Dialectical behavioral therapy is a technique developed by clinicians to help individuals who don’t respond to traditional psychotherapy methods. It reinforces the importance of one’s experience and emotions, without attempting to alter thought patterns or correct behaviors.

Accordingly, this results in a positive treatment environment, free of judgment. Still, DBT requires extreme dedication from the patients—from practicing daily mindfulness to filling out worksheets at home and handing in diary cards.

In this guide, we’ll tell you all the information you need to know about dialectical behavioral therapy for addiction treatment. Keep reading to learn the four pillars of DBT and how they work.

Let’s dive in.

Dialectical Behavioral Therapy (DBT)

Understanding Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) is a branch of psychotherapy developed by Marsha Linehan. It focuses on treating interpersonal conflicts without correcting behaviors or changing personal beliefs.

Instead of altering the perception of the patient, DBT aims to help them understand their triggers and accept their troubled emotions.

In turn, this will help people struggling with mental conditions cope with difficult situations and prevent their intrusive thoughts from getting the best of them.

DBT requires a deep understanding of the self, not just knowledge of addiction and mental health. The latter is nothing but textbook definitions and technical information on the chemistry of addiction.

On the other hand, DBT unlocks deep parts of peoples’ personalities they never knew existed by validating their external emotions. Since each person is different, this journey is extensive and complex.

Clinicians also need to offer plenty of support during the DBT treatment journey. Most people struggling with addiction will be apprehensive about sticking to a routine and practicing mindfulness rather than impulsivity.

For this reason, they need a judgment-free, supportive treatment environment, where they’re allowed to make mistakes.

Elements of Dialectical Behavioral Therapy

DBT involves plenty of hands-on experience from the professional consultation team. It’s more than just identifying triggers and rewiring your brain.

This psychiatric treatment gives patients access to various coping strategies, preventing self-injury and resulting in a significant reduction in relapses. The DBT skills training sessions involve four main portions:


The core element of DBT is mindfulness. Many people already practice this beneficial technique for health or religious reasons. However, integrating mindfulness into therapy has a substantial positive impact.

Mindfulness, in its simplest form, is about focusing on the present moment. By shifting your attention to your current experience and allowing yourself to feel your emotions to the fullest, you’ll control your actions.

Moreover, mindfulness helps people with addiction accept their feelings without any guilt or judgment. Then, this can radically reduce the shame of opening up and asking for help, as well as prepare people with addiction for a peaceful journey.

This is easier said than done, especially when dealing with the harmful thought patterns associated with addiction.

Typically, mindfulness techniques consist of the following steps:

1. Freeing up Time

It’s crucial to be fully immersed when practicing mindfulness, avoiding any external stimuli or distracting events. Make sure to set some time aside every day to practice mindfulness. Over time, you’ll be mindful at all times.

2. Mindful Breathing

Breathing exercises significantly reduce anxiety and prevent overthinking. Not only will this help you during triggering situations, but it’ll also prepare you for a full experience.

3. Observing Your Surroundings

Next, you should hone your mindfulness skills by shifting your attention to your surroundings. These exercises, also known as grounding, focus on engaging your five sensations. You can do this by identifying elements you can see, hear, touch, taste, and smell.

4. Paying Attention to Your Body

If you frequently experience dissociation, this step will be particularly helpful for you. By recognizing the current state of your body, you’ll be able to reconnect with your present moment and get comfortable with the following steps.

5. Relaxing Your Body

Throughout your meditation session, your body must be relaxed. It’s normal to find you’re clenching your jaws or shaking your leg since you’re exploring difficult feelings. Checking in with your body now and then will ensure you’re letting go of all the negative feelings.

Emotional Regulation

Numerous personality disorders and mental health conditions come with severe emotional dysregulation. This is particularly seen in individuals struggling with addiction, suicidal ideation, and borderline personality disorder (BPD).

In these cases, individuals experience intense emotions that might lead to self-injury. These feelings might even be hard to pin down, as they’re too complex.

With a few mindful techniques, patients can regulate their emotions so that they’re able to think clearly. Then, they’ll be able to move on to solutions. These techniques include:

1. Distinguishing Your Current Emotions

Properly feeling your feelings is a mindful skill very few people learn when they’re young. It’s up to us adults to become aware of our emotions, sit with them, and tell them apart.

This includes distinguishing between our actual emotions and sensations brought on by external stimuli, such as hunger, pain, and discomfort. It’ll take many trials and errors until you get the hang of things, but once you do, you’ll be in complete control of your mind.

2. Describing Your Feelings

It’s not enough to describe your emotions with simple words, like “upset” or “sad.” Instead, mindfulness involves expressing your emotions using specific vocabulary rather than broad terms. In turn, this will enhance your communication skills and help you make sense of your complex thoughts and feelings.

3. Letting Go of Judgement

As you’re navigating your deep emotions and identifying your thought patterns, it’s crucial to be non-judgmental. Observe your emotions without labeling them “bad” or “harmful.” This way, the mindfulness experience won’t have any negative connotations, and you’ll be able to practice it daily without discomfort.

4. Being Comfortable With Negative Emotions

Life has its ups and downs. Unfortunately, many people fear the downs of life, choosing to block negative feelings rather than face them.

Well, once you take judgment out of the situation, things will be much simpler. From there, all you have to do is sit with your feelings and ask yourself a couple of questions: Is the feeling getting more intense or subsiding? Is my body being affected by my feelings? Have I felt this way before?

5. Avoid Reacting

Lastly, you should think of intense emotions as temporary waves. Most harmful behaviors result from reacting to these deep, neglected feelings. However, noticing your emotions and allowing yourself to calm down before reacting will alter how you perceive your situation and allow you to gain control.

Distress Tolerance

Distress tolerance might be a popular spiritual and religious practice, but it’s also a potent strategy in DBT treatment. Its main elements are radical acceptance and intentional self-soothing.

These DBT skills will come naturally if you practice mindfulness long enough. The reason is that mindful techniques require basking in overwhelming thoughts and emotions without acting.

Similarly, distress tolerance arms you with numerous approaches, so you can navigate distressing feelings. These include:

Interpersonal Effectiveness

The new skills of DBT also help individuals foster healthier relationships. Sequentially, they’ll lead a happier life, avoid toxic people, and develop self-assurance.

The three main pillars of interpersonal effectiveness in DBT are:

  • Assertiveness: By expressing your needs and feelings more honestly, not only will you get the right support, but you’ll also build trust in your relationships and prevent setbacks.
  • Active Listening and Validation: Maintaining relationships is a two-way street. You must learn to shift your focus onto others, which in itself can be a self-soothing strategy, to retain a close bond.
  • Boundaries and Self-Respect: Numerous people with addiction feel intense shame over not keeping close friends and feeling uncomfortable in crowds. Developing interpersonal effectiveness will slowly build confidence and self-respect, funneling back into enhancing interpersonal skills.

When Dialectical Behavioral Therapy Is Useful

DBT is an ideal psychiatry practice for many people. In particular, it’s comparable to cognitive behavioral therapy (CBT) in effectiveness with some key distinctions.

For starters, DBT is perfect for people who find CBT to be invalidating, such as adolescents and people with substance abuse issues. That’s because CBT’s focal point is correcting harmful behavior and thought patterns, while DBT is all about accepting the bad before the good.

Moreover, the evidence-based approach can help anyone struggling with impulsivity and addiction, as well as people with dual diagnosis.

Healthcare providers will probably suggest DBT sessions for the following:

  • Substance-use disorders
  • Eating disorders
  • Bulimia
  • Binge-eating disorder
  • Self-harm
  • Post-traumatic stress disorder
  • Suicidal behaviors

Still, even individuals who don’t fall under the criteria of DBT patients can find helpful tips from these techniques.

Dialectical Behavior Therapy for Addiction Treatment

DBT is the perfect supplementary treatment for addiction. After successfully detoxing, people with addiction must learn how to cope with negative emotions without resorting to substance abuse.

Typically, DBT is combined with other treatment elements, such as 12-step programs and medication-assisted treatment, for the best results.

Furthermore, these individuals often feel immense guilt, which is amplified by traditional CBT. What they need is a supportive, judgment-free environment, where they can learn to harness their strengths and avoid relapsing.

Fortunately, DBT is becoming increasingly accessible, Most addiction treatment centers employ this powerful treatment strategy.

The best part is that it doesn’t require admission or plenty of time. Instead, people with addiction can become reacquainted with their regular lives, while developing helpful techniques and accepting themselves.

Outpatient Sessions

DBT is a long-term outpatient program. The individual therapy sessions are similar to CBT, where mental health professionals help patients explore their emotions, and offer support.

Yet, DBT therapists are more likely to assign “homework”, and teach you several techniques. These might include any of the following:

  • Breathing exercises
  • Grounding techniques
  • Self-soothing methods
  • Diary cards
  • Behavior change worksheets

Group Therapy

Group therapy is an essential element of DBT, as it significantly enhances interpersonal effectiveness. These are more like classes, where everyone shares their experience with various DBT exercises.

Additionally, group therapy sessions allow patients to look better at the grounding techniques and learn how to use them in more lifelike scenarios.

At-Home Resources

Finally, DBT requires substantial work at home. In addition to homework, DBT therapists will also encourage their patients to explore the topic through online resources and come up with a treatment plan that’s comfortable for them.

Moreover, many professionals offer phone coaching sessions. This way, patients, especially those just starting with DBT, have accessible treatment. Accordingly, this significantly reduces relapses.

Frequently Asked Questions

How long do dialectical behavior therapy sessions last?

DBT sessions are comparable to CBT sessions, lasting from 40 to 60 minutes. The individual therapy sessions occur weekly, with group sessions occurring once every week or two weeks.

That said, DBT is a long-term solution. While CBT typically lasts for 12 to 20 sessions, DBT has no specific end dates. That’s because patients are encouraged to exercise the mindful strategy daily, and for the rest of their lives. Still, most patients attend outpatient sessions for about 6 months.

Is DBT expensive?

At first glance, DBT might seem more expensive than other treatment options. The reason is that while DBT is becoming more and more accessible, it’s still less available than CBT, for example.

Moreover, DBT arms patients with life-long skills. It’s an extensive program that requires more involvement from mental health professionals. It’s also one of the few options for the treatment of borderline personality disorder.

To Conclude

Dialectical behavioral therapy is an increasingly popular branch of psychiatry that helps patients regulate their emotions and handle negative life events by themselves.

This patient-led approach was developed to help people who don’t respond well to traditional psychiatry practices. It offers a safe environment, free of judgment, where patients’ experiences are valid.

Instead of altering patients’ perceptions of events or rewiring their thoughts, DBT focuses on reinforcing their experience and increasing their self-confidence. Then, they can ride out any intense emotions, reflecting on their feelings mindfully rather than impulsively reacting. The result: increased self-respect and control, and a feeling like life is worth living once again.

Published on: 2024-06-11
Updated on: 2024-06-20