Dialectical Behavior Therapy (DBT)

Dialectical Behavioral Therapy: Origins, Concepts, Modules, and Benefits


Dialectical behavioral therapy (DBT) is a comprehensive therapeutic approach to thoughts, emotions, and behaviors. The foundation of this therapeutic practice lies in the philosophical dialogue known as the “dialectical method,” where two people sit and talk about a subject while sharing opposing views in hopes of uncovering the truth. This points directly to the therapeutic dialectical method, as it involves a client and their therapist sitting down and discussing challenges in the client’s life. Once they establish the subject of discussion, the therapist can then use DBT to help their client accept the problem and find alternative solutions. 

Dialectical behavioral therapy was first developed by Marsha Linehan and was originally proven to be effective in treating borderline personality disorder. Studies have shown this treatment to be effective for substance abuse disorders by promoting abstinence and reducing the length and probability of relapses. 


Dialectic — or fusion of two opposites — in the case of DBT refers to two things: change and acceptance. The central concept of DBT is to never accept a proposition as a final truth or an indisputable fact. The three main concepts involved with DBT are:

  • Change is inevitable
  • Conflicts frequently arise in life
  • Many things in life are interconnected either through our emotions or thought processes

Many individuals with substance abuse disorders (SUD) have difficulty accepting that they have an addiction because of the stigma around the word. Dialectical behavioral therapy can be helpful for clients with SUD by reframing the way they view addiction and the way they view themselves. 

These can be difficult concepts to grasp, especially in the throes of addiction. Because of this, therapists work in collaboration with their clients in DBT to support their needs and guide them to solving the conflicts they face. Through this kind of relationship, both the client and professional can sort out the best plan of action. 

4 Modules of DBT

There are four modules in DBT meant to encourage the acceptance of change in clients with a SUD. Many of these modules help bring peace of mind and stability to the client so they will be better prepared to handle stressful situations outside of treatment. This can be especially beneficial in recovery, as managing stress through healthy practices can prevent relapse in the future. 

The four modules of DBT and how they help clients include:

#1. Mindfulness: By practicing and gaining mindfulness, clients become more in touch with their bodies and how they interact with their minds. In mindfulness meditation, professionals bring a client’s attention to different areas of their own body. They can do this through a checklist of sorts to relax any areas where tension is held. By bringing the body to a fully relaxed state, the mind can be at rest. This is a beneficial tool to use in-session or at home for when the client feels overwhelmed. Ultimately, instead of using substances to bring the mind to a relaxed state, the client can do it naturally through mindfulness.

#2. Interpersonal Effectiveness: In this area of DBT, the focus is placed on the client’s interpersonal skills. Through interpersonal effectiveness, clients can learn how to assert boundaries, address confrontation, and ask for help from their loved ones. Often, when a person is in active addiction, they seclude themselves from their loved ones for fear of confrontation or hurt feelings. Interpersonal effectiveness teaches clients how to rebuild broken or damaged relationships through one-on-one therapy sessions, support groups, and family therapy.

#3. Distress Tolerance: Everyone experiences distressing situations in life; some people have a higher threshold for distress before participating in risky or impulsive behaviors. Through DBT, a client experiencing distress learns to accept what they are feeling and the inevitability of conflicts in their life. Through this understanding, clients can be better prepared to face the real world after addiction treatment.

#4. Emotion Regulation: This skill can be beneficial for people who experience multiple, overwhelming emotions at once and have trouble placing and identifying them. This can be a common practice during detox while the psychological symptoms of withdrawal are active. Through an exercise known as “noting,” clients learn to be mindful of their emotions when they arise and log them as needed. This fourth module of DBT can also benefit interpersonal effectiveness because it can improve communication and understanding between two or more parties.

How DBT Benefits Addiction

Clients receiving DBT can improve their ability to handle stress and adopt healthy coping mechanisms that will carry them through addiction treatment and into lasting recovery. Through the four modules, clients learn how to handle distressing situations as they arise in the moment.

Specifically, DBT is beneficial to those with SUD by:

  • Alleviating the psychological and physical symptoms of withdrawal in detox
  • Addressing and diminishing cravings and urges
  • Reducing and correcting behaviors conducive to drug abuse like impulsivity, suicidal ideations, and relapse
  • Encouraging avoidance of opportunities and triggers that influence abuse

Dialectical behavioral therapy questions and corrects a client’s internal dialogue. Once they can begin to question that internal dialogue themself, they won’t be as tempted by urges and excuses to drink or use substances in the future. 

Dialectical behavioral therapy is an evidence-based approach to addiction treatment meant to provide healthy coping mechanisms and stress management techniques to reduce the desire for relapse, encouraging lasting recovery. Laguna Shores Recovery utilizes many different forms of CBT, including DBT, in treating addiction to drugs and alcohol. Call us today to learn more about our individualized treatment plans at 866-934-5276.