Living with addiction takes a serious toll on a person’s health, finances and relationships. While he or she knows change is necessary, making adjustments that will stick, day in and day out, can be difficult. Sometimes, the way someone thinks and reacts to the world outside of treatment can create major stumbling blocks to recovery. Dialectical Behavior Therapy (DBT) is a treatment approach designed to help those struggling with drug or alcohol addiction understand and adjust their thoughts and emotional responses.

While originally created for borderline personality disorders, DBT been modified for use in the treatment of a wide variety of other mental health issues, including:

  • Substance abuse issues
  • Eating disorders
  • Post-traumatic stress disorder
  • Anxiety
  • Obsessive-compulsive disorder2

Early Stages of DBT

DBT use a skill-based approach to help patients learn to control and manage their emotions, tolerate stress and improve interpersonal relationships.3 In the early stages of treatment, therapists focus on the need for change while accepting and validating the patient’s current condition. The therapist must find a balance between supporting the person and helping him or her feel accepted while pointing out why change is necessary. Since this relationship between the therapist and the person in therapy is so important, early stages of DBT often involve very long, intense conversations between the therapist and the patient. These early sessions allow patient and therapist the opportunity to build a relationship and understand one another.

As the therapy progresses, the therapist begins to provide instruction on mindfulness techniques. The therapist encourages the patient to identify when thoughts are coming from the emotional part of the brain. When those emotional thoughts are identified, the person is then asked to take a step back and observe the situation with logic and objectivity before choosing to react. For some people, this means learning how to simply accept a situation without approving of it. In other words, some people learn how to move beyond things they cannot control. No judgments are needed, and no intercessions are required.4

Middle and Late States of DBT

Therapy sessions may be incredibly helpful, but they may not allow the person to truly practice the lessons and apply them in real time. Group sessions can help to fill this gap. Group sessions in DBT tend to begin weeks after the person has started to work with a therapist, and that therapist remains in charge of the group sessions. DBT group sessions are tightly structured and controlled by the therapist and are designed to allow people to interact in a safe environment and practice their skills. In addition to group sessions, people in DBT are often provided with lengthy homework assignments. They may be asked to read articles and write about them, or they might be asked to use a specific technique in a stressful situation coming up that week, and then describe how that technique either worked or did not work.

Finding Help for Mental Illness and Addiction

At Michael’s House, we use DBT techniques with our residents and have found the therapy remarkably effective. If you or a loved one struggles with addiction or mental illness, call us now. Our admissions coordinators are available 24 hours a day to answer your questions about how we integrate this therapy into our programs.


1Our Team.” Behavioral Research Therapy Clinics. Accessed 28 Mar. 2018.

2 Olenchek, Christina. “Dialectical Behavioral Therapy – Treating Borderline Personality Disorder.” Dialectical Behavior Therapy – Treating Borderline Personality Disorder. Accessed Mar. 28, 2018.

3Borderline Personality Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 30 July 2015.

4 Grohol , John M. “An Overview of Dialectical Behavior Therapy.” Psych Central, 23 Mar. 2018.

Speak with an Admissions Coordinator 877-345-8494