Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) is a treatment method used in addiction rehabilitation in combination with individual and group therapy and other tactics. DBT is a fairly new addition to substance abuse treatment, and it holds a lot of promise for success in treating addiction. DBT therapy can help:
- Increase mindfulness
- A higher tolerance level for physically and mentally unpleasant situations
- Improved interpersonal skills and better relationships.
- Emotion control so that behavior is more even-keeled.
Addiction is largely based on repetitive negative patterns that create a vicious cycle of addiction. Despite known negative consequences, addicts continue to indulge in compulsive patterns that are extremely harmful. Addiction eventually takes precedence over everything else in the person’s life, including work, family, relationships, and other normal adult responsibilities.
DBT helps a wide range of clients deal with their problems. It can help with anxiety, depression, borderline personality disorder, and eating disorders. All of these things can play a huge role in contributing to addiction. When these root issues are addressed, people in drug and alcohol treatment have a much stronger chance of achieving and maintaining sobriety. At The Florida House Experience, we strive to give our clients a well-rounded treatment approach. DBT is an essential part of helping our clients heal from past trauma and emotional scars to have the best possible chance at recovery.
Dialectical Behavior Therapy is part of our well-rounded approach to drug and alcohol addiction treatment. At The Florida House Experience, we want to ensure that our clients have the best possible chance to achieve sustained sobriety.
DBT is a type of cognitive-behavioral therapy developed by psychologist Marsha M. Linehan in the late 1980s. It was originally developed to treat borderline personality disorder, and since then has been used to treat a wide variety of mental disorders, including addiction.
DBT emphasizes psychosocial aspects of treatment. This means that it focuses on social factors and individual thought and behavior. It is believed that certain people are predisposed to react in an over-the-top manner to normal emotional situations. These people have a much more intense rate of arousal and emotion than other people. They require less stimulation to become more excited and have a hard time returning back to normal levels where stimuli have been taken out of the equation.
DBT is support oriented in order to foster a sense of well-being, self-respect, and a generally more optimistic outlook to avoid the extreme highs and lowest of lows. It also helps to identify behavior that is negative, especially when it comes to negative self-talk that makes a person think they are not worthy. Together, the client and therapist work as a team to come up with more positive self-talk. Problems are identified and worked out, and the client may even have “homework” they need to do in between sessions to keep the process moving along towards a positive outcome.
During these sessions that are confidential and private, problems and issues are identified along with the problem-solving behavior that the client needs to engage in. The most important behaviors to address are self-harm or suicidal thoughts or actions if they exist. From there on the importance of issues tapers down as it is relevant. The goal is to focus on improving the overall quality of life, and coming up with healthy solutions to issues so that turning to drinking or using drugs is no longer the best option. During individual sessions, the focus is also on improving relationships so that the client can begin to fix relationships that may have gone bad and repair the damage that was done during addiction. Explosive behavior tendencies are toned down so that the client has time to think about their actions before they act out. If any trauma happened in the client’s past, this will also be addressed in privacy and coping skills will be discussed.
The clients come together in a group setting to discuss current issues and solutions with a trained DBT therapist who can help to facilitate the discussion and make sure that it stays on track. These sessions focus on four modules: interpersonal relations, acceptance skills, emotional regulation, and mindfulness. The therapist may guide the discussion to speak about one of these or all of them. Here are the four modules broken down:
1. Interpersonal relations – this kind of therapy helps train people to better react in common situations they may encounter. A prime example might be how to deal with a loved one who has been a negative influence in the past. Learning how to set boundaries, use self-respect, say “no” when appropriate, and conflict resolution.
2. Acceptance skills – this works to retrain the brain to deal with distressing situations in a healthier way than turning to drugs or alcohol. A lot of this is based on mindfulness and acceptance. It also requires some self-control in emotionally volatile situations so that a rational conclusion can be drawn.
3. Emotional regulation – addiction brings with it the highest of highs and lowest of lows. It is important to learn how to operate on an even keel so that emotions don’t easily get out of hand and cause a bad situation to get even worse.
4. Mindfulness – this is a skill that encompasses all of the skills listed above. It is the practice of being able to take a step back and assess a situation before becoming explosive and unnecessarily emotional. Simple tactics like taking a few breaths during an uncomfortable situation and keeping emotions under control can help a client be less inclined to act out irrationally and more thoughtful about the events that occurred.
Dialectical means “a synthesis or integration of opposites.” In this type of therapy, it means differentiating acceptance and change in clients so that they have a more stable approach to dealing with life without addiction. DBT treats a variety of problems starting with the most significant and tapering down. The most significant are usually considered life threatening behaviors, all the way down to skill acquisition, which is considered less significant and is introduced in the later stage of treatment once progress is made.
Research has shown that DBT is effective in reducing negative behaviors and influencing positive change. For clients in rehab, it helps to lower the rate of treatment dropout and to improve functioning so that they get the most out of their treatment experience. While DBT was originally developed to treat people with suicidal tendencies, it has since been proven effective in treating substance abuse, depression, anxiety, PTSD, and even eating disorders.