According to the American Psychological Association, dialectical behavior therapy (DBT) combines aspects of behavior therapy, cognitive-behavioral therapy (CBT), and traditions of mindfulness. In DBT, clients learn skills to change unhelpful thoughts and behaviors. DBT can help people who have difficulty with emotional regulation or who exhibit self-destructive behaviors rooted in unresolved trauma. It is also an effective treatment modality for substance use disorder (SUD).

The main goals of DBT are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others. Some of the core tenets of DBT, such as improving communication skills, coping skills, and self-image, are critical to helping people with SUD to overcome their addiction.

Dialectical Behavior Therapy Core Tenets

In order to better understand how DBT works, it helps to understand that this therapeutic approach is based on four core tenets:

  • People are doing the best that they possibly can in their current situation
  • Problems are not always the individual’s fault, but it is their duty to try to resolve their challenges
  • People want their situations to improve
  • Everyone is capable of learning new behaviors that will improve and change their lives

DBT works because it helps people unlearn unwanted thoughts and behavior patterns through a number of exercises and coping skills. It also works because of its four tenets and the idea that as unwanted behaviors and thoughts were learned, so they can be unlearned.

Dialectical Behavior Therapy Tools

DBT uses four core skills and tools to help shift unwanted or destructive thoughts and behaviors into more positive, healthy ones.

Therapists using DBT teach new behavioral skills by modeling, providing instructions, telling stories, providing opportunities for practice, giving feedback, and coaching. The primary tools used to help in letting go of old, negative thoughts and behaviors and replacing them with positive thoughts and behaviors are mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance.


Mindfulness means being able to be fully immersed in the moment while also being able to observe one’s thoughts and feelings with a degree of impartiality. Mindfulness is at the core of treatment as it is central to all other skills in DBT.

Through mindfulness, individuals can learn about and practice bringing awareness to the moment. By doing so, they are able to observe their thoughts and feelings. They can also tune in to their senses and the environment around them, which allows them to effectively slow down and focus on healthy coping skills when they are experiencing unwanted thoughts or behaviors.

Interpersonal Effectiveness

When a person has developed Interpersonal effectiveness, they are better able to repair, maintain, and establish healthy relationships. Interpersonal effectiveness helps people improve their communication and conflict resolution skills. Training in interpersonal effectiveness also incorporates assertiveness training to help individuals create and enforce healthy boundaries with others. This helps people find balance in their relationships and in their lives.

Emotional Regulation

Emotions are a normal part of everyday life, but it’s important to recognize that there is a difference between having emotions and being controlled by them. Emotional regulation focuses on identifying, naming, and changing the negative effects of an emotional response by helping to recognize and cope with intense negative emotions and develop a positive response.

The goal of developing emotional regulation is to help individuals have more positive emotional experiences by learning how to manage overwhelming or unwanted feelings and by understanding one’s own emotions.

Distress Tolerance

When people experience distress, the immediate desire is to get rid of that feeling. Distress tolerance teaches individuals to sit with discomfort and accept negative emotions. Techniques such as distraction and self-soothing skills empower individuals to cope with intense emotions. These techniques help people learn to live with emotional discomfort.

Dialectical Behavior Therapy and Addiction

Oftentimes, substance abuse is driven by feelings of discomfort and a need to escape unwanted thoughts and feelings. When DBT is used in treating substance abuse, individuals are encouraged to commit to abstinence. Their motivation to change their behavior and work through the painful emotions that may have led to addiction is bolstered by the various activities and techniques used in DBT.

DBT is also used to help people get back on track after a relapse. DBT treats relapse as a problem to solve and an opportunity to learn, not as a failure. Using DBT, therapists help individuals assess the events that led to the relapse and help them repair any harm caused by the relapse. Individuals become more aware of the negative consequences of substance abuse and the emotions and situations that led them to abuse drugs or alcohol in the first place.

Oftentimes, substance use disorders (SUD) are driven by the need to alleviate feelings of distress or discomfort through self-medicating. By confronting these feelings of discomfort and realizing we can control them, we are able to move through a successful recovery process, all while keeping negative feelings at bay and replacing them with more positive ones. Here at Bella Monte Recovery Center in Desert Hot Springs, California, we believe in treating the trauma that leads to addiction rather than treating substance abuse alone. At Bella Monte Recovery Center, we lead individuals through dialectical behavior therapy (DBT) in conjunction with other therapeutic modalities to help ease the recovery process and teach new skills and behaviors. If you or someone you love is struggling with addiction and you want to learn more about what we have to offer, call (800) 974-1938 for more information.