DBT for Substance Use: How Can it Help?

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Substance Use Disorders (SUDs) present a complex challenge with far-reaching impacts on individuals and society. 

Finding effective treatment strategies is crucial in fostering recovery and preventing relapse. Dialectical Behavior Therapy (DBT), a strategy that has demonstrated considerable potential, is one such approach. 

Initially created to manage Borderline Personality Disorder, DBT has been modified over time to treat a wide array of mental health issues and substance use disorders.

This article will explore the benefits of DBT for substance use, discuss potential challenges and considerations, and encourage those struggling with SUDs to consider DBT as a potential treatment option

With its practical skill-building focus and evidence-based approach, DBT may offer a path toward recovery and improved quality of life. 


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Understanding DBT

Devised by psychologist Marsha M. Linehan in the late 1980s, Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy initially intended to aid individuals diagnosed with borderline personality disorder.

The term 'Dialectical Behavior Therapy' stems from the idea of dialectics, a concept that seeks to establish harmony and integration between two contradicting viewpoints.

DBT operates on five core principles: mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and walking the middle path. 

These principles equip individuals with skills to manage painful emotions and decrease conflict in relationships. 

Unlike other forms of therapy, DBT emphasizes the psychosocial aspects of treatment — that is, it recognizes the role that a person's environment and interactions can play in their mental health. 

This focus on both individual psychological processes and group relational dynamics sets DBT apart as a uniquely comprehensive approach to mental health treatment.



Substance Use Disorders

Substance Use Disorders (SUDs) are complex conditions characterized by uncontrolled use of a substance despite its harmful consequences, leading to significant impairment or distress. 

These disorders are shaped by a combination of genetic, environmental, and psychological factors, and encompass an array of substances, including alcohol, illicit drugs, and prescription medications. 

Physiologically, SUDs can lead to changes in the brain's structure and function, impacting areas responsible for reward, stress, and self-control, often resulting in cravings and withdrawal symptoms. 

Psychologically, they can contribute to mood disorders, anxiety, and cognitive impairments. Societally, SUDs pose significant challenges, contributing to increased healthcare costs, lost productivity, family disruption, and criminal behavior. 

The ripple effects of these disorders underscore the necessity for comprehensive prevention, intervention, and treatment strategies. 


DBT and Substance Use Disorders

Dialectical Behavior Therapy (DBT) has been increasingly recognized as a potentially effective treatment for Substance Use Disorders (SUDs). 

DBT's holistic approach, which combines individual therapy, group skills training, and phone coaching, can be tailored to address the specific challenges associated with SUDs. 

The individual therapy component can help patients understand the triggers for their substance use and develop healthier coping mechanisms, while group skills training can provide a supportive environment to practice these new skills.

One of the core principles of DBT, distress tolerance, is particularly relevant for SUDs. Many individuals with SUDs use substances as a way to cope with emotional pain or stressful situations. 

DBT's focus on building distress tolerance can equip these individuals with alternative strategies for managing stress and negative emotions, reducing their reliance on substances.

In addition, DBT's emphasis on mindfulness can help individuals with SUDs become more aware of their thoughts, feelings, and behaviors related to substance use. 

This increased self-awareness can be a crucial first step in changing harmful patterns of behavior.

Lastly, DBT's commitment to 'validation' – acknowledging and accepting the patient's experiences without judgment – can help to build a therapeutic relationship that encourages honesty about substance use and fosters motivation for change. 

This non-judgmental stance is particularly important in treating SUDs, where shame and stigma often serve as barriers to seeking help. 



The Benefits of DBT for Substance Use

Effective and Adaptable Treatment Approach: DBT has been adapted effectively for individuals struggling with severe substance use disorders (SUDs) and co-occurring disorders like borderline personality disorder (BPD). 

The flexible nature of DBT allows it to be tailored to the unique needs of each individual, making it an effective treatment approach for a wide range of disorders.

Evidence-Based Therapy: DBT is recognized as an evidence-based form of psychotherapy used to treat people with multiple mental health and substance use disorders. 

Numerous studies have demonstrated its efficacy in reducing substance use and improving overall mental health outcomes.

Skills for Coping with Cravings and Stress: DBT equips individuals with practical skills to manage distress, cope with cravings, and navigate challenging interpersonal situations — all of which can be triggers for substance use.

Emphasis on Validation and Acceptance: DBT's focus on validation and acceptance can help reduce the shame and stigma associated with substance use, fostering a therapeutic environment that encourages honesty and motivates change.

Reduced Relapse Rates: DBT has been associated with reduced rates of relapse among individuals with SUDs, suggesting that the skills learned during therapy can have long-lasting benefits. 


Challenges and Considerations

While Dialectical Behavior Therapy (DBT) has considerable potential in treating Substance Use Disorders (SUDs), it's important to acknowledge potential challenges and considerations. 

One of the primary challenges is the availability of trained therapists. DBT is a specialized form of therapy that requires extensive training, and not all areas may have providers readily available. 

Additionally, DBT involves a significant time commitment, typically involving weekly individual therapy sessions, group skills training, and phone coaching. For those with work or family commitments, this can be difficult to manage. 

Cost can also be a barrier as DBT, particularly when delivered in a comprehensive format, can be expensive and not always covered by insurance.

Moreover, while DBT is effective for a range of SUDs, it may not be suitable for everyone. Certain individuals may struggle with the focus on self-reflection and emotional regulation. 

Therefore, each person's suitability for DBT must be carefully assessed, taking into consideration their specific needs, circumstances, and preferences. 


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Conclusion

In conclusion, Dialectical Behavior Therapy (DBT) offers a comprehensive and adaptable treatment approach for Substance Use Disorders (SUDs). 

Its focus on skill-building, distress tolerance, mindfulness, and validation can equip individuals with practical strategies to manage stress, cope with cravings and navigate challenging interpersonal situations. 

While there are challenges to consider such as cost, time commitment, and availability of trained therapists, the benefits, including reduced relapse rates and improved mental health outcomes, make it a promising option. 

If you or a loved one is struggling with substance use, exploring DBT as a potential treatment option could be a step towards recovery and improved quality of life. 

Remember, it's crucial to seek help from a healthcare professional who can guide you in making informed decisions about your treatment options. Reach out to one of our specialists at Overcomers Counseling today!

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July 14th, 2024

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