The Benefits of DBT for Addiction Recovery 

Nicholas Weiss, LMSW, CAADC

Clinical/Program Director

Nicholas serves as the clinical/program director at Rushton Recovery. He oversees the development of programming materials for residential clients, supervises clinical staff and interns, and provides both individual and group therapy to clients.

Nicholas earned his bachelor’s degree in social work from the University of Michigan in 2008, with a minor in health education and behavior. He continued his education by completing his master’s degree in social work in 2009, launching a career dedicated to supporting individuals with severe and persistent mental illness.

Over the years, Nicholas has worked with children, adults, families, and couples, helping them navigate complex mental health challenges.

In recent years, Nicholas’s focus has shifted to working with individuals facing substance use disorders. As a Certified Advanced Alcohol and Drug Counselor (CAADC), he has developed a deep understanding of addiction as a disease that requires compassion and specialized care.

Throughout his career, Nicholas has remained dedicated to empowering individuals to reclaim their lives and achieve lasting well-being and sobriety.

Nicholas Weiss, LMSW, CAADC

Clinical/Program Director

Nicholas serves as the clinical/program director at Rushton Recovery. He oversees the development of programming materials for residential clients, supervises clinical staff and interns, and provides both individual and group therapy to clients.

Nicholas earned his bachelor’s degree in social work from the University of Michigan in 2008, with a minor in health education and behavior. He continued his education by completing his master’s degree in social work in 2009, launching a career dedicated to supporting individuals with severe and persistent mental illness.

Over the years, Nicholas has worked with children, adults, families, and couples, helping them navigate complex mental health challenges.

In recent years, Nicholas’s focus has shifted to working with individuals facing substance use disorders. As a Certified Advanced Alcohol and Drug Counselor (CAADC), he has developed a deep understanding of addiction as a disease that requires compassion and specialized care.

Throughout his career, Nicholas has remained dedicated to empowering individuals to reclaim their lives and achieve lasting well-being and sobriety.

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You may have heard of DBT but aren’t sure what it is because it sounds like CBT. However, it can be a very effective approach for treating substance use disorders (SUDs). Dialectical Behavior Therapy is an evidence-based model of therapy that helps people learn and use new skills and strategies so they build lives worth living. 

Read on to learn more about what it is, what it can treat, and its benefits.

What Is DBT? 

In DBT, you are taught two opposing strategies: acceptance (i.e. that your experiences are valid) and change (i.e. that you have to make positive changes to manage emotions and move forward in life).

DBT focuses on the emotional and social aspects of living and was originally created to help people manage their intense emotions.

Stages of Treatment

There are four stages of treatment in DBT, defined by how severe a person’s behaviors are [1]:

  • Stage 1: The person is often miserable and behaves out of control. The goal is to move from that state to achieving behavioral control.
  • Stage 2: The person may feel they are living a life of quiet desperation. Their life-threatening behavior is under control, but they continue to suffer. The goal is to move from that state to full emotional experience. 
  • Stage 3: The challenge is to learn to live, define goals, build self-respect, and find peace and happiness. The goal is to lead a life of ordinary happiness and unhappiness.
  • Stage 4: Some may need this stage. The goal is to find deeper meaning through a spiritual existence. 

Standard DBT Program

There are usually five components. The goal of all of these is to help the person build a life they feel is worth living:

  • DBT skills training group: This is facilitated by a trained skills therapist in a group format, once a week for 24 weeks, sometimes repeated. The purpose is to help people introduce effective and practical skills into their lives, which they can use when distressed and replace unhealthy behaviors. Tasks are provided to practice between sessions. See the section below for more on this.
  • Individual psychotherapy: Focuses on enhancing motivation and helping people apply the skills to specific challenges and events in their lives.
  • In-the-moment coaching: This uses telephone coaching and real-life coaching to help people through a stressful event. It encourages them to use their DBT skills applied to their daily life.
  • Case management strategies:  These empower the person to take control of their lives and care. The therapist teaches the person how to be autonomous and be their own case manager.
  • DBT consultation team: This is focused on helping the people who provide DBT to stay motivated and competent.

Skills Training

DBT skill training has four key elements. It is intended for those with Borderline Personality Disorder who have a local therapist they see at least bi-weekly.

  1. Mindfulness: Focus on presence, awareness, and acceptance.
  2. Distress tolerance empowers people to cope with crisis in a safe & healthy way. 
  3. Interpersonal effectiveness: These improve communication, assertiveness, and relationship management skills.
  4. Emotion regulation skills: These facilitate understanding and control over intense emotions, promoting more adaptive responses.

Through individual therapy, group skills training, phone coaching, and therapist consultation teams, DBT provides a comprehensive framework for understanding and tackling emotional and psychological challenges.

What Conditions Can DBT Treat? 

DBT was originally developed to help people with Borderline Personality Disorder, an often difficult condition to treat. It can also help people with other mental health problems, including:

  • Suicidal behavior
  • Self-harm
  • Substance use
  • Post-traumatic stress disorder
  • Depression
  • Eating disorders

Benefits of DBT in Addiction Treatment 

DBT for substance abuse was developed by Dr. Marsha Linehan. Studies show it decreases substance abuse in patients with BPD. Treatment can be adapted and helpful for those with SUDs and other co-occurring disorders or who have not responded to conventional therapy.  [2

Features of DBT adapted for substance abuse include:

  • Drug-specific behavioral targets for the treatment of problem drug use
  • A set of attachment strategies for fostering and building a strong therapeutic relationship
  • Dialectical abstinence—a synthesis of two polar opposite methods for addressing drug abuse.

DBT’s substance abuse-specific behavioral targets include:

  • Decreasing abuse of substances
  • Alleviating physical discomfort associated with abstinence and /or withdrawal
  • Diminishing urges, cravings, and temptations to abuse
  • Avoiding opportunities and cues to abuse, for example by burning bridges to persons, places, and things associated with drug abuse and by destroying telephone numbers of contacts and throwing away drug paraphernalia
  • Reducing behaviors conducive to drug abuse, such as momentarily giving up the goal to get off drugs and instead functioning as if the use of drugs cannot be avoided
  • Increasing community reinforcement of healthy behaviors, such as fostering the development of new friends, rekindling old friendships, pursuing social/vocational activities, and seeking environments that support abstinence and punish behaviors related to drug abuse

A common misunderstanding involves the scope of abstinence required in DBT. 12-step programs require complete abstinence. In DBT the counselor determines the scope of abstinence for each patient on a thorough assessment and several guiding principles.

Addiction Recovery in Michigan   

Rushton Recovery understands the complex nature of drug & alcohol recovery. We prioritize your well-being, safety, and comfort during treatment. Our detox and residential treatment center in Michigan offers a healing space to embark on your journey toward sobriety. 

We offer evidence-based therapies designed to evolve with your individual needs and address the root of your substance abuse. Let our team help you get clean, repair relationships, and equip you with the skills to achieve long-term recovery. Reach out to our Admissions team now.

Sources

[1] Center for Addiction and Mental Health. Dialectical Behaviour Therapy (DBT)

[2] Dimeff LA, Linehan MM. Dialectical behavior therapy for substance abusers. Addict Sci Clin Pract. 2008 Jun;4(2):39-47

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