How DBT Can Help With Substance Use Disorders
Read below to learn why Dialectical Behavior Therapy (DBT) isn’t just for borderline personality disorder—and how our team uses it to support meaningful, sustainable recovery from substance use disorders.
Substance use disorders are complex. They’re often intertwined with painful emotions, past experiences, and overwhelming urges to escape. Many of the clients we work with have tried to stop using on sheer willpower—only to find themselves pulled back into the same patterns.
This isn’t a lack of discipline.
It’s a sign that you deserve support, skills, and a different approach.
That’s where DBT comes in.
What Is DBT?
Originally developed by Dr. Marsha Linehan for borderline personality disorder, DBT has since been adapted for a wide range of mental health concerns—including substance use recovery. It’s a structured, skills-based therapy that blends acceptance and change.
DBT is especially effective for individuals who feel emotionally overwhelmed, stuck in black-and-white thinking, or unsure how to navigate urges without numbing out.
How DBT Supports Substance Use Recovery
Substance use isn’t just about the substance itself—it's often about coping. Whether the underlying issues involve anxiety, depression, trauma, shame, or low self-worth, DBT teaches skills to help you manage intense emotions without relying on substances.
Here’s how our team uses DBT to support clients in recovery:
1. Mindfulness – “What” Skills: Observe, Describe, Participate
Skill Example: Observe Without Judgment
In early recovery, urges can appear suddenly and feel urgent. Mindfulness helps you pause, notice what’s happening internally, and respond rather than react.
Try this:
“I feel an urge to use. My chest feels tight. My thoughts are racing. I’m craving relief.”
No judgment—just awareness.
The goal is not to eliminate the urge but to watch it rise and fall like a wave.
2. Distress Tolerance – Crisis Survival Skills
Skill Example: TIPP (Temperature, Intense Exercise, Paced Breathing, Progressive Muscle Relaxation)
When cravings spike or emotions feel unbearable, TIPP helps reset the nervous system quickly.
Try this:
– Splash cold water on your face or hold an ice cube
– Move your body with 20–30 seconds of intense activity
– Slow your breath: in for 4, out for 6
Small physiological shifts can be enough to ride out the moment without using.
3. Emotion Regulation – Understand & Change Emotions
Skill Example: Check the Facts
Substance use is often triggered by intense emotions that feel larger or more threatening than they really are.
Try this:
“I messed up at work. I’m a failure. I need a drink.”
Now check the facts:
“I made a mistake. My boss didn’t say I’m in trouble. People make mistakes. I can fix this.”
Emotion regulation helps you respond to feelings instead of spiraling from them.
4. Interpersonal Effectiveness – Strengthen & Repair Relationships
Skill Example: DEAR MAN
Substance use can create strain, conflict, or confusion in relationships. These skills help you set boundaries, repair trust, and communicate clearly—without shutting down or blowing up.
Try this:
“When you ask about my sobriety (Describe), I feel supported but also pressured (Express). I’d like us to check in once a week instead of daily (Assert).”
5. Dialectics – Hold Two Truths at Once
Skill Example: Both-And Thinking
Recovery isn’t linear. Dialectical thinking helps you hold compassion and accountability at the same time.
Try this:
“I slipped today AND I’m still committed to recovery. I feel disappointed AND I’m still showing up.”
This balanced mindset is essential for long-term recovery.
What DBT Looks Like in Our Practice
At Healing Lane Therapy, our team integrates DBT skills into individual therapy with teens, young adults, and adults who are navigating complex mental health concerns and substance use recovery. Our approach is:
personalized
trauma-informed
evidence-based
honest and nonjudgmental
DBT isn’t about perfection.
It’s about building a life that feels worth being present for.
Ready to Explore DBT for Substance Use Recovery?
If you’re tired of white-knuckling recovery or feel stuck in familiar patterns, DBT may be the missing piece. Our therapists are here to walk alongside you and help you build the skills needed for sustainable change.
Reach out today to schedule a complimentary 15-minute consultation with our team.