Dialectical Behaviour Therapy for Addiction

Sanctuary Lodge is proud to announce that Dialectical Behaviour Therapy is now part of our rehab program. Dialectical behaviour therapy (DBT) is a specific type of empirically based cognitive-behavioural psychotherapy developed in the late 1980s by psychologist Marsha M. Linehan to help better treat borderline personality disorder. Since its development, it has also been used for the treatment of other kinds of mental health disorders, including drug and alcohol addiction. DBT skills training provides the client with a simple set of skills that can help create the difference between a bad day and a full blown relapse. DBT skills are divided among 4 modules, each designed to help with a particular aspect of sobriety.

The first module is mindfulness, which is the foundation of DBT. DBT looks are the underlying factors of addiction, the things that create the pressure that leads to using your drug of choice. DBT believes that two huge factors that lead to drug and alcohol use are the inability to tolerate strong unpleasant emotions and thoughts. The client feels overwhelmed by these feelings and thoughts and without tools to tolerate them turns to their drug of choice. In the mindfulness module the client begins to learn skills to handle their thoughts and feelings so they no longer feel at their will. The ultimate goal of mindfulness is to get to the point where you can say a thought is just a thought, a feeling is just a feeling, and an urge is just an urge, I get to choose what I do with it. There’s a tremendous power to knowing you are in control of your feelings and thoughts. Another part of the mindfulness module is the concept of Wise Mind. Wise mind deals with the process of making decisions. A huge part of recovery is making changes in your life and wise mind teaches skills to help the client make decisions that are in line with their values.

The second module is interpersonal effectiveness. This module deals with relationships and creating boundaries. Many clients come into treatment saying that they don’t know who they are without their addiction to define them. DBT teaches them that the way they can begin to define themselves in recovery is through their boundaries. Boundary setting is essential in allowing clients to get back in touch with their core values. People in addiction can be incredible at getting what they want but in doing so they hurt their relationships and damage their self respect. This module gives them skills designed to help ask for what they want in a healthy way so as to maintain their relationships and feel good about themselves. The module also deals with ways to say no in relationships and not let small problems build themselves into larger ones. These skills translate to all areas of life, they can be used with family, friends, and co-workers.

The third module in DBT is emotion regulation. In this module clients begin to understand the ways in which they react to stressors and cravings. By understanding the way they react to difficult situations, clients can create an “emergency exit strategy” to handle hard times without making things worse (using their drug of choice or any other unhealthy coping behaviour). The skill of opposite action is introduced to help clients better handle strong and uncomfortable feelings and urges that can derail early recovery from substance abuse.

The last module in DBT is distress tolerance. This is DBT’s version of relapse prevention for substance abuse. In this module DBT introduces strategies for times when things are at their worst and when life circumstances catch clients off guard. Distress tolerance also introduces the DBT concept of radical acceptance. Radical acceptance is the act of accepting life on life’s terms and learning how to get through the loss and traumatic events of clients’ past.

In summary, dialectical behaviour therapy, created by Dr Marsha Linehan, has been clinically proven effective in helping clients have better control over their emotions, thoughts, cravings, and relationships. By using simple DBT skills taught in the four modules, the client can reach the goal of having and maintaining a sober life worth living. We at sanctuary lodge are excited to have an empirically based treatment added to our program with the continued goal of meeting our clients needs.