Dialectical Behaviour Therapy (DBT)
Addiction treatment has come a long way in the last 50 years. We have transitioned from an environment that applied a single treatment method in every case to one in which patients are treated on an individual basis. Now there are literally dozens of treatments that can be selected to treat patients based on their unique needs. One of them is a treatment known as dialectical behaviour therapy (DBT).
DBT is relatively new as compared to older treatments such as medically supervised detox and cognitive behavioural therapy (CBT). But it has been proven to be rather effective for patients suffering from psychosocial disorders, including addiction. In this article, you will learn more about DBT, where it came from, how it works, and how you can find an addiction rehab programme that includes the treatment as an option.
Developed from CBT
Dr Marsha Linehan developed dialectical behaviour therapy at the University of Washington in Seattle (USA). Though Dr Linehan initially designed her therapy in the late 1970s to treat people suffering from borderline personality disorder, it wasn’t until recently that DBT became a tool for treating drug addiction.
The treatment is closely related to CBT. In fact, it is a modified form of CBT with an additional emotional component attached. Where CBT is more aligned with the principal of problem-solving, DBT goes one step further by teaching patients to create, for themselves, a life worth living by properly channelling their emotions in productive ways. DBT is based on four primary components, or life skills, that patients learn during rehab treatment:
- Mindfulness – Mindfulness is the skill of controlling one’s thoughts and mind rather than allowing them to control the individual.
- Emotion Regulation – Patients learn to recognise their emotions and regulate them in such a way as to ensure they are productive rather than destructive.
- Distress Tolerance – Patients learn how to manage their own crisis situations without engaging in destructive behaviour.
- Interpersonal Effectiveness – Patients learn how to be more effective in their interpersonal relationships, including better communication and being aware of their own limits as well as the limits of others.
The fundamental difference between CBT and DBT is its willingness to embrace the thoughts and emotions as tools that can be used to overcome problems. For example, other kinds of therapies applied to substance abuse and psychosocial disorders present patients with an ‘either/or’ choice. Either they can deny their thoughts and emotions any opportunity to influence destructive behaviour or succumb to that behaviour. DBT does not seek to deny those thoughts and emotions; it aims to harness them and re-channel them in a positive direction.
To that end, DBT is more heavily intertwined with emotional response than other kinds of therapies. Patients learn skills that help them harness and refocus their emotions; skills such as:
- living in the present rather than the past
- continuing to live productively even in times of distress
- using emotions as a force for good
- learning to balance acceptance and change
- living productively with others.
Doctor Linehan’s original purpose in developing DBT was to create a therapy that would help patients with severe borderline personality disorder avoid suicidal thoughts and actions. Her therapy was later developed further for use in treating substance abuse, based on the knowledge that many people suffering from borderline personality disorder are also substance abusers.
Today, DBT is a therapy that is being utilised more heavily in the treatment of substance abuse and addiction. Not every private treatment clinic employs it, but there are very few treatments that have been universally adopted.
How DBT Can Be Used for Addiction Treatment
Although addiction rehab programmes vary from one rehab clinic to the next, they all have essentially the same goal: to help substance abusers and addicts come to terms with their conditions so that they can be overcome physically, mentally, and emotionally. DBT is a therapy that is aimed squarely at the mental and emotional side of addiction.
DBT is administered in two kinds of settings. First is the group setting, which enables participants to learn together. They learn about themselves and others; they also learn how to interact with others in a way that promotes healthy thoughts and emotions. The second setting is one of individual therapy. In this setting, the patient works with a therapist to identify and refocus thoughts and emotions.
There are some key differences between CBT and DBT in terms of modality. Patients treated with DBT discover that it:
- is presented as a class, structured around learning rather than problem-solving
- is very accepting of who the patient is rather than suggesting the patient become someone he or she is not
- trains patients to accept that hardship is part of life, and how to manage it more effectively
- trains patients how to regulate and control their emotions and thoughts
- teaches patients the skills they need to manage anxiety so as to live the kinds of lives they want to live.
How does all of this help with substance abuse and addiction? For starters, it puts patients on a path to understanding that they can learn to be in control of their own lives rather than allowing drugs or alcohol to control them. Once on that path, patients begin to understand that their thoughts and emotions are not necessarily right or wrong in an absolute sense, but simply that those thoughts and emotions need to be directed positively.
The redirection of thoughts and emotions is key to DBT. To understand why consider how drug and alcohol treatment was practised back in the 70s when Dr Linehan was developing her therapy. Recovering addicts in counselling were mainly told what they couldn’t and shouldn’t do. They could not keep using drugs because those drugs would kill them. They should not keep drinking because it was destroying their family. The problem was, they were never taught what they could and should do to create a happy and productive life for themselves.
DBT addresses that area. Other therapies still deal with the cannot and should not aspect while DBT empowers patients to do those things that will create positivity and productivity.
DBT Rehab Programmes
Clinics offering DBT rehab programmes are available here in the UK. Bear in mind that utilising one of these clinics does not mean the patient will only receive DBT. To the contrary, DBT is just one of many treatments the average addict will receive while in rehab. There are multiple aspects of substance abuse and addiction that all have to be treated.
Addictions to alcohol and most drugs require at least some sort of detox treatment. Detoxing from some substances is more difficult than others, but detox rarely takes more than 7 to 10 days. All of the clinics we work with utilise a medically supervised detox that ensures the health and safety of patients. Rehabilitative therapies, including DBT, begin once detox is complete.
Some patients may receive DBT in addition to CBT and various forms of group therapy. Another patient may focus mainly on DBT and individual counselling. Still another may combine music or art therapy with DBT. How therapies are applied is determined by individual circumstances. It is up to trained therapists to figure out the best way to treat each patient.
We Can Help You Find Treatment
If you want to learn more about finding a DBT treatment programme for yourself or a loved one, we invite you to contact us at your earliest convenience. Addiction Helper specialises in assisting substance abusers and their families finally ready to seek professional treatment. We maintain an ongoing database of available rehab clinics in the UK – including those that utilise DBT as a treatment option.
When you contact us, we will first offer you a comprehensive assessment of your situation. The purpose of this assessment is to determine what kind of substance abuse or addiction problem you are dealing with, how severe the problem is, and how that problem might be most effectively treated. The assessment gives us a starting point for recommending clinics and treatment programmes.
With your assessment complete, you will be offered a list of treatment options after being given the choice of whether you want to seek treatment or not. If you do, you will also be able to choose which facility you want to be treated at. If you don’t want treatment, that is entirely your decision. We will remain on the phone with you for as long as it takes to answer your questions and point you in the right direction.
Substance abuse and addiction are serious problems that will not go away on their own. Thankfully, there are treatments like DBT that have proven effective in helping substance abusers overcome their problems. If you or someone you know is struggling to break free from drugs or alcohol, we encourage you to contact our 24-hour helpline right away. We will do everything we can to help you get the treatment you need.