How We Treat
Dialectical Behavior Therapy for Substance Use Disorders
Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD) is an evidence-based therapy designed to help individuals manage addiction, emotional dysregulation, impulsive behaviors, and relapse patterns.
DBT-SUD combines addiction recovery strategies with practical skills focused on mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. This approach is commonly used for individuals experiencing co-occurring mental health and substance use concerns, including trauma, anxiety, depression, and self-destructive coping patterns. At Counseling Center Group, DBT-informed therapy is provided by clinicians experienced in addiction recovery, trauma-informed care, and evidence-based behavioral treatment approaches.
What Is Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD)?
Dialectical Behavior Therapy Substance Use Disorders (DBT-SUD) is a specialized adaptation of Dialectical Behavior Therapy originally developed by psychologist Marsha Linehan. DBT-SUD was created to support individuals struggling with substance use disorders alongside emotional dysregulation, impulsivity, self-destructive behaviors, trauma-related symptoms, and co-occurring mental health conditions.
DBT-SUD combines traditional DBT principles with addiction-focused interventions aimed at reducing substance use, strengthening emotional coping skills, increasing distress tolerance, and supporting long-term recovery. The treatment helps individuals better understand the relationship between emotions, behaviors, triggers, and substance use while building healthier coping strategies.
DBT-SUD is commonly used for individuals who experience difficulty managing intense emotions, chronic stress, shame, impulsivity, or interpersonal conflict that contributes to relapse or substance misuse. Sessions are collaborative, structured, and focused on applying skills in everyday life situations.
Treatment may include individual therapy, DBT skills training, relapse prevention strategies, behavioral chain analysis, and coordination with additional recovery supports when clinically appropriate.
What Does Dialectical Behavior Therapy Substance Use Disorders Treat?
DBT-SUD may help individuals experiencing:
- Substance Use Disorders DBT-SUD provides an integrated, framework for addressing the emotional and behavioral drivers of substance use across a wide range of substances and use patterns.
- Alcohol Misuse Structured skills target the emotional triggers, social cues, and distress states that sustain problematic alcohol use and complicate recovery.
- Drug Misuse DBT-SUD builds the behavioral awareness and coping capacity needed to interrupt patterns of drug use driven by emotional dysregulation, avoidance, or urge-based responding.
- Relapse Prevention Therapy directly addresses the cognitive, emotional, and situational patterns that precede relapse, equipping individuals with concrete skills to recognize warning signs and respond effectively before a lapse occurs.
- Emotional Dysregulation DBT’s core emotional regulation skills help individuals identify, understand, and modulate intense emotional states that frequently drive substance use as a coping mechanism.
- Impulsivity & High-Risk Behaviors Treatment targets the impulsive behavioral patterns and risk-taking tendencies that often co-occur with substance use, building greater self-awareness and behavioral control over time.
- Co-Occurring Anxiety DBT-SUD addresses anxiety and substance use as interconnected concerns, providing skills that reduce both the emotional overwhelm that drives use and the anxiety that recovery itself can produce.
- Depression & Mood Concerns Because depression and substance use frequently reinforce one another, DBT’s integrated approach targets mood dysregulation and substance-related behavior within the same structured framework.
- Trauma & PTSD When substance use is rooted in or complicated by trauma, DBT-SUD’s trauma-informed structure provides a clinically appropriate framework for addressing both without destabilizing the recovery process.
- Self-Harm Behaviors DBT was originally developed to address self-harm, and its application in SUD treatment provides robust skills for replacing self-destructive behavioral patterns with safer, more adaptive alternatives.
- Chronic Shame & Self-Criticism Shame is one of the most powerful drivers of continued substance use and relapse. DBT directly targets shame-based emotional cycles and builds the self-compassion needed to sustain recovery.
- Stress-Related Coping Difficulties For individuals who have relied on substances to manage stress, DBT provides a concrete, skills-based alternative that builds genuine distress tolerance without chemical coping.
- Interpersonal & Relationship Challenges DBT’s interpersonal effectiveness module equips individuals with the communication, boundary-setting, and relationship skills that support a stable, recovery-oriented social environment.
- Distress Tolerance Difficulties A core DBT competency, distress tolerance skills allow individuals to move through painful emotional states without acting on urges.
- Avoidance-Based Coping DBT addresses the avoidance patterns that maintain both emotional dysregulation and substance use, building the behavioral willingness to engage with difficult experiences rather than escape them.
- Emotional Overwhelm in Recovery The emotional intensity of early and sustained recovery can itself become a relapse trigger. DBT provides the skills and clinical support needed to navigate that overwhelm with stability and intention.
- Step-Down from Intensive Treatment For individuals transitioning out of residential rehabilitation, inpatient treatment, or an intensive outpatient program, DBT-SUD provides the structured outpatient continuity needed to protect and build on the progress made in higher levels of care.
- Co-Occurring Concerns During MAT For individuals engaged in Medication-Assisted Treatment, DBT-SUD addresses the emotional dysregulation, relapse triggers, interpersonal stressors, and co-occurring mental health concerns that medication alone does not target. This behavioral health layer makes MAT most effective.
What to Expect / How DBT-SUD Works at CCG
At Counseling Center Group, clients seeking Dialectical Behavior Therapy for Substance Use Disorders begin with an intake process focused on understanding emotional, behavioral, relational, and recovery-related concerns. Our intake team works to match clients with clinicians experienced in DBT-informed therapy, addiction recovery support, trauma-informed care, and co-occurring mental health treatment.
DBT-SUD focuses on helping individuals reduce reliance on substances as a coping strategy while strengthening healthier behavioral and emotional coping skills. Our clinicians help clients develop practical skills related to mindfulness, emotional regulation, distress tolerance, relapse prevention, interpersonal effectiveness, and behavioral awareness.
DBT-SUD as a Step-Down After Rehab, Residential, or Intensive Treatment
The transition out of residential or intensive treatment is one of the most vulnerable moments in recovery and DBT-SUD at the Counseling Center Group is designed to meet you there.
- Provides structured, clinician-matched outpatient support that reinforces the progress made in residential rehabilitation or intensive outpatient programs (IOP)
- Builds and sustains core recovery skills like distress tolerance, emotional regulation, relapse prevention, and urge management within the context of real-world stressors
- Bridges the gap between intensive programming and independent daily life through a structured, evidence-based framework that doesn’t leave you to figure it out alone
- Our clinicians work collaboratively alongside your existing recovery team to ensure continuity of care, not a restart from zero
If you’ve recently completed a higher level of care and are ready for the next step, we’ll match you with a specialist who understands where you’ve been and what it takes to keep moving forward.
Supporting Recovery Alongside Medication-Assisted Treatment (MAT)
Medication-Assisted Treatment works best when it’s paired with behavioral health support and that’s precisely where DBT-SUD at the Counseling Center Group comes in.
- MAT medications including Methadone, buprenorphine (Suboxone), and naltrexone (Vivitrol) are among the most well-researched tools available for opioid use disorder and alcohol use disorder, and research consistently shows they are most effective when combined with behavioral therapy
- Our DBT-SUD clinicians work directly with clients currently engaged in MAT, targeting what medication alone cannot reach: emotional dysregulation, relapse triggers, interpersonal stressors, and co-occurring mental health concerns
- Treatment is individualized and may include individual therapy, skills-based interventions, relapse prevention planning, and group therapy. All treatment is available in person or via secure telehealth in 45–60 minute sessions
- When clinically appropriate, our clinicians coordinate directly with prescribing providers to ensure a cohesive, whole-person approach to recovery
If you are currently engaged in MAT and are ready to add the behavioral health layer that makes recovery sustainable, we’ll match you with a DBT-SUD specialist who will meet you with evidence-based, nonjudgmental care from the first session.
FAQ's
Dialectical Behavior Therapy Substance Use Disorders (DBT-SUD) is an evidence-based adaptation of DBT designed to help individuals struggling with addiction, emotional dysregulation, impulsivity, and relapse behaviors develop healthier coping skills and long-term recovery strategies.
DBT-SUD places a stronger emphasis on emotional regulation, mindfulness, distress tolerance, and behavioral coping skills. In addition to addressing substance use directly, DBT-SUD helps individuals understand and manage the emotional patterns that often contribute to addiction and relapse
Yes. DBT-SUD is commonly used for individuals experiencing both substance use disorders and co-occurring mental health concerns such as anxiety, depression, trauma, self-harm behaviors, and emotional dysregulation.
Yes. DBT-informed treatment approaches for substance use disorders are supported by peer-reviewed research and are commonly used in behavioral health and addiction treatment settings, particularly for individuals with co-occurring emotional and behavioral difficulties.
Treatment length varies depending on recovery goals, relapse history, symptom severity, and co-occurring mental health needs. Some individuals benefit from shorter-term skills-focused treatment, while others participate in ongoing therapy for longer-term recovery support.
Yes. Depending on clinician licensure and client location, DBT-informed therapy for substance use concerns may be available through secure telehealth sessions in addition to in-person appointments.
No. DBT-SUD may benefit individuals at various stages of recovery, including those struggling with emotional coping patterns, relapse concerns, problematic substance use, or co-occurring mental health difficulties.
Yes. DBT-SUD is well-suited for individuals transitioning out of residential treatment, inpatient rehabilitation, or intensive outpatient programs (IOP). The step-down period is clinically significant and DBT-SUD provides ongoing structure, skills reinforcement, and relapse prevention support as individuals reintegrate into everyday life. Our clinicians can also coordinate with your existing treatment team to support continuity of care.
Yes. DBT-SUD is commonly used alongside Medication-Assisted Treatment (MAT). Research supports the combination of behavioral therapy and MAT as more effective than medication alone for long-term recovery from opioid and alcohol use disorders. Our clinicians are experienced working with clients engaged in MAT and can collaborate with prescribing providers when clinically appropriate.
Author
Reviewed by Paul Rahn, LCSW-C, a licensed mental health clinician at Counseling Center Group with experience providing Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD), addiction recovery support, trauma-informed care, and treatment for co-occurring mental health and substance use concerns.