Dialectical Behavior Therapy, or DBT, was developed by psychologist Marsha Linehan in the late 1980s to treat borderline personality disorder. It has since been adapted specifically for substance use disorders, a version researchers call DBT-SUD, and that adaptation has been tested and replicated in independent studies across the United States, the Netherlands, and Canada.
DBT is built around four skill areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The core idea is that a lot of substance use is really an attempt to manage overwhelming emotion, and if you build a real, practiced alternative for handling that emotion, the pull toward substances loses some of its grip.
At Ray Recovery, DBT is one of the core therapies used across our outpatient programs in Hudson and Uniontown, serving clients throughout Akron, Canton, and the surrounding Northeast Ohio communities.
Call 888-598-6299 or reach out online to talk with our admissions team about your treatment options.
The Four DBT Skill Areas
Mindfulness. Staying present and aware in the current moment instead of on autopilot, which is the foundation the other three skills build on.
Distress tolerance. Getting through a crisis or intense craving without making it worse, using specific, practiced techniques rather than hoping you’ll cope in the moment.
Emotion regulation. Understanding what you’re feeling, why, and how to influence it, instead of feeling controlled by it.
Interpersonal effectiveness. Asking for what you need, saying no, and maintaining relationships and self-respect at the same time, especially useful for clients whose substance use is tangled up with difficult relationships.
Why DBT and Addiction Are Closely Connected
Substance use disorders and borderline personality disorder overlap far more than most people realize, research shows roughly three-quarters of people with BPD also meet the criteria for a substance use disorder. That overlap is part of why DBT, originally built for BPD, translates so directly to addiction treatment: both conditions are often driven by the same underlying difficulty regulating intense emotion.
You don’t need a BPD diagnosis to benefit from DBT. It’s widely used for anyone whose substance use is closely tied to emotional intensity, impulsivity, or a pattern of relationships that escalate into crisis.
Request A Callback
"*" indicates required fields
How Effective Is DBT for Addiction?
A pilot randomized controlled trial studying DBT for marijuana use disorder found that participants in the DBT group had meaningfully higher cessation rates than the control group, both right after treatment and at follow-up. Broader research on DBT for substance use disorders has shown consistent reductions in substance-use outcomes across multiple independent studies, and DBT’s four skill areas in particular show strong results for reducing the emotional dysregulation that often triggers relapse.
DBT vs. CBT vs. ACT
DBT is often combined with other therapies. Here’s how it compares:
| Therapy | What it focuses on | Best fit for |
|---|---|---|
| DBT | Emotional regulation and interpersonal skills | Clients with intense emotions, impulsivity, or relationship conflict |
| CBT | Identifying and directly changing negative thought patterns | Clients who respond well to structured, skills-based work |
| ACT | Accepting thoughts and feelings, acting on values instead of fighting them | Clients who feel overwhelmed trying to control their thoughts |
Who DBT Helps Most
DBT tends to be a strong fit for clients who:
- Experience intense, hard-to-manage emotions
- Have a history of impulsive behavior or self-harm
- Struggle with relationships that repeatedly reach a crisis point
- Have been diagnosed with, or show signs of, borderline personality disorder alongside substance use
- Have tried other therapies before without the results holding up
What DBT Looks Like in Treatment
A full DBT program typically includes individual therapy, weekly skills group training, and access to coaching between sessions for real-time support when a crisis or craving hits. As part of our Intensive Outpatient and Partial Hospitalization programs, DBT is often combined with group therapy or dual diagnosis treatment for clients managing a co-occurring mental health condition alongside substance use.
Frequently Asked Questions
Do I need a BPD diagnosis to do DBT?
No. DBT is used broadly for anyone whose substance use is closely tied to emotional intensity or relationship difficulty, not only for clients diagnosed with borderline personality disorder.
What’s the difference between DBT and CBT?
CBT focuses on changing the content of negative thoughts. DBT focuses more on regulating intense emotions and improving relationships, and it includes structured skills training that CBT typically doesn’t.
How long does DBT treatment usually take?
Full DBT programs are often structured over several months, though the length of your specific treatment depends on your individual needs and level of care.
Does insurance cover DBT for addiction treatment?
Yes, when it’s part of a covered treatment program. We work with Anthem, Humana, Medicare, and Ohio Medicaid. Verify your benefits for free before starting.
Get Started
If intense emotions, impulsivity, or relationship crises keep pulling you back toward substance use, DBT may be a strong part of the answer. Call 888-598-6299 or start your pre-assessment to talk with our team.
