Dialectical Behavioural Therapy (DBT)

Dialectical Behavioural Therapy, or DBT, is a therapeutic approach that has been shown to be successful in the treatment of addiction. Developed by Dr Marsha Linehan in the 1980s, DBT is a cognitive-behavioural therapy that aims to help people manage their emotions and change their behaviour. But how does DBT for addiction work in practice and how can it help you through recovery?

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What is DBT for addiction?

At its core, DBT for addiction is about helping people to change their behaviours. This might involve learning new coping mechanisms for dealing with difficult emotions or situations or making changes to the way you think about yourself and your addiction.

Since its development, DBT has proven very helpful for other conditions and it is now being used effectively to treat substance abuse and addiction, borderline personality disorder (BPD), depression, anxiety, obsessive-compulsive disorder (OCD), and other mental disorders involving interpersonal struggles.

There are three features of DBT that make it an effective therapy for addiction treatment:

DBT is support-based

DBT is designed to be supportive in every way. It helps you to identify your strengths and then use them to develop strategies to avoid relapse. In addiction treatment, combining your strengths with your individual recovery successes (i.e. completed detox or the completion of one of the 12-steps) will help you to feel good about your progress and keep you on the right path.

DBT is cognitive-based

A cognitive-based therapy identifies various thoughts, assumptions, emotions and beliefs that tend to make it harder for you to overcome addiction. Such identification allows you to better understand the underlying causes of your addiction and develop strategies for coping during triggering moments.

DBT is collaborative

Lastly, DBT is not designed for you to do speaking while a therapist writes down notes; it is a collaborative therapy that encourages you and your therapists to work things out together. Most of the therapists at UKAT have been through rehab themselves so having somebody who knows what you are experiencing can be invaluable.

How does DBT for addiction treatment work in practice?

Dialectical behaviour therapy for addiction involves four main modules:

1: Mindfulness

Linehan created DBT with mindfulness being one of its core elements. The principle of mindfulness is one of using various meditative exercises to teach patients to be in the present and live in the moment. This will allow you to fully embrace your thoughts and emotions. There are two sets of skills learned in the mindfulness module: what (observing the current environment) and how (maintaining focus even when the current environment is not positive).
Meditative exercises may include:

Progressive muscle relaxation
Diaphragmatic breathing
Guided imagery
Mantra repetition
Walking meditation

All of these exercises help you to focus on the present, which is an important skill in recovery. It can be easy to dwell on the past or worry about the future, but mindfulness helps you to stay in the here and now and accept your thoughts and emotions without judgement.

2: Distress tolerance

The second module is known as distress tolerance. It naturally flows from mindfulness in that it uses the what and how skills to teach you how to deal with stressful situations without falling back on previous negative behaviours. Distress tolerance teaches you how to work through stressful situations through a variety of strategies to keep your mind focused on the positive. These include:

Learning to accept reality
Distracting yourself from thoughts and feelings related to the stressful situation
Self-soothing using positive activities or sensory experiences (e.g., listening to music, going for a walk)
Improving the moment by doing something fun or positive
Reframing your thinking about the stressful situation in a more positive light

3: Emotion regulation

The third module is known as emotion regulation. The skills learned during emotion regulation are designed to keep your emotions in check rather than allowing them to dictate your actions. This is of particular importance to people in addiction treatment who are prone to temptations by way of their emotions.
The skills you will learn may include:

Identifying and labelling emotions
Refraining from reacting to emotions in an unhealthy way
Reducing the intensity of negative emotions
Increasing positive emotions
Taking the opposite action to your emotion

4: Interpersonal effectiveness

The fourth and final module is interpersonal effectiveness. In this module, you will learn skills that will govern your interpersonal relationships. You will learn to identify your own needs and ask for help in meeting them. You will learn to say no to people, circumstances, and behaviours that are negative and to positively and effectively handle interpersonal conflicts with others.
The skills you may learn include:

Effectively communicating your needs
Saying no in a positive way
Asking for what you want
Dealing with disagreements and difficult people constructively

How does DBT for addiction complement other addiction treatments?

DBT for addiction is most effective when used in conjunction with other addiction treatments, such as 12-step programmes, individual therapy, and group therapy. DBT complements these other treatments by teaching you the necessary skills to effectively cope with your emotions and manage stress without turning to drugs or alcohol.

This is very important because the recovery journey can be a stressful and emotional time, and it is during these times that you are most likely to relapse. DBT provides you with the tools you need to deal with these difficult emotions and situations in a healthy way.

How is DBT used after rehab?

DBT is often used after rehab in order to help you transition back into everyday life. The skills you learned during treatment will be put to the test when you are no longer in the protective environment of rehab.

This is why it is so important to continue practising your DBT skills after rehab, either in individual therapy or in a DBT skills group. This will help you to solidify the skills you learned in treatment and continue to use them in your everyday life.

Frequently asked questions

Where can I access Dialectical Behaviour Therapy in UKAT centres?

Most of UKAT’s rehab centres provide DBT for addiction treatment because we believe that it can be a hugely effective recovery approach. We have highly-rated addiction treatment centres across the UK so get in touch with us today and we can help you find the right centre for your addiction recovery treatment.

Can I access DBT as an outpatient?

While DBT may be available as an outpatient, DBT for addiction treatment is best done as part of a comprehensive rehab programme at a residential treatment centre. However, DBT is also important after you have left rehab to help you stay on track with your recovery so you may receive it as an outpatient at that point.

What is the difference between DBT and CBT?

DBT builds upon the principles learned in Cognitive Behavioural Therapy (CBT). Once you understand how thoughts influence behaviours and emotions, you can then begin to restructure your thoughts to produce more positive behaviours and emotions. More specifically, you will learn how to create constructive thought patterns within interpersonal relationships and in circumstances that trigger volatile emotional responses.

Disclaimer:

The availability of therapies may vary across UKAT centres. The specific therapies provided will be determined based on your treatment plan and the programme offered at your chosen facility. All treatments are subject to clinical assessment and programme availability at the time of admission. For further details on the therapies included in your treatment plan, please contact our admissions team.