DBT and Substance Abuse

Did you know that there is a Dialectical Behavior Therapy curriculum specific to targeting Substance Abuse? DBT-SUD adds new principles, strategies, and protocols to address addiction and has numerous Random Clinical Trials (RCT’s) in support of its effectiveness.

I believe that many people who abuse drugs and alcohol do so as a way of coping with difficult, and painful emotions. Many people do not have skills to manage life on ‘life’s terms’. The goal of DBT is to help develop more healthy and effective ways to cope with uncomfortable emotions, thoughts, and behaviors in order to move the patient towards developing their Life Worth Living goals. DBT requires a commitment to give up maladaptive coping behaviors and replace these behaviors with more healthy and effective strategies. DBT-SUD teaches effective coping strategies instead of turning to drugs and/or alcohol to numb out intense emotions. Patients receive group skills training to learn standard DBT skills of Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness as well as a set of skills specific to treating addictions such as Burning Bridges, Alternate Rebellion, Urge Surfing among others. Individual therapy helps patients develop awareness of their triggers to use and focuses on applying skills to achieve their treatment goals. DBT therapists offer phone coaching to support and coach patients between sessions and before they act out on an urge to use.

Some strategies of the DBT clinician is to:

  • Build greater awareness of urges to use drugs or alcohol through cultivation of a mindfulness practice and by using diary cards and behavior chain analysis.
  • Teach how to manage the distress of strong urges to use drugs or alcohol by practicing distress tolerance skills such as DISTRACT by implementing healthy behaviors and activities.
  • Understand the function of Emotions and use Opposite Action to Emotion when cravings are strong.