Dialectical Behavior Therapy Program
Most people are easily able to identify their bad habits.
They know that they are engaged in self-destructive behaviors, yet struggle to make the conscious choices necessary to change them.
The challenge of changing an ingrained habit is typically due to the benefits a person obtains from the self-harming behavior; all maladaptive habits emerge from an inability to cope with unpleasant feelings or situations.
Patients with a substance abuse disorder often regulate their emotions with substances for lack of better behavioral skills.
Dialectical behavioral therapy, an evidence-based approach to developing behavioral skills and coping mechanisms, represents the most effective treatment for patients with substance and personality disorders.
At Restorations Health Group in Anaheim, California, we use dialectical behavioral therapy to enable long-term recovery for our Southern California patients.
What is Dialectical Behavioral Therapy (DBT)?
Dialectical behavioral therapy (DBT) is a cognitive-behavioral approach to healing dysfunctional patterns of behavior and emotional dysregulation by providing psychotherapy, group skills training, therapy sessions, and phone coaching.
American psychologist Marsha Linehan developed DBT in the early 1990s to treat borderline personality disorder (BPD)—and research supports the effectiveness of the practice.
DBT emerged from Linehan’s efforts to account for the weaknesses of cognitive behavioral therapy (CBT), a therapeutic approach that prioritizes talk therapy.
Since then, therapists have found that DBT can help treat patients with generalized anxiety disorder, substance use disorder, eating disorders, and many other illnesses characterized by self-destructive behavior.
How It Works
DBT helps patients develop the coping skills they need to regulate their emotions and develop mindful awareness and acceptance.
DBT treatment consists of four modules:
- Mindfulness
- Distress tolerance
- Emotional regulation
- Interpersonal effectiveness
Together, these modules empower our Anaheim patients to assume control over their emotions and develop the self-respect they need to improve their quality of life.
Benefits of DBT
All habits have good intentions.
Patients develop maladaptive mechanisms to self-soothe and regulate their emotions. When these coping mechanisms are no longer helpful, a DBT therapist helps patients promote acceptance and change in the interest of developing new behavioral skills.
A study found that DBT skills promote immediate and long-term relief for addiction patients.
DBT enhances the quality of life for those who respond to little else.
Patients Learn to Reconcile Acceptance and Change
The first principle of DBT is learning to reconcile self-acceptance and change.
In individual therapy, patients work with their therapists to assess their self-respect, acceptance, and responsiveness to change.
Ultimately, patients learn to practice self-improvement from a place of nonjudgment and acceptance.
Dialectical Behavioral Therapy Promotes Mindfulness
The first module of DBT is mindfulness.
Patients learn to cultivate mindful awareness to track changes in mood and behavior. This empowers them to make different decisions without resorting to automatic habits.
Additionally, mindfulness allows our Anaheim patients to accept and enjoy their circumstances—no matter what.
Patients Learn to Manage Impulsivity
By cultivating mindfulness, patients are better able to manage impulsivity and less likely to experience urges to act self-destructively.
DBT Helps Patients Manage Distressing Situations
The distress tolerance module arms patients with the new skills they need to accept and adapt to stressful emotions and environmental triggers.
This module offers healthy behaviors as replacements for unhealthy coping mechanisms, steadily empowering patients with new and improved habits.
Patients Learn to Identify and Cope with Emotions
Emotions are often the catalyst for substance use.
In the emotional regulation module, patients learn to identify and name their emotions and reduce their vulnerability to overreaction.
Additionally, this module empowers students to increase the proportion of positive events in their lives, improving the overall quality of life.
Patients Learn to Identify and Change Harmful Behaviors
Patients can limit their resorting to harmful behaviors using mindfulness, distress tolerance, and emotional regulation.
DBT disrupts the behavior at the root: the emotional reaction that provokes the self-harming action.
DBT Improves Relationships
With DBT skills at their disposal, patients can begin to reengage in healthy relationships and help others.
They learn to balance others’ needs while prioritizing their safety and comfort.
In this way, DBT contributes to improving communities as a whole.
Patients are Less Likely to Relapse or Engage in Self-Harming Behaviors
Studies show that DBT reduces the likelihood of relapse and decreases self-harm by increasing distress tolerance and giving patients a wider pool of coping skills to pull from.
Even if patients relapse, they can better identify the relapse and cope with it in a healthy manner—and without judgment.
DBT Improves Quality of Life
With the skills provided by dialectical behavioral therapy, patients can begin to experience a better quality of life overall.
Practicing emotional constancy, self-respect, acceptance, and interpersonal skills heightens and multiplies positive experiences.
What DBT Can Treat
Although Linehan originally intended DBT for patients with borderline personality disorder (BPD), the medically reviewed practice is proven to improve outcomes for patients with substance use disorders, eating disorders, binge eating disorder, generalized anxiety disorder, and depression with suicidal behaviors.
While some patients may experience these disorders individually, many are comorbid, meaning they coexist in the same patient.
Borderline Personality Disorder
Patients with BPD struggle to reconcile opposing ideas and beliefs.
They often think in “black and white” and, as a result, experience emotional fluctuations. To cope with their feelings, they frequently engage in self-destructive behaviors, such as self-harm, suicidal behavior, substance use, binge eating, or other mind- or mood-altering behaviors.
BPD is a disease of instability, and behavioral therapy introduces new skills that enable patients to cultivate stability and presence of mind.
Depression, Anxiety, and Stress Disorders
Patients with depression and anxiety also struggle to regulate emotions and evaluate situations without judgment. They may experience shame due to chronic suicidal ideation.
DBT can help such patients recognize the validity of their emotions while challenging the damaging thoughts and behaviors that frequently accompany them.
Substance Use Disorders & Other Addictions
Addiction is a disease, and though the above disorders may, at first glance, appear to be distinct from one another, patients share the same internal inability to cope with life and regulate their emotions.
DBT works for many because it addresses the patient’s cognitive reality rather than the symptoms of their suffering.
As a result, DBT works for substance users and those with process addictions (such as eating disorders or gambling addictions).
For our Anaheim patients, DBT can represent the path to a better future.
Benefits of CBT
Studies involving CBT have shown several benefits that stand as tangible improvements in the lives of psychotherapy patients.
Rational Thinking
The most significant advantage of cognitive therapy may lie in its ability to promote more rational thinking in patients. Someone with various thinking disorders might experience distractions and distress due to thoughts and patterns they may feel they have no control over.
A common thinking problem called distorted thoughts can wreak havoc on a person’s mental state. Over time, these reactions become automatic and cause distress.
For instance, if a patient bakes a tray of cookies, gets distracted, and ends up burning them, distorted thinking might lead them to think, “I’m a terrible baker.” Their baking ability has little to do with being distracted and leaving the cookies in for too long. They simply made a mistake, but distorted thoughts can translate a simple misstep into disaster in their mind.
They might further think they can’t do anything right, that they’re worthless, that everything they touch gets ruined, and on and on.
To an onlooker, these seem like extreme conclusions to draw from one burned batch of cookies, but to an individual with distorted ways of thinking, they seem perfectly logical. As a result, they may have low self-esteem and little inclination to try anything new.
By gaining conscious control of their thought patterns, one can leave distorted thoughts behind and stop feeling defined by them.
Improved Self-Esteem
Low self-esteem can cause real problems in a patient’s life. It can lead to feelings of inadequacy, a lack of control over one’s life, and the inability to trust oneself.
A Dartmouth Medical School study showed that low self-esteem occurs more often in specific demographics, including women, Hispanics, and individuals with obesity. However, these groups are not the only ones afflicted with low self-esteem, as it can occur in just about anyone.
Low self-esteem can contribute to the recurrence of negative thinking and distorted thoughts, as it can often lead people to compare themselves (however unfairly) to those around them.
Cognitive behavioral therapy can help break low self-esteem patterns by addressing the thinking processes involved, disrupting them, and replacing them with healthier forms of self-talk.
Hope for the Future
As someone utilizing CBT begins seeing results from the changes in their thought patterns and, by extension, their mental health, they very often feel hope. Since many self-destructive habits stem from distorted thinking, when CBT plays a role in changing those patterns, the behaviors subside while problem-solving skills are developed.
By learning that one’s thoughts do not always represent reality, a person can begin feeling better about the world around them and what their place in it may be.
When you understand how your thoughts work—and how they are under your control—your entire belief system changes. In particular, you gain different perspectives on how you (and the real world) view yourself.
CBT involves learning to identify negative thoughts and realizing that our feelings about something are not facts. Just because you believe you are worthless doesn’t make it a fact. Simply believing that everyone hates you doesn’t make it accurate.
So, instead of a cycle of negative thoughts influencing behavior, you gain positive ones. CBT can disrupt unhealthy patterns—and help you develop more confidence in your abilities.
What CBT Can Treat
Since CBT focuses on thought patterns to adjust and modify behaviors, it works as a treatment for multiple mental illnesses and mood disorders.
Anxiety Disorders
Anxiety disorders result from fears usually out of proportion to the situation or thing sitting at the root of the anxiety. Some levels of anxiety are normal in life, but when it begins interfering with day-to-day activities, it could be a disorder. CBT works to show the patient how to recognize the roots of the anxiety, alter the associated thought patterns, and develop healthy coping skills.
Bipolar Disorders
A central part of bipolar disorders involves the aftermath of episodes. CBT can help a person deal healthily with the feelings of guilt that may occur following a manic episode, for instance.
The treatment can assist someone with bipolar disorder in recognizing the mental health conditions precipitating an episode, which could lessen or prevent associated behaviors.
Depression
As one of the most common mental disorders, depression can have a devastating impact. A therapist can guide a patient through depressive episodes by using CBT to identify and alter thought processes that fuel depression.
CBT is used for both situational and chemical depression. In the latter, studies show that CBT in conjunction with medication works better than meds alone.
Eating Disorders
Since many eating disorders have roots in a distorted perception of self, CBT stands as a singularly effective method of treating them.
CBT is one of the most effective options for treating bulimia because the disorder has at its root the patient’s mistaken perception that they are overweight or otherwise shaped in a way that cultural ideals deem improper.
Allowing a patient to identify and confront these misperceptions sets them on a path to changing the unhealthy behaviors intrinsic to an eating disorder like bulimia.
Phobias
To treat phobias, which are generally irrational fears not grounded in reality, therapists sometimes employ exposure therapy to support a patient in overcoming that fear.
Exposure therapy is a form of CBT. A therapist will gradually increase the patient’s proximity to or involvement with the object of the phobia to lessen the anxiety responses. By demonstrating that their fears are misplaced, therapists may eliminate, or at least lessen, the phobia.
This approach works by encouraging the patient to recognize the irrational nature of the fear in question. Essentially, that fear is a type of distorted thinking. For instance, a fear of snakes can be assuaged when the patient comes to recognize that whatever they perceive about the reptiles is probably untrue or highly unlikely.
Post-Traumatic Stress Disorder
In treating PTSD, therapists use CBT to reduce symptoms by helping patients recognize distorted thoughts associated with PTSD. For instance, a war veteran might associate loud noises with the explosions, violence, and horror they experienced on the battlefield.
However, it’s distorted thinking to assume that every loud noise away from the front lines indicates imminent harm and destruction.
Professionals might also employ a form of therapy akin to exposure therapy, in which the patient recounts the trauma in a safe environment to experience a feeling of control over what’s happening.
Other mental conditions which CBT has successfully treated include:
- Obsessive-compulsive disorder (OCD)
- Phobias
- Schizophrenia
- Sexual disorders
- Sleep disorders
- Substance use disorders
Effectiveness of Cognitive Behavioral Therapy
Since medical science continues trending more and more toward evidence-based conclusions, we can quantify the effectiveness of CBT. Indeed, we’ve already referred to several studies investigating different aspects of CBT and the patients using it.
By helping patients identify and change harmful thoughts, CBT allows for a better quality of life in patients who can gain some control of destructive thoughts.
As CBT has developed since the 20th century, therapists have applied scientific methods to create CBT treatment regimens for specific disorders. Since not every mental disorder or illness manifests the same or affects the same parts of a patient’s life, different CBT approaches can offer more nuanced support.
No matter the issue to which a therapist applies CBT, the protocol aims to do the same things:
- Reduce a patient’s symptoms
- Improve the way a patient functions
- Effect a remission in the patient’s disorder
As the treatment addresses thoughts and behaviors, CBT techniques can improve mental health, raise self-esteem, and engender feelings of well-being.
Effectiveness of Dialectical Behavioral Therapy
Dialectical behavioral therapy has built a reputation for improving outcomes for most patients. Research shows that 77 percent of patients with borderline personality disorder experience successful results from undergoing DBT.
The success rate is equally high within populations of patients with substance use disorders.
But why is DBT so practical?
Each feature of DBT contributes to building special skills to promote long-term change.
Consultation Team
Each patient works with a consultation team of mental health professionals. This ensures that multiple expert opinions weigh in on progress and treatment options.
Furthermore, patients can access several DBT technicians, therapists, and psychiatrists for support.
Individual Therapy
Each patient works with an individual therapist to balance the contradiction between change and acceptance.
“Dialectical” means “acting through opposing forces.” Patients must accept and respect themselves before they can change.
Individual therapy helps them do so.
Group Skills
In groups, patients learn among their peers to develop the behavioral skills they need to regulate their emotions and manage stress responses.
Working in a group promotes collaboration, empathy, and skill mastery.
Within their groups, Anaheim patients work across all four modules within DBT to cultivate different ways to cope with stress and regulate their emotions.
Mindfulness
Mindfulness is a core element of BPD.
Patients must develop self-awareness to initiate change.
Practicing mindfulness enables patients to live in the present moment, minimize fear and stress, experience emotions, and engage their senses.
Patients also learn to proceed with change from a place of nonjudgment.
Distress Tolerance
Many substance users also have stress disorders, self-harm habits, suicidal behaviors, and other damaging responses to being emotional overwhelmed.
The distress tolerance module teaches patients to cultivate acceptance and maintain composure during highly stressful or traumatic events.
Emotional Regulation
Once patients learn to tolerate distress, they can develop the ability to regulate intense negative emotions and are less likely to react impulsively to them.
Students learn to:
- Identify and name emotions
- Identify and overcome obstacles to changing emotional states
- Reduce their vulnerability to a reaction
- Increase positive events
- Develop mindfulness
- Apply distress tolerance techniques
Interpersonal Effectiveness
In this module, students learn to cultivate self-respect, treat others with care and kindness, and practice assertiveness and boundary maintenance.
Why Do We Use DBT in Addiction Treatment?
Studies suggest that BPD and SUD often manifest in the same person and that the two disorders share many crucial characteristics. As a result, effective treatment for one is often effective for the other.
Addiction is a manifestation of emotional dysregulation and acceptance. People with SUD use substances because they often believe the substance is the only thing keeping them safe from the pain that torments them.
DBT Promotes Positive Outcomes for Substance Users
The most effective treatments for SUD treat the person rather than the behavior. The behavior is merely a symptom of internal suffering.
DBT works for substance users because it is a person-centered approach to treatment. Rather than emphasizing the consequences of behaviors, as with cognitive behavioral therapy, it prioritizes emotional constancy and mindfulness.
When patients experience relief from internal pain, they are far less likely to engage in the behaviors they used to quell that pain.
Therefore, DBT treats the problem at the source, contributing to profound relief and long-term recovery. DBT is also exceptionally effective in treatment settings for the following reasons.
DBT Works Best When Patients Are Sober
Studies show that DBT works best on patients not currently using substances.
In our Anaheim facility, patients can safely detox and begin the treatment when it is most likely to be effective.
DBT Requires Environmental Safety
There is no safer place than a treatment facility.
DBT works best for patients whose basic needs are met. Substance users are often in unsafe situations due to their addictions. When they come to our Southern California facility, they receive access to the basic comforts and necessities they need to focus on treatment.
Patients Learn the Most from One Another
The skills group is an integral component of DBT—but many outpatient groups can be unpredictable, and patients may have difficulty holding themselves accountable to attend.
We bring our patients together in a safe and accountable environment where they are motivated to attend their groups and participate fully.
Our groups are led by certified DBT technicians and therapists who expertly facilitate participation and learning.
As a result, students learn a great deal from one another.
We Care About California
Substance abuse is a threat to our community.
As of 2022, 9 percent of Californians suffer from SUD, and the death rate from fentanyl-related overdoses has climbed 30 percent from 2011 to 2019.
In bringing DBT to Southern California, we aim to help our clients recover and improve our more significantly impacted communities.
A healthy community is one in which its members are happy, healthy, and respectful of one another.
Find Relief
Entering treatment can be overwhelming.
Whether you are suffering from an addiction or suspect someone you love is grappling with SUD, you can find relief at our beautiful Anaheim facility.
We offer a variety of programs to enable recovery, including:
- Addiction detox
- Residential treatment
- Addiction aftercare
Additionally, we offer extensive treatments other than DBT, including:
- Individual psychotherapy
- Group therapy
- Family therapy
- Young adult treatment
- 12-step groups
- Aftercare planning
To contact us today for a consultation, you can send us a message on our website, call us at (831) 243-5604, or visit us at our facility at 1247-A North Lakeview Avenue, Anaheim, CA 92807.
Recovery is a journey that requires bravery to take the very first step. We encourage you to reach out with any questions regarding dialectical behavioral therapy and other treatment options, and we hope to hear from you soon.