DBT and the Treatment of Drug Addiction
Granite Recovery Centers’ program for successfully treating substance use disorders centers upon the A.A.’s 12-Step curriculum integrated with evidence-based clinical modalities that may include:
- Cognitive Behavioral Therapy
- Trauma Therapy
- Grief and Loss Therapy
- Eye Movement Desensitization and Reprocessing Therapy
- Dialectical Behavior Therapy
Identify the Compulsion, Modify the Response
Dialectical Behavioral Therapy is an evidence-based clinical therapy which was originally created in the 1980s by Marsha M. Linehan to treat clients suffering with borderline personality disorder and/or suicidal ideation and tendencies. Psycho-social professionals soon realized that clients suffering with drug and alcohol use presented with the same compulsive behaviors, marked by irregular and dramatic responses to their environment, that were difficult to change.
Dialectical Behavior Therapy (DBT), is a skill-building psychotherapy that focuses on the development of mindfulness and the regulation of stress response, as it impacts behavior. Clients recommended for DBT have an exaggerated response to stress, which results in negative and oftentimes, self-destructive patterns of behavior. Clients with substance use disorders respond to stress with a compulsion to use. In DBT group and individual sessions, licensed clinicians teach cognitive and behavioral coping mechanisms that clients can adopt to re-think their stress response and manage the compulsory thoughts that fuel their substance use.
Sam (name changed) is a hard-working and successful CEO of his own company, as well as a seemingly happy husband and father. He had been abusing alcohol at work and at home for six years before realizing he needed treatment. In working through Step 4 of the 12 Steps, as he’s taking his moral inventory of his life, his behaviors, and his wrongdoings, he realizes that the high level of stress in his job makes him feel intensely angry and overwhelmed – forcing him to respond by drinking to quiet the anger and stress. In DBT clinical work with his therapist, he learns that the anger and stress he feels is a result of feelings of incompetency and fear that he is likely to be “found out”. Through individual and group DBT skill-building sessions, Sam is able to develop and manage a new set of beliefs about himself along with methods of coping with his stress in order to help curtail his drinking.
Four Tenets of Dialectical Behavioral Therapy
Developing Skills to Tame the Compulsion
Today, clinicians trained in DBT help clients, like Sam above, to learn new ways to perceive and respond to stressors that drive their compulsive behavior. In both individual and group therapy settings clinicians help clients to develop actionable skills such as:
- Mindfulness: Being aware of yourself and others in the present
- Emotional Regulation: Responding with appropriate emotion, in intensity and kind
- Interpersonal Effectiveness: Communicating more effectively with others
- Distress Tolerance: Building a defense from negative emotions
By helping clients find balance and mindfulness in their response to everyday stressors, DBT, in concert with 12-Step work, can be as an effective therapy for treating addiction.