Dialectical Behavior Therapy for Addiction
Dialectical Behavior Therapy for Addiction adapts DBT’s skills—mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness—to reduce substance use and self-harm while improving stability. This page turns manuals into clinic pathways: skills groups plus individual coaching, phone-in support with guardrails, and contingency strategies that reinforce practice. If you’re exploring a DBT addiction conference, you’ll find protocols for chain analysis, commitment strategies, and aligning DBT with MOUD/AUD medications and harm-reduction. Because crises are common, we emphasize safety planning and rapid re-entry after lapses. For transdiagnostic CBT skills, see CBT for Substance Use.
Success depends on fidelity plus flexibility. Programs define target hierarchies (life-threatening, therapy-interfering, quality-of-life interfering), set homework with real-life practice, and use data to personalize modules. Co-occurring trauma, personality traits, or eating-disorder features are addressed without losing focus on substance targets. Sleep and circadian anchors support emotion regulation; peers normalize effort and setbacks. Equity demands language-appropriate materials and low-barrier formats (evening, tele-skills), with privacy safeguards.
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DBT-SUD Core and Clinical Moves
Target hierarchy and chain analysis
- Identify sequences from trigger to use; design skill inserts.
- Reinforce commitments with visible progress markers.
Skills modules for SUD
- Mindfulness for craving and urge surfing; distress tolerance during spikes.
- Emotion regulation and interpersonal skills for high-risk contexts.
Reinforcement and contingencies
- Pair skills practice with CM where feasible.
- Use crisis plans and brief coaching to prevent derailment.
Medication and harm-reduction
- Align with MOUD/AUD meds; avoid sedative stacking.
- Normalize naloxone, safer-use, and sleep-first plans.
Delivery Models, Equity, and QA
Group + individual structure
Weekly skills plus coaching with clear boundaries.
Phone-in coaching
Limited, skills-focused support during high-risk windows.
Integration with teams
Therapists, prescribers, peers coordinate messaging.
Youth and perinatal
Adapt modules, confidentiality, and supports for these stages.
Digital augmentation
Apps for diary cards, prompts, and skills videos.
Equity and access
Language options, tele-skills, and transport support.
Measurement and outcomes
Track use days, crises, retention, and QoL.
Fidelity and supervision
Manualized delivery with observation and feedback.
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