Addiction Rehabilitation Treatment Modalities: Dialectical Behavioral Therapy

According to the National Institute on Drug Abuse, “Treatment approaches and individual programs continue to evolve and diversify, and many programs today do not fit neatly into traditional drug addiction treatment classifications.” That is why the search for the ideal rehab facility is so tricky. How do you know where to start or what to look for? One good starting point is identifying an approach, or modality, that works for your needs.

But, what work will you be doing? It is important to learn about different modalities because you need to find a rehab program that you will respond to. You need to share a philosophy. One possible modality that may work for you is dialectical behavioral therapy.

If you would like help exploring the modalities of rehabilitation programs, contact Centers.com at 800-256-3490 and speak with someone today.

Dialectical Behavioral Therapy

One of the cognitive therapies proven to be an effective addiction treatment is dialectical behavioral therapy (DBT), which is used to not only treat substance addiction but to also address aggression, depression, and self-harm. DBT teaches clients how to regulate their emotions in order to decrease the self-destructive behaviors that result from powerful emotions.

Development

In DBT, patients learn behavioral skills such as mindfulness and emotion regulation.

DBT was developed in late 1970s by Marsha M. Linehan, a psychology researcher at the University of Washington. Linehan noticed therapists had a tendency to burn-out after dealing with non-motivate patients who refused to cooperate with successful treatment. This caused two insights:

1. Chronically suicidal patients tend to have been raised in invalidating surroundings and therefore require a form of unconditional acceptance developed in an environment of loving-kindness.
2. Patients need to commit to the same degree as their therapists; patients need to be willing to accept the degree to which they are emotionally dysfunctional.

These insights are the reason that DBT attempts to make patients and therapists allies in fighting addiction. The therapist will make an effort to accept and validate a patient’s feelings but will also explain that some behaviors are inappropriate and suggest better options.

Skills

The Linehan Institute recognizes four sets of behavioral skills that patients should learn: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.

• Mindfulness: the practice of being fully aware and present in this one moment
• Distress Tolerance: how to tolerate pain in difficult situations, not change it
• Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
• Emotion Regulation: how to change emotions that you want to change

Components

According to the Linehan Institute, all DBT has four components: skills training group, individual treatment, DBT phone coaching, and consultation team.

1. DBT skills training group is focused on enhancing clients’ capabilities by teaching them behavioral skills. The group is run like a class where the group leader teaches the skills and assigns homework for clients to practice using the skills in their everyday lives. Groups meet on a weekly basis for approximately 2.5 hours and it takes 24 weeks to get through the full skills curriculum, which is often repeated to create a 1-year program. Briefer schedules that teach only a subset of the skills have also been developed for particular populations and settings.
2. DBT individual therapy is focused on enhancing client motivation and helping clients to apply the skills to specific challenges and events in their lives. In the standard DBT model, individual therapy takes place once a week for as long as the client is in therapy and runs concurrently with skills groups.
3. DBT phone coaching is focused on providing clients with in-the-moment coaching on how to use skills to effectively cope with difficult situations that arise in their everyday lives. Clients can call their individual therapist between sessions to receive coaching at the times when they need help the most.
4. DBT therapist consultation team is intended to be therapy for the therapists and to support DBT providers in their work with people who often have severe, complex, difficult-to-treat disorders. The consultation team is designed to help therapists stay motivated and competent so they can provide the best treatment possible. Teams typically meet weekly and are composed of individual therapists and group leaders who share responsibility for each client’s care.

If a rehabilitation program advertises the use of DBT, it is imperative that you determine that they offer the full program and not just the parts that fit into their agenda. Ask whether or not the facility includes the four components listed above. If not, they aren’t practicing DBT. Also, make sure that the entire clinical staff is trained in DBT and incorporating and utilizing all its components in daily practice. If you would like help finding a rehab facility that uses DBT, contact Centers.com at 800-256-3490 and access our vast resources in your search.

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