Living with addiction can take a serious toll on a person’s health, finances, and relationships. Knowing change is necessary is one thing, but making adjustments that will stick, day in and day out, can be challenging. Sometimes, how a person thinks and reacts to the world outside of treatment can create major stumbling blocks to recovery. Dialectical behavior therapy (DBT) is a treatment approach designed to help those struggling with drug or alcohol addiction understand and adjust their thoughts and emotional responses.
At Michael’s House, we use DBT and a range of other therapeutic modalities to devise an individualized treatment plan for each patient. A dialectical behavior therapy program can help bring about lasting change and a renewed purpose. Call 760.548.4032 to learn how we can help you start on a path of recovery.
The History of Dialectical Behavior Therapy Programs
Traditional forms of therapy encourage people to look closely at their lives, see the areas where change is needed, and determine how best to make those changes. While some forms of therapy can be supportive, other types are confrontational and force people to look at reality and why change is so important.
In the late 1980s and early 1990s, Marsha Linehan—a therapist and researcher in the state of Washington—determined that confrontational tactics were not working with her patients. Many of these patients had borderline personality disorders and, when confronted, responded with anger or distress. Patients dropped out of the program or shut down in therapy sessions without making progress.
To reach these patients and come up with a program that could help them truly change their lives, Dr. Linehan developed DBT. She and her colleagues then created a manual that other therapists could use to apply the DBT principles with their own patients.1
While initially created for borderline personality disorders, DBT has been modified for use in the treatment of a wide variety of other mental health issues, including:
- Substance abuse issues
- Eating disorders
- Post-traumatic stress disorder
- Obsessive-compulsive disorder2
Understanding the Power of Thought
For many people, huge emotional responses only manifest after a long period of stress. When that stress is removed, the person returns to a calm state relatively quickly. By contrast, some only need a tiny bit of heat to explode, and they may stay in this heightened state for an incredibly long period of time. Living like this can take an extreme toll on a person’s relationships.
People who feel consistently alone because of their behavior may feel as though drugs and alcohol provide the only reasonable means of comfort. Dialectical behavior therapy programs strive to help people change their thoughts so they don’t have to numb those thoughts with substance abuse.
Early Stages of DBT
DBT uses a skill-based approach to help patients learn to control and manage their emotions, tolerate stress, and improve interpersonal relationships.3 In the early stages of treatment, therapists focus on the need for change while accepting and validating the patient’s current condition. The therapist must find a balance between supporting the person and helping them feel accepted while pointing out why change is necessary. Since this relationship between the therapist and the person in therapy is so essential, the early stages of DBT often involve very long, intense conversations between the therapist and the patient. These early sessions allow the patient and the therapist the opportunity to build a relationship and understand one another.
As the therapy progresses, the therapist begins to provide instruction on mindfulness techniques. The therapist encourages the patient to identify when thoughts are coming from the emotional part of the brain. When those emotional thoughts are identified, the person is then asked to step back and observe the situation logically and objectively before reacting. For some people, this means learning how to simply accept a situation without approving of it. In other words, some people learn how to move beyond things they cannot control. No judgments are needed, and no intercessions are required.4
Middle and Late States of DBT
Therapy sessions may be beneficial, but they may not allow the person to truly practice the lessons and apply them in real-time. Group sessions can help to fill this gap. Group sessions in DBT tend to begin weeks after the person has started to work with a therapist, and that therapist remains in charge of the group sessions. DBT group sessions are tightly structured and controlled by the therapist and are designed to allow people to interact in a supportive environment and practice their skills. In addition to group sessions, people in DBT are often given lengthy homework assignments. They may be asked to read articles and write about them, or they might be asked to use a specific technique in a stressful situation and then describe how that technique either worked or did not work.
Supporting Lasting Changes
While therapy might allow a person to make significant changes in how she thinks and responds to the world, those changes may not truly stick when therapy ends unless the environment around the person also changes. For this reason, DBT also includes a significant amount of family therapy, allowing the group to come together and work through their past trauma. Family therapy sessions in DBT always include the patient. Allowing the patient to be in all family therapy sessions keeps the trust between the therapist and the patient.
Find Help at a DBT Program in Palm Springs, California
At Michael’s House, located in beautiful Palm Springs, we use DBT techniques with our residents and have found the therapy remarkably effective. If you or a loved one struggles with addiction or mental illness, call us now at 760.548.4032 or contact us online. We are available to answer your questions about our dialectical behavior therapy program and how we integrate it into our treatment approach.
3 “Borderline Personality Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 30 July 2015.
4 Grohol, John M. “An Overview of Dialectical Behavior Therapy.” Psych Central, 23 Mar. 2018.