Undertaking DBT Therapy for Substance Misuse


Do you feel you have a substance misuse issue? Enter dialectical behavior therapy (DBT) to help!

Marsha Linehan developed DBT therapy to treat mental health disorders, specifically borderline personality disorder, and for people who felt suicidal and/or had suicidal behaviors.

Through the years mental health professionals have expanded DBT to include other issues such as substance use disorder, eating disorders, post-traumatic stress disorder, self-harm, and depression.

DBT is full of techniques, skills, goals, and benefits.

Here we will go over what DBT is, its techniques, what the goals are for people with substance misuse issues who choose DBT, skills learned in DBT, and the benefits for those who undertake it.

Continue reading to gain an understanding of how DBT therapy could be useful specifically for substance misuse!

Coping Skills Therapists in Colorado

Stefanie Kerr, LPCC

Stefanie Kerr, LPCC

Colorado Springs, Colorado
(719) 203-7021
Seth Boughton, SWC

Seth Boughton, SWC

(720) 449-4121
Samantha Zavala, LPCC

Samantha Zavala, LPCC

Aurora, Colorado
(719) 345-2424
Julie Maloney, LPCC

Julie Maloney, LPCC

(719) 345-2424
Sarah Munk, LPC

Sarah Munk, LPC

(719) 345-2424
Leigh Harlan, LPC

Leigh Harlan, LPC

Colorado Springs, Colorado
(719) 602-1342
Dominique Schweinhardt, MA, LPCC, LPP

Dominique Schweinhardt, MA, LPCC, LPP

Colorado Springs, Colorado
(719) 602-1342
Cassondra Chagnon, LPCC

Cassondra Chagnon, LPCC

Colorado Springs, Colorado
(719) 481-3518
Joshua Goldberg, LPCC

Joshua Goldberg, LPCC

(719) 345-2424
Vanessa Dewitt, LCSW

Vanessa Dewitt, LCSW

Pueblo, Colorado
(719) 696-3439

What is DBT therapy?

People undertake DBT for substance misuse because it is a proven treatment approach.

It takes many concepts from cognitive behavioral therapy (CBT) and adds acceptance skills.

The "dialectical" in DBT means putting together two opposite truths that exist at the same time.

In DBT for substance misuse, the two opposites are acceptance and change.

These are important concepts in DBT therapy.

When one accepts own's thoughts and feelings, and validates their emotions, even when painful, one can manage and get through the uncomfortable times.

In DBT a therapist will work with you to get stable through both accepting what you cannot change and changing what you can.

The therapist will also help develop an awareness of what you can change, and what you cannot. 

DBT Therapy Techniques

DBT is a comprehensive program that includes both group and individual therapy.

Every DBT component plays a role in getting a person to accept and get through dysfunctional thoughts, feeling, and behavior patterns.

DBT skills teach a person how to improve their life quality. When one goes to a DBT skills group, they will find themselves in a classroom setting, whether in-person or online.

Many classes have homework assigned and meet once per week. In individual therapy, you will be encouraged to apply what you have learned to your daily life.

An individual therapist will help you build and keep motivation for change. You will likely meet with the therapist one-on-one once per week. 

Goals for People With Substance Misuse Issues Who Choose DBT

There are four main stages to DBT therapy treatment.

The first one is to get into control from out of control. At this place, you want to get control over problematic behaviors. That is because right now, your behaviors are reckless and erratic.

In the second stage, you want to find yourself to be emotionally engaged instead of emotionally unavailable.

You want to see that your dangerous behaviors are under control at this point. In this stage, you may still have high emotional distress, and may still suffer and be miserable.

Now, you need to learn how to be less miserable and experience a wide emotional range in a productive and healthy way.

Stage three is to build an ordinary life and solve problems. At this stage, you will work to build and keep self-respect.

Work will be done on identifying both short- and long-term goals for yourself.

Your aim is to get to a space where your life supports feelings of contentment, joy, and happiness.

Stage four gets you to feel connected and complete from the incompleteness you may have felt before.

You will strengthen your spirituality, and through that will find tons of value in life.

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Skills Learned in DBT Therapy for Addiction

Above we mentioned that DBT is based on acceptance and change. There are two acceptance skills units. One of those is distress tolerance.

In distress tolerance, you will learn how to accept painful feelings without extreme reactions and worsening your situation.

The other is mindfulness. Through mindfulness skills, you will learn to fully participate in the current moment with no judgment and no attempt to change it.

Now, there are two change skills units. One is interpersonal effectiveness skills. This teaches you how to get needs and wants to be met in relationships.

You do that while maintaining your self-respect and setting healthy boundaries to build and continue those relationships.

There are also emotional regulation skills. If you want to change painful and negative emotions, then you will especially enjoy this unit.

You will change those emotions to healthy ones, and work to avoid so many to begin with.

DBT Therapy Benefits for Substance Misuse

Research has shown that women with co-occurring substance misuse disorder and borderline personality disorder who obtained DBT for addiction showed a serious decrease in opioid use within twelve months.

DBT has been helpful for people with substance misuse issues because of how it teaches acceptance.

DBT therapy synthesizes both acceptance and change. That is crucial because if one is treating addiction, acceptance is important as well.

Through acceptance, one will realize that if they relapse they will still have the same health goals and want to recover.

Relapse can be reduced through problem-solving skills. DBT also teaches skills that reduce dangers coming from drug use, such as overdose and health problems.

DBT encourages people with substance abuse issues to keep trying, even if they do relapse.

A therapist helps people analyze their relapses to teach them skills to hopefully prevent them from happening again.

DBT also has treatment targets: life-threatening behaviors, therapy-interfering behaviors, quality of life behaviors that include interpersonal conflict, and skills acquisition.


Although DBT therapy is useful for various mental health conditions, it can be especially helpful for those dealing with substance misuse.

DBT has plenty of benefits and has many components for its participants to get things out of.

If you feel that you have a substance misuse issue, we encourage you to reach out to a mental health professional.

There, you can discuss your specific issues and decide if DBT–with its group and individual sessions–could be right for you at this time.


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July 13th, 2024

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