Dialectical Behavior Therapy (DBT) for Addiction
How DBT's four core skill sets — mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — support addiction recovery at Keystone Health Group.
Dialectical behavior therapy (DBT) was originally developed by Dr. Marsha Linehan for borderline personality disorder, but has since been adapted and validated for addiction treatment — particularly for people with co-occurring emotional dysregulation. DBT is built on the dialectic of acceptance and change: accepting yourself as you are while simultaneously working to change behaviors that are causing harm. In addiction treatment, DBT teaches four core skill sets that directly address the emotional and interpersonal drivers of substance use.
The Four DBT Skill Sets
DBT teaches four core skill sets: (1) Mindfulness — the foundation of all DBT skills, teaching clients to observe and describe their experience without judgment; (2) Distress Tolerance — skills for surviving crises without making them worse, including distraction, self-soothing, and radical acceptance; (3) Emotion Regulation — skills for understanding, managing, and changing intense emotions; (4) Interpersonal Effectiveness — skills for maintaining healthy relationships and setting limits while keeping self-respect.
DBT for Substance Use Disorder
DBT has been specifically adapted for substance use disorder (DBT-SUD). The adaptation includes dialectical abstinence (combining absolute commitment to abstinence with acceptance of relapse as a learning opportunity), clear mind (the state of being neither addicted nor craving), and community reinforcement (using the treatment community to support recovery). DBT-SUD has been shown to be particularly effective for people with co-occurring BPD and substance use disorder.
DBT Format
DBT is typically delivered in a combination of individual therapy and skills training groups. Individual therapy focuses on motivation and applying skills to specific problems. Skills training groups teach the four skill sets in a structured, psychoeducational format. Our DBT program integrates individual and group components within the inpatient treatment structure.
Signs & Symptoms of Addiction
Our Treatment Approach
Frequently Asked Questions
Is DBT different from CBT?
Yes. While both are evidence-based therapies, DBT places greater emphasis on acceptance and validation alongside change, and specifically addresses emotional dysregulation. DBT also includes a skills training group component that CBT does not.
Who benefits most from DBT?
DBT is particularly effective for people with emotional dysregulation, co-occurring BPD, self-harm behavior, or a history of trauma. It is also effective for people who have not responded well to CBT alone.
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