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DBT Therapy Techniques for Substance Abuse

DBT therapy techniques promote growth for individuals in treatment for drug and alcohol addiction. In dialectical behavior therapy (DBT), you practice DBT therapy techniques to promote lasting change in recovery from substance use disorder. Building skills is a core part of dialectical behavior therapy and recovery in general.

During substance abuse treatment, groups participate in thought exercises and role-playing activities to practice DBT therapy techniques. These techniques help you learn alternative ways to view your experiences. In DBT groups, you’ll practice DBT therapy techniques that promote healthy alternative behaviors and accountability in recovery.

What Are DBT Therapy Techniques and Skills?

Dialectical behavior therapy is well-established in the treatment of several psychiatric disorders, including borderline personality disorder (BPD) and substance use disorders (SUDs). In dialectical behavior therapy (DBT), our counselors introduce the four main skills used for therapeutic healing. As you are guided through DBT therapy techniques, you will gain a clearer understanding of what your emotions are and how your emotions impact your relationships. Using these therapy techniques in your daily routine can help improve:

  •  Self-awareness
  • Communication
  • Emotional control
  • Stress management

Skill sets in DBT therapy techniques include:

  1. Mindfulness skills 
  2. Interpersonal effectiveness skills 
  3. Emotion regulation skills
  4. Distress tolerance skills 

DBT therapy techniques use these skills for behavioral change in treatment. Mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance help you regain control over your thoughts, emotions, actions, and reactions. For this reason, dialectical behavior therapy techniques are helpful in the treatment of many mental health disorders including:

  • Substance use disorders
  • Borderline personality disorder
  • Bipolar disorder
  • Eating disorders
  • Suicidal behaviors

While there are many variations and applications of DBT therapy techniques, DBT groups help you incorporate these four skill sets to prepare you for all types of situations in recovery. 

Mindfulness Skills 

As you learn DBT therapy techniques, mindfulness skills can help you to pay closer attention to the present moment. As you develop personal goals, our counselors break down DBT mindfulness skills into four categories.

DBT mindfulness skills include:

  • Core mindfulness skills
  • Mindfulness from a spiritual perspective
  • Doing Mind vs. Being Mind
  • Wise Mind vs. Emotion Mind

While it can seem difficult in times of stress, being mindful can greatly increase your ability to remain calm. For example, mindfulness can improve your ability to comprehend accurately what is going on inside your mind and body. At the same time, you also notice what is going on outside of your inner experience. As you practice DBT mindful meditation exercises, you become more in tune with yourself and your surroundings. As you refocus your mind it becomes easier to stay calm and centered.

With attention to DBT therapy techniques, our counselors will ask you to write down your individual goals for recovery. Each week, group therapy people meet and discuss mindfulness skills training goals and how they apply to recovery.  Sharing with your peers allows you to receive feedback about your goals and progress. 

What Are the Core Mindfulness Skills?

DBT therapy techniques that incorporate core mindfulness (CM) skills teach you how to observe and experience reality as it is in real-time. These techniques also show you how to be less judgmental and live in the present moment. Simply put, core mindfulness skills ask “what” and “how” questions. By using these skills, you can naturally pause to think about the situation rather than immediately acting on your emotions.

While participating in dialectical behavior therapy (DBT), our counselors will introduce the six core mindfulness skills.

Core mindfulness skills include:

  1. Observe
  2. Describe
  3. Participate
  4. Nonjudgmental Stance
  5. One-Mindfully
  6. Effectively

Fundamentally, mindfulness groups in addiction and treatment focus on learning and understanding these skills. During these groups, you will become aware of the mindfulness skills you already regularly use. 

How Can Mindfulness Help In Recovery? 

DBT therapy techniques also teach you to create concrete definitions of each mindfulness skill and how each can be applied in stressful or emotional situations.  These skills will allow you easier access to mindfulness practices and the ability to control when you use them. 

DBT therapy techniques for mindfulness include:

  • Wise Mind
  • Loving Kindness
  • Balancing Doing Mind and Being Mind
  • Walking the Middle Path to Wise Mind
  • Mindfulness of Pleasant Events

DBT therapy techniques for mindfulness help you learn to be fully present in the moment. More importantly, these techniques help you stop living in the past or the future.

When practicing mindfulness DBT therapy techniques, you’ll learn to:

  • Experience your thoughts, emotions, and surroundings without judgment
  • Describe your situation clearly and logically to yourself and others
  • Participate in goal-oriented behavioral change

Mindfulness works by directing your attention to the present moment and away from other ruminating thoughts. By concentrating on what is in front of you, mindfulness meditation techniques can decrease anxiety, depression, and suicidal thoughts. In general, the way you think, and what you think about, can affect how you feel and act.

For instance, if you lose yourself in upsetting memories, you probably experience long periods of sadness or depression. Likewise, if you find yourself fixating on future failures and potential rejection, you may struggle with low-self esteem and procrastination. Given that, these DBT therapy techniques can be incredibly helpful for people in early recovery who can be triggered by difficult emotions and thoughts.

Interpersonal Effectiveness Skills 

Interpersonal effectiveness helps you maintain and improve relationships with people you are close to and strangers. As you discuss your personal goals for recovery, our counselors introduce the DBT skills that help you develop interpersonal effectiveness into two categories.

The two types of interpersonal effectiveness skills include: 

  • Building healthy relationships and ending destructive relationships
  • Walking the middle path through acceptance and honesty

While learning interpersonal effectiveness, you develop skills to deal with conflict, communicate what you want and need, and say no to unwanted requests. Using interpersonal effectiveness also helps you maintain your self-respect and others’ respect for you.

DBT therapy techniques for interpersonal effectiveness include:

  • Objective Effectiveness: DEAR MAN
  • Relationship Effectiveness: GIVE
  • Self-Respect Effectiveness: FAST
  • Options for Intensity
  • Finding and Getting People to Like You
  • Mindfulness of Others
  • Ending Relationships
  • Think and Act Differently
  • Self-Validation
  • Validating Others
  • Changing Behavior with Reinforcement

These skills help you:  

  • Find potential friends
  • Get people to like you
  • Maintain positive relationships with others

Interpersonal effectiveness also teaches you how to build closeness with others on the one hand, and how to end destructive relationships on the other. 

In practicing these DBT therapy techniques, you walk a middle path in your relationships, balancing acceptance with change in yourself and your relationships with others. 

Emotion Regulation Skills 

Emotion regulation includes increasing control of emotions, even though complete emotional control isn’t possible. For the most part, you are who you are, and your emotions are part of you.

In order to help you gain more control of your emotional reactivity,  DBT therapy reframes your perspective on emotions. 

Throughout the developmental stage of goal setting, DBT therapists introduce the key elements involved with emotional regulation in four main categories.

The four types of DBT emotion regulation skills include: 

  • Understanding and naming emotions
  • Changing emotional responses
  • Reducing vulnerability to the Emotion Mind
  • Managing really difficult emotions

As you learn DBT therapy techniques for emotional regulation, you will identify, observe, and describe your emotions. It’s important to know what emotions you experience and how they impact your perspective on life and recovery.

DBT techniques for emotional regulation include:

  • Identifying Primary Emotions
  • Check the Facts
  • Opposite to Emotion Action
  • Problem-Solving
  • Accumulating Positive Emotions in Short Term
  • Accumulating Positive Emotions in Long Term
  • Building Mastery
  • Cope Ahead
  • PLEASE skills
  • Nightmare Protocol 
  • Sleep Hygiene 
  • Mindfulness of Current Emotions
  • Managing Extreme Emotions
  • Troubleshooting ER skills

DBT therapy techniques for emotional regulation can help you understand and name emotions so that you can identify your own emotions. 

In doing so, you can learn how to change your knee-jerk emotional responses. As a result, DBT therapy techniques for emotional regulation help you reduce the intensity of painful or unwanted emotions.

Why Is Emotional Regulation Important in Recovery? 

When you aren’t mindful, emotional regulation skills can fall by the wayside. A lot of times, gut reactions can be a default position for people during active addiction. For this reason, many people are seen as volatile, reactive, and emotional. 

Substance abuse can affect your ability to think clearly, making you rely on your emotions. As a result, you may find you act on instantaneous reactions made without thinking the situation over before acting. That’s because knee-jerk responses are based on feelings, not careful thought. 

Gaining a better understanding of your emotional reactions will help you limit impulsive decision-making and improve your ability to self-soothe with DBT therapy techniques. As you acknowledge and accept your emotions, emotional regulation works to strengthen your reactionary control.

Gaining Control Over Your “Emotion Mind”

DBT therapy techniques can help you reduce your vulnerability to the “emotion” mind. In essence, these techniques make you less susceptible to extreme or painful emotions. Once you develop the skills to manage your “emotion mind,” you also increase your emotional resilience. 

In addition, DBT therapy techniques can teach you how to manage overwhelming emotions. For the most part, managing really difficult emotions pose challenges for most people. In DBT therapy groups, our counselors help you practice skills that help you to accept ongoing emotions and manage extreme emotions. 

Distress Tolerance Skills 

Distress tolerance is the ability to tolerate crisis situations without losing control. They help you accept your life even if your current circumstances may not be exactly what you want.

While you define your goals in recovery, our counselors introduce the integral role distress tolerance plays in recovery, presenting the distress tolerance skills in three distinct categories.

The three types of distress tolerance skills include: 

  • Crisis survival skills
  • Reality acceptance skills
  • Addiction crisis skills

In individual and group therapy, DBT therapists pose questions about the goals of distress tolerance skills training. Together with others in DBT, you brainstorm ways you can benefit from distress tolerance skills and strengthen your ability to manage stress. During each therapy session, you receive feedback about your progress toward achieving your stress management goals.

DBT therapy techniques for distress tolerance include:

  • STOP skills
  • TIP skills
  • Distract with Wise Mind ACCEPTS
  • Self-Soothing
  • IMPROVE the Moment
  • Body Scan Meditation
  • Sensory Awareness
  • Radical Acceptance
  • Turning the Mind 
  • Willingness
  • Half-Smiling and Willing Hands
  • Mindfulness of Current Thoughts

DBT therapy techniques for distress tolerance help you survive big and small crises. These crisis survival skills teach you how to tolerate painful interactions, urges, and emotions when you can’t immediately fix an issue. Similarly, you gain the ability to fight stress with fact-checking and radical acceptance.

For example, radical acceptance assists you in reducing stress by accepting your current situation, even if it’s not ideal. Instead of fighting the feeling and allowing your stress levels to grow, you accept reality. After that, you can use DBT therapy techniques to self-soothe. In doing so, you can remind yourself that you are not stuck where you are. Even more, you can use disappointment as motivation to make healthier decisions.

DBT Therapy Techniques For an Addiction Crisis

In times of crisis, you may use unhealthy coping strategies to deal with your emotions. While self-isolating and avoidance may temporarily make you feel better, they don’t solve a problem. Other unhealthy coping skills like self-harm, substance abuse, or emotional outbursts can cause harm to yourself and others.

When the crisis is addiction, you can protect yourself from relapse triggers by replacing destructive coping mechanisms with DBT therapy techniques for distress tolerance.

DBT therapy techniques for an addiction crisis include:

  • Dialectical Abstinence
  • Reinforcing Non-Addictive Behaviors
  • Alternative Rebellion
  • Adaptive Denial

DBT therapy techniques for substance abuse are designed to promote abstinence and reduce relapses’ length and negative impact. Among these are dialectical abstinence, “clear mind,” and attachment strategies practiced in individual therapy as well as group therapy. 

Several studies support the benefits of DBT therapy techniques for substance abuse, showing a consistent decrease in substance abuse for people with borderline personality disorder (BPD). The findings also support the use of DBT to treat people with SUD and other co-occurring disorders. Similarly, DBT therapy can benefit your recovery if other evidence-based SUD therapies have failed in the past.

Dialectical Abstinence in Substance Abuse Treatment

“Dialectical abstinence” is one of the foundational DBT therapy techniques for addiction. While the widely-known concept of abstinence is a complete absence of substance abuse and addictive behavior, dialectical abstinence provides more gray areas and fewer restrictions. 

Typically, most treatment programs and self-help groups preach the belief that to be recovered, people must never again use any substance for the remainder of their lives. If you slip up, you better hand in your chip.

Dialectical abstinence, however, acknowledges that while the ideal recovery is without a relapse, mistakes can happen. That being said,  DBT therapy techniques that address addiction and recovery are founded on harm-reduction efforts. Unlike the AA model, DBT techniques for addiction crises focus on minimizing harm and getting back on track to a life of fulfillment in sobriety. Simply put, DBT’s approach to addiction recovery removes the strict requirements on abstinence as you follow your path to recovery. 

Additionally, DBT therapy techniques for substance abuse are effective for people with SUDs rooted in emotional dysregulation who struggle to stay sober using other evidence-based treatments.

DBT therapy techniques for substance abuse include:

  • Decrease abuse of substances, including illicit drugs and misused prescription medications
  • Alleviate the physical discomforts of withdrawal and extended abstinence
  • Lower cravings and urges to abuse drugs and/or alcohol
  • Avoid triggering situations that may lead to relapse
  • Take steps to remove people, places, and things associated with drug abuse
  • Reduce unhealthy behaviors and beliefs related to substance abuse
  • Increase community integration and support systems that promote healthy behaviors

As you navigate recovery, you can add DBT therapy techniques to your recovery tool kit. For example, DBT techniques can strengthen your recovery resolve when you encounter triggers. These skills also help you maintain control when experiencing intense emotions, communicating with others, and managing stress.

Can DBT Help Me Recover?

Unsure of whether dialectical behavior therapy techniques will help you in recovery? Raise your hand if you’ve practiced the Serenity Prayer! The famous 12-step program mantra states, “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Just like Alcoholics Anonymous (AA), DBT therapy techniques stress the importance of two opposing goals — acceptance and change.

To help you heal during recovery from addiction, dialectical behavior therapy includes a variety of skills, but techniques that instill acceptance and change are the most fundamental. Once you accept your situation and enter treatment for substance abuse, you can begin your journey of healing, growth, and change in recovery.

Reach Out

At Royal Life Centers, we provide dialectical behavior therapy to help our guests build healthy coping skills so that they may maintain their sobriety and build happy, healthy lives in recovery. If you or a loved one is struggling with substance abuse, please feel free to reach out to us at 888-907-0898.

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