What DBT Is
DBT was originally created by psychologist Marsha Linehan to treat people with chronic suicidality and borderline personality disorder — populations that conventional therapy often failed. It has since become one of the most evidence-based treatments for emotional dysregulation across many conditions, including substance use.
DBT combines two ideas that sound contradictory but work together:
- Acceptance of yourself, your emotions, and your present reality exactly as they are
- Change of the behaviors that are hurting you
Holding both at the same time — the dialectic — is what makes the work move.
Why DBT for Addiction
For many patients, substance use is the only effective way they have ever found to turn down emotions that feel intolerable. Asking them to stop using without giving them other tools is asking them to give up the one thing that has worked. DBT provides those tools:
- Distress tolerance — getting through a crisis without making it worse
- Emotion regulation — reducing the intensity and duration of painful emotions
- Mindfulness — staying present instead of being hijacked by thoughts and urges
- Interpersonal effectiveness — getting your needs met and protecting your boundaries without burning relationships
How DBT Is Delivered at BetterChoice
- DBT skills group — multiple times per week, working through the four core skill modules
- Individual therapy that integrates DBT principles with CBT, trauma work, and addiction-focused content
- In-the-moment skills coaching during the rest of the day from clinical staff using DBT skills
- Diary cards that track urges, emotions, and skills used between sessions
Who DBT Is Especially Helpful For
- People whose substance use is tied to emotional crashes, anger, or self-harm
- Patients with co-occurring borderline personality features
- Patients with chronic suicidal thinking or a history of self-injury
- People who feel emotions more intensely or for longer than seems "normal"
- Patients with unstable, high-conflict relationships
- Anyone who has tried CBT and found it useful but incomplete
What to Expect
DBT is structured and skill-heavy. You will not spend most of your time exploring childhood — you will spend most of your time learning specific techniques (TIPP, ACCEPTS, DEAR MAN, PLEASE, opposite action, radical acceptance) and practicing them in real situations. The skills are concrete enough to remember, and the practice happens both in session and in your everyday life.
Ready to Start?
Call (725) 550-5655 to ask whether DBT is appropriate for your situation. Ask admissions whether DBT skills work is included in your program cost; insurance coverage depends on your plan and the level of care authorized.