It’s not uncommon for people with a drug or alcohol addiction to also have a mental health condition, called having a dual diagnosis. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2018 National Survey on Drug Use and Health, roughly 9.2 million adult Americans have a coexisting mental illness along with a substance use disorder.
One approach that’s been proven effective for people with dual diagnosis is a well-known form of talk therapy called cognitive behavioral therapy (CBT). Less widely known is a CBT-based approach called dialectical behavioral therapy, or DBT. Developed in the late 1980s by University of Washington psychologist, Marsha M. Linehan, DBT has become the gold-standard talk therapy approach for treatment-resistant mental health cases.
According to the American Psychological Association, DBT encompasses elements of a variety of behavioral therapies, mindfulness practices, and CBT. The term “dialectical” in dialectical behavioral therapy refers to the integration of two opposing sides – acceptance and change. DBT’s foundation is built on the concept that both acceptance and change can coexist.
Very often, people struggle with the idea of accepting themselves as they are versus changing the parts of themselves that prevent them from reaching their goals. DBT acknowledges that both can be true and both can occur at the same time.
For example, an individual with a substance abuse problem can accept their addiction, yet still see the need for — and work toward — change. One can exist alongside the other, which is what makes DBT beneficial for many people with a substance or alcohol disorder.
Although DBT stems from CBT, DBT places a larger emphasis on the psychosocial aspects of rehabilitation and recovery. DBT centers on building an individual’s skills in four principal areas of core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
The mindfulness techniques utilized in DBT come from traditional eastern cultural mindfulness concepts. Paying focused, nonjudgmental, and purposeful attention to the present moment helps individuals cultivate an understanding of their triggers, reactions, and thoughts.
By developing an enhanced awareness of themselves and the world around them, individuals are better able to manage their emotions and find healthy solutions to their problems.
Trauma often brings about distressing emotions long after the traumatic event has passed. Individuals who have experienced trauma may seek out unhelpful coping strategies in moments of distress. While some of these strategies offer distraction or short-term relief – like substance use – they can end up being harmful in the end.
Not surprisingly, over 75% of people in substance-abuse treatment programs have suffered some kind of trauma in their lifetime. To address the uncomfortable feelings from trauma and challenging life situations, DBT includes distress tolerance techniques to recognize, tolerate, and manage painful and disturbing emotions. Rather than turning towards harmful coping mechanisms (like alcohol or substance use), DBT empowers individuals to confront and manage their distressful feelings.
Anger, sadness, and fear are appropriate reactions to a variety of alarming situations, although many people consider them as “bad” emotions. The truth is, emotions are neither good nor bad. They simply exist.
DBT seeks to help individuals understand and manage their emotions, without judging their emotions as “good” or “bad.” Rather than trying to suppress or deny emotions, DBT helps to:
Rather than trying to suppress or deny emotions. In short, DBT teaches a person to control their own actions, rather than letting their emotions dictate their actions.
No one lives in isolation, no matter how hard a person might try. Because interpersonal skills are integral to success and life satisfaction, DBT highlights interpersonal effectiveness as a principal area for therapy. Interpersonal relationships are tricky, even for people without mental health conditions.
For individuals who struggle with substance use or are dual-diagnosed, however, interpersonal relationships are all the more challenging. DBT offers practical guidance and skills to navigate relationships, both personal and professional. When it comes to interpersonal effectiveness, DBT aims to:
Dialectical behavioral therapy has long been the treatment of choice for Borderline Personality Disorder, or BPD. Individuals with BPD have difficulty managing their emotions, which leads to unstable relationships. The treatment approach’s success with people who have DBT has led to its use for other psychological conditions, including:
Current research indicates that DBT is an effective approach to treating individuals with both a substance-use disorder and a mental health condition, particularly borderline personality disorder or who have not responded successfully to other treatments.
DBT’s effectiveness lies in the participant’s enhanced awareness of the negative consequences of their choices, therefore making DBT an excellent option for people with substance-use disorders. Furthermore, DBT alleviates the symptoms of other mental health conditions, making it less likely that a person with addiction will seek drugs or alcohol as a way to self-medicate.
Because DBT is typically reserved for dual diagnosis or hard-to-treat cases, the process demands increased commitment from both the individual being treated and those that are treating them. Depending on whether DBT is done in an outpatient or inpatient setting, treatments may include:
Data from the National Alliance on Mental Illness (NAMI) indicates that in the state of California alone, roughly 5,566,000 adults have a mental health condition. Sadly, almost half of these people have been unable to receive any treatment within the past year.
At No Matter What Recovery, we aim to help as many people as we can. If you’re searching for DBT therapy in LA, let us help. Our expert mental health and addiction professionals will explore every option that meets your needs. Call us today (323) 347-5535 or send us a message. Our services are always confidential, compassionate, and cutting-edge. Let us start you on your journey to recovery today.