Dialectical Behaviour Therapy Addiction Treatment

There are several types of therapies used during the treatment of conditions such as addiction and mental health disorders; dialectical behaviour therapy (DBT) is one of these. If you are wondering what to expect from this type of treatment, you will learn here more about what it is and what it does.

What Is Dialectical Behaviour Therapy?

Dialectical behaviour therapy is a type of talking therapy that is used to help people overcome a range of emotional issues associated with illnesses like substance abuse and addiction, as well as behaviour disorders and mental health problems. It is based on cognitive behavioural therapy and the idea that thoughts and emotions are linked to actions. However, DBT has been adapted specifically for use in those who experience intense emotions and have more complex needs.

While DBT was initially developed for the treatment of borderline personality disorder, it has proved useful as part of treatment in a range of illnesses. It is often used for those who are self-harming or who have had suicidal thoughts or tendencies. As well as this, it is commonly used to treat conditions where the primary symptoms are depression and anxiety.

How Does Dialectical Behaviour Therapy Work?

DBT works in a similar way to cognitive behaviour therapy. If you are an individual, and DBT is being utilised in your treatment, it should help you to identify the negative thoughts that lead to your destructive behaviour. You can then work on challenging these thoughts and ideas and seeing them for what they are. In a nutshell, the aim of DBT is to help you accept your thoughts and behaviours so that you can change them.

If the priority is to change your destructive behaviour, then DBT is probably the right treatment for you and your situation. While elements of cognitive behavioural therapy are used in terms of identifying and challenging your negative thoughts and actions, DBT also encourages you to accept who you are.

A big part of how it works is developing a trusting relationship with your counsellor. It is this relationship and how secure you feel in it that will allow you to see the benefits of change.

By learning how to control your feelings and emotions, you can get through both good and bad days. You will learn vital coping skills that will enable you to deal with stressful situations in a positive manner. A big part of how DBT works is in the development and enhancement of life skills.

DBT is usually used for individuals who have multiple problems and require a more complex form of therapy. It is often used for those struggling with more than one condition, such as a dual diagnosis (addiction coupled with mental health disorder) or people struggling with various problems associated with one condition.

The most severe problems will usually be addressed first. This means that life-threatening behaviours are the first to be addressed by DBT. Any behaviours that you are exhibiting that could result in potential death, such as suicidal thoughts, for example, will be the first to be dealt with. This will be followed by behaviours that could threaten your recovery.

If you are in a treatment programme for recovery, your behaviour could be sabotaging your current treatment. It might be the case that you are arriving late to your appointments, or that you are not committing fully to your sessions. You may even be cancelling appointments, which puts you at risk of relapse.

Other behaviours that are addressed during DBT sessions will include those that affect your quality of life and those that affect your ability to achieve long-term goals. As mentioned above, during DBT sessions, you and your counsellor will work on the most destructive behaviours first.

DBT has proven to be especially effective in terms of reducing suicidal behaviour and self-harm. It is also successful when it comes to reducing substance use and improving mood. Ultimately, those who take part in DBT sessions are less likely to drop out of treatment while having a higher chance of achieving long-term recovery.

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Understanding Dialectical Behaviour Therapy

To understand DBT, it makes sense for you to know what the term ‘dialectics’ means. Dialectical means bringing together two opposites to see how they relate to each other. When it comes to DBT, you are likely to work with your therapist to see how you can work on accepting yourself for you who are, at the same time trying to change your behaviour for more positive alternatives.

It might first appear that accepting yourself while at the same time trying to change things that you do is a conflict, but the whole point of DBT is to help you understand the relationship between two. DBT can be a challenge, particularly in the early days of treatment; many patients even wonder what the benefit is in the beginning and whether the therapy is actually helping. However, if you are prepared to work hard with your therapist, you will be surprised at how effective DBT can be.

While DBT sessions are typically based on individual meetings between you and your therapist, you can also take part in DBT skills groups, where you learn various skills that you can practice with other group members. During the individual therapy sessions, you will be working with your therapist to identify your negative thought processes and resulting behaviours. During group sessions, you will be taught the skills required to change your maladaptive behaviour. These sessions are usually led by a DBT specialist and you will be encouraged to share your experiences with other members of the group. The shared experience is designed to provide mutual support and improve results.

After each session, you are likely to be given a homework exercise, which could be practising mindfulness or meditation before the next session. There may also be phone coaching available between sessions where you can work with your therapist who will try to guide and help you to practice your new skills in the real world.

DBT typically requires that you commit to around two-and-a-half hours per week. Individual sessions are usually about an hour long and then group sessions tend to last for about ninety minutes. Depending on your requirements, you might choose to attend both individual and group sessions or you might attend one and not the other.

What Abuse/Addictions Is Dialectical Behaviour Therapy Used to Treat?

  • Alcohol Addiction
  • Drug Addiction
  • Major Depressive Disorder
  • Bipolar Disorder
  • Generalised Anxiety Disorder
  • Binge Eating Disorder
  • Anorexia Nervosa
  • Bulimia Nervosa
  • Post-Traumatic Stress Disorder

How Does Dialectical Behavioural Therapy Work in Addiction Recovery?

Cognitive behavioural therapy has long been an effective tool for the treatment of those in recovery for addiction. As DBT is based on the principles of cognitive behavioural therapy with a few additions and modifications, it too is particularly useful. This is especially so for those suffering with severe depression and anxiety as a result of their illness.

The basis of DBT is the idea that opposites can work together to create a balance. This can be difficult to deal with initially, but it has been proven to be very effective in the treatment of various addictions and mental health disorders.

DBT treatment for addiction is based on the idea that negative thoughts and behaviours are learned and then reinforced. This is particularly true in the case of substance abuse. Negative thoughts are often followed by negative actions. For example, an addict might believe that his or her life is never going to get better and will then react by abusing substances that are causing harm, often because they believe these substances will make them feel better. This quickly becomes their natural response to any kind of situation.

When it comes to cognitive behavioural therapy, you learn how to identify the negative thoughts that are causing you to act in a maladaptive way. But DTB goes one step further; it aims to help you learn that even though you are acting in a harmful manner, you are still doing your best and that you can make improvements. You will also learn that some of the things that cause you to react in the way that you do are not your fault. Nevertheless, you do have the responsibility of changing the way that you respond to certain things.

Dialectical Behaviour Therapy Techniques

There are four main techniques when it comes to DBT: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation. These techniques are designed to help you learn how to accept yourself and change your behaviours.

Mindfulness – The goal of mindfulness is to help you learn how to focus your attention on the here and now rather than on the past or the future. You will learn how to accept and endure the strong and intense emotions that you experience when identifying and challenging any negative thoughts and behaviours. A major part of mindfulness is learning how to accept your feelings and emotions without needing to control them.

Interpersonal Effectiveness – Helps you develop and nurture relationships while being more assertive. It is designed to help you learn how to ask for things that you need and to say no when the situation warrants it. You will also learn how to positively deal with conflict with other people without losing your self-respect but while maintaining respect for others.

Distress Tolerance – If your natural reaction to stressful situations and feelings of distress is to abuse substances or self-harm, then DBT is a hugely beneficial therapy. Distress tolerance will teach you how to accept yourself and your current situation without resorting to harmful behaviours. With this technique, you will learn how to bear the pain and deal with it in a positive manner. It is likely that you will be taught various skills, including self-soothing and distraction.

Emotion Regulation – Controlling your emotions is a big part of recovery from addiction and mental health disorders. With emotion regulation, you will learn how to manage and control your emotions rather than letting them control you.

How Dialectical Behaviour Therapy Differs from Other Psychotherapies?

With DBT so closely linked to cognitive behavioural therapy, you might be wondering what the difference really is and why you would even need such a treatment? It is important to remember that DBT is actually a form of CBT, but it has been modified to enhance its effectiveness and to address specific concerns that CBT overlooks.

DBT puts a greater focus on the social and emotional aspects of treatment. It was initially developed as an enhanced form of CBT to treat those who were experiencing severe emotions that were leading to harmful behaviours.

It is believed that techniques such as distress tolerance can affect the neurological pathways of the brain, specifically in the reward centre. The idea is that learning to cope with stressful situations without reacting in a harmful manner will result in a reward of not getting in trouble or suffering negative consequences. By reinforcing this, the brain will adapt and ‘rewire’ itself around this new way of thinking.

Perhaps the biggest difference between DBT and say, CBT, is the fact that you will also have the opportunity to attend regular group sessions where you will be taught coping skills that you can practice with other members of the group. Group settings are considered to be safe non-judgemental environments and therefore perfect for learning these core life skills.

DBT places a huge emphasis on relationships; your relationships with those you love but also your relationship with your therapist.

Co-Occurring Mental Disorders Dialectical Behaviour Therapy Treats Include:

  • Borderline Personality Disorder
  • Major Depressive Disorder
  • Post-Traumatic Stress Disorder
  • Obsessive Compulsive Disorder
  • Panic Disorder
  • Generalised Anxiety Disorder
  • Social Anxiety

Other Supplemental Therapies

  • Art Therapy
  • Cognitive Behavioural Therapy
  • Motivational Interviewing
  • Music Therapy
  • 12-Step Therapy
  • Fitness Therapy
  • Meditation
  • Yoga
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