Dialectical Behavioral Therapy for Addiction

Dialectical Behavioral Therapy for Addiction 

Dialectical Behavioral Therapy for Addiction (DBT) is a comprehensive treatment program whose ultimate goal is to aid patients in their efforts to build a life worth living. It combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice. Research indicates that DBT is effective in treating patients who present varied symptoms and behaviors associated with mood disorders, including self-injury. Recent work suggests its effectiveness for treating chemical dependency.

When dialectical behavioral therapy for addiction is successful, the patient learns to envision, articulate, pursue, and sustain goals that are independent of his or her history of out-of-control behavior, including substance abuse, and is better able to grapple with life’s ordinary problems. The fundamental principle of DBT is to create a dynamic that promotes two opposed goals for patients: change and acceptance.

The treatment includes five essential functions:

  • improving patient motivation to change
  • enhancing patient capabilities
  • generalizing new behaviors
  • structuring the environment
  • enhancing therapist capability and motivation

History of Dialectical Behavioral Therapy

DBT was initially used as the standard behavioral therapy of the 1970s to treat chronically suicidal individuals. Subsequently, Dialectical Behavioral Therapy for Addiction was adapted for use with individuals with both severe substance use disorder (SUD) and borderline personality disorder (BPD), one of the most common dual diagnoses in cases of addiction. DBT includes explicit strategies for overcoming some of the most difficult problems that complicate treatment of both conditions.

Dialectical Behavioral Therapy for Addiction

The ultimate goal in dialectical behavior therapy for addiction is to aid patients in their efforts to build a life worth living. When DBT is successful, the patient learns to envision, articulate, pursue, and sustain goals that are independent of his or her history of out-of-control behavior, including substance abuse, and is better able to grapple with life’s ordinary problems.

The all-encompassing embrace of both acceptance and change in dialectical behavior therapy for addiction is consistent with the philosophical approach found in Twelve-Step programs, expressed in the Serenity Prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

Like other behavioral approaches, DBT addresses the most detrimental to the least detrimental behaviors in that order. This is used to decrease behaviors that are imminently life-threatening (e.g., suicidal or homicidal); for substance-dependent individuals, substance abuse is considered the most important target within the category of behaviors that interfere with quality of life. Dialectical behavioral therapy for addiction targets include:

  • decreasing abuse of substances (both illicit drugs and legally prescribed drugs taken in a manner not prescribed);
  • alleviating physical discomfort associated with abstinence and/or withdrawal;
  • diminishing urges, cravings, and temptations to abuse;
  • avoiding people, places, and things associated with drug abuse, deleting the telephone numbers of drug contacts, getting a new phone number, and throwing away drug paraphernalia;
  • reducing behaviors that encourage drug abuse;
  • increasing reinforcement of healthy behaviors, such as making new friends, rekindling old friendships, pursuing social/vocational activities, and seeking environments that support abstinence






Grief and Substance Abuse

Grief and Substance Abuse

Grief and Substance Abuse

Grief is a response to loss and it can involve many different facets. It is feelings of sorrow, emotion, and confusion after losing someone or something that is important to you. It is a natural, normal part of life. Grief can be experienced in reaction to death, divorce, job loss, a move away from family and friends, or a loss of health due to illness.

Grief and Substance Abuse: Emotions

Grief is often associated with crying, anger and depression. But these are not necessarily the only emotions a person experiences when they are grieving. Some people feel emptiness and apathy. Others get angry or frustrated. Still others will use drugs and alcohol as a way to cope with the grief. This is why the link between grief and substance abuse is so strong. Drugs and alcohol become a way for some people to numb the difficult emotions.

Grief and Substance Abuse: The Connection

Many people turn to drugs and alcohol to cope with a loss. They may find comfort in drugs and alcohol, that the substances are there for them when they need them. They may wish to numb the way they are feeling or forget about what happened. Or they may use substance abuse to punish themselves for the loss, in the case of a divorce, job loss, accident, or death of a child.

When people combine grief and substance abuse, they may appear strong when they are not. They may feel that grief is a weakness. But people who abuse drugs and alcohol to deal with a loss are in fact just numbing their emotions and prolonging the process of grief.

In addition, combining grief and substance abuse can cause people to act out recklessly. The combination of their emotional state plus the reduction of inhibitions from drugs and alcohol can cause them to do things they otherwise would not do. They may use multiple drugs, drink until they are intoxicated, engage in risky sexual behaviors, drive while drunk, share needles, or take drugs they normally would not take. This tendency is especially common in people with a history of substance abuse, anxiety, depression, or negative behavior patterns.

Grief and Substance Abuse: The Danger

Substance abuse masks grief. Some people who have significant substance abuse issues may have started using or drinking as a way to cope with loss or grief. They continue to use because they don’t want to feel it. They know that as soon as they stop using drugs and alcohol, they will have to feel all the emotions they have been suppressing.

Grief and substance abuse is a common problem in drug addicts and alcoholics. Whether or not they were already abusing substances when it happen, many addicts and alcoholics experienced some type of grief which kicked off or worsened their substance abuse. To recover, they have to get clean sober and deal with the emotions that are associated with the loss. They will have to come to terms with it and learn how to process emotions in a healthy way.


Therapy for Drug Abuse Treatment

Therapy for drug abuse treatment

Therapy for drug abuse treatment

Therapy for Drug Abuse Treatment

By Jenny Hunt

Therapy for drug abuse treatment can take many different forms. There is inpatient therapy, outpatient therapy, intensive outpatient treatment, group therapy, individual talk therapy, hypnotherapy, holistic therapy, anger management therapy, trauma therapy, family therapy, etc. Most treatment centers offer several different types of therapy for drug abuse treatment because no two people are the same, and no two people respond in the same way to a certain kind of therapy. Here we explore some of the most common types of therapy for drug abuse treatment.

Standard therapy for drug abuse treatment is talk therapy. Talk therapy is the generic name given to a range of psychotherapeutic therapies that includes cognitive behavioral therapy, psychoanalysis, and counseling. Cognitive behavioral therapy basically works on changing dysfunctional ideas about certain events or behaviors and eliminating negative associations through talking and role-playing. Psychoanalysis is a process by which you work with a therapist to identify the root cause of dysfunctional ideas and behaviors and why you think the way you do. Counseling is just the process of advising the client on how to handle situations and events.

Almost all treatment centers incorporate some form of talk therapy. Usually there is a mixture of group and individual sessions. In individual sessions, you are able to talk about your specific problems and concerns. Group talk therapy allows you to hear other people’s perspective on a topic. Talk therapy is considered an integral piece in therapy for drug abuse treatment.

It is becoming more and more common for treatment centers to incorporate holistic therapy for drug abuse treatment. It has been shown that clients are three times more likely to succeed when they are introduced to at least one holistic practice during treatment. Holistic practices can include acupuncture, massage, yoga, or meditation.

Family therapy is also a common therapy for drug abuse treatment. Addiction affects the whole family and often, the loved ones of the addict or alcoholic are just as sick as the addict or alcoholic themselves in their own way. Family therapy can heal broken relationships and reveal enabling behaviors that may threaten an addict or alcoholic’s recovery.

Many addicts and alcoholics have experienced trauma either during or prior to active addiction. Sometimes a traumatic event caused the pain that was eventually numbed by drugs or alcohol. Other times, use of drugs or alcohol caused the individual to find themselves in risky or unsafe circumstances and it was then that the trauma occurred. Regardless, many addicts and alcoholics carry the burden of trauma around like an albatross. It affects the way they feel about themselves, other people, and life in general. If this trauma is not resolved, it can make it almost impossible for a drug addict or alcoholic to recover. This is why therapy for drug abuse treatment often includes trauma resolution.

Every individual is different, as is every drug abuse treatment program. It is important to carefully assess your needs before deciding on the best place to get help, and to make sure they have the resources to respond to your needs.