involves teaching you how to apply these skills in real life, outside of a treatment setting. It involves practical application rather than just learning theory. It is closely tied to the third function. This function involves creating and maintaining motivation for change. Treatment can teach you the skills you need to find and maintain recovery, but if you do not have the motivation to learn or apply these skills, sobriety will be a challenge. No one can do the work of recovery for you, but therapies like DBT help you find the reasons, energy and confidence to do the work yourself.

A fourth function of treatment involves the relationship between therapist and patient. You need education, support and motivation. Professionals do as well. Psychiatry explains, “Another important function of DBT involves maintaining the motivation and skills of the therapists…One essential ingredient of an effective treatment for BPD patients is a system of providing support, validation, continued training and skill-building, feedback, and encouragement to therapists.”3 DBT emphasizes continued education and community support for treatment providers. This helps therapists continue to provide the most empathetic, up-to-date care.

The final function of DBT involves modifying your environment. This may involve helping you create a new social circle that does not support or enable drug use. Your home or work environment may have to change. Your therapist will help you identify triggering places, relationships, and situations. You will work together to create a healthy environment outside of treatment. A positive environment supports rather than challenges continuing, life-long sobriety.

Finding DBT and Substance Dependency Treatment

When choosing substance dependency treatment, choose a comprehensive treatment option. Consider Michael’s House. We offer Dialectical Behavior Therapy and other integrated treatment options. We want you to find freedom from addiction, a healthy mind and a happy home. We are here for you from your earliest questions about treatment to aftercare and alumni resources years after treatment ends. Call and learn more about what we offer and what options can work for you.


[1] https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/. “An Overview of Dialectical Behavior Therapy.” Psych Central. 17 Jul 2016. Web. 2 May 2017.

[2] https://addiction.surgeongeneral.gov/surgeon-generals-report.pdf. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Surgeongeneral.gov. Nov 2016. Web. 2 May 2017.

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/. “Dialectical Behavior Therapy.” Psychiatry (Edgemont). Sep 2006. Web. 2 May 2017.