DBT for Addiction and Co-Occurring Disorders in Wilmington, Delaware
Dialectical behavior therapy (DBT) is an evidence-based, skills-based form of therapy that helps people manage intense emotions, tolerate distress, improve relationships, and change behaviors that interfere with recovery. Originally developed for borderline personality disorder, DBT is now also used to support people experiencing substance use disorders and co-occurring mental health concerns.
At Redemption Addiction Treatment Center in Wilmington, Delaware, DBT is one of the evidence-based therapies used in addiction treatment to help clients recognize the emotional and behavioral patterns connected to substance use and develop healthier ways to respond to cravings, stress, conflict, and other recovery challenges.
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The History of DBT
Dialectical behavior therapy was developed by psychologist Dr. Marsha Linehan at the University of Washington in the late 1980s. It was originally developed to treat borderline personality disorder (BPD), particularly for people experiencing severe emotional dysregulation, impulsive behavior, or self-harm.
DBT combines behavioral change strategies with acceptance and mindfulness. Over time, its use expanded beyond BPD to address other behavioral and mental health concerns, including substance use disorders. For addiction treatment, this balance is particularly relevant because clients learn both to accept difficult emotions without immediately acting on them and to change behaviors that interfere with recovery.
How DBT Helps With Addiction and Co-Occurring Disorders
Substance use can become closely connected to how a person responds to difficult emotions, stress, conflict, trauma, or impulsive urges. When those experiences become overwhelming, drugs or alcohol may be used as a way to escape, numb, or change how someone feels.
DBT helps clients recognize these patterns and practice different responses. Instead of relying on substance use when distress rises, clients develop skills for tolerating uncomfortable emotions, regulating their reactions, communicating more effectively, and making choices that support recovery.
This approach may be particularly useful for people whose substance use occurs alongside concerns such as anxiety, depression, trauma-related symptoms, emotional dysregulation, impulsivity, or borderline personality disorder.
DBT skills can also support relapse prevention by helping clients recognize emotional triggers and respond to cravings or high-risk situations without automatically returning to substance use.
The Four Core Skills of DBT
DBT teaches four primary sets of skills that can help clients respond differently to emotions, cravings, stress, and interpersonal challenges.
Mindfulness
Mindfulness teaches clients to pay attention to thoughts, emotions, physical sensations, and their surroundings without immediately judging or reacting to them. In addiction recovery, this can help someone notice a craving or emotional trigger without automatically acting on it.
DBT also uses the concept of the "wise mind," which encourages decisions that consider both emotional experience and rational thinking.
Distress Tolerance
Distress tolerance focuses on getting through difficult moments without making the situation worse. Clients learn ways to manage intense emotions, urges, and stressful situations when the problem cannot be immediately changed.
For someone recovering from addiction, these skills can be especially useful when cravings, conflict, disappointment, or other uncomfortable experiences create an urge to use drugs or alcohol.
Emotion Regulation
Emotion regulation helps clients better identify, understand, and respond to their emotions. Skills may focus on recognizing emotional patterns, reducing vulnerability to overwhelming reactions, evaluating whether an emotional response fits the situation, and choosing healthier actions.
For people with co-occurring substance use and mental health concerns, learning to regulate emotions can reduce reliance on substances as a coping mechanism.
Interpersonal Effectiveness
Interpersonal effectiveness focuses on communicating needs, setting boundaries, managing conflict, and maintaining healthier relationships while respecting both yourself and others.
These skills can be particularly valuable during recovery, when clients may be rebuilding relationships affected by substance use or learning how to navigate relationships without returning to old behavioral patterns.
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Benefits of DBT for Addiction Treatment
Addiction can affect emotional health, decision-making, relationships, and the way a person responds to stress. DBT gives clients practical skills they can use when difficult emotions or situations threaten their recovery.
Potential benefits of incorporating DBT into addiction treatment include:
- Greater awareness of emotional and behavioral triggers
- Healthier responses to cravings and distress
- Improved emotional regulation
- Stronger communication and boundary-setting skills
- Reduced impulsive or self-defeating behavior
- Improved ability to navigate conflict and stressful situations
- Practical coping skills that can support relapse prevention
At Redemption, treatment is individualized around each client's needs. DBT may be incorporated alongside other evidence-based therapies and addiction treatment services when clinically appropriate.
DBT vs. CBT for Addiction Treatment
Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are both evidence-based behavioral therapies, but they place emphasis on different skills and strategies.
CBT focuses heavily on identifying unhelpful patterns of thinking and behavior and learning ways to change them. DBT incorporates behavioral change strategies while placing greater emphasis on acceptance, mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
The two approaches are not necessarily mutually exclusive. Depending on a client's needs, different therapeutic approaches may be incorporated into an individualized addiction treatment plan.
Can DBT Skills Be Practiced Independently?
Some DBT skills, including mindfulness and basic distress-tolerance techniques, can be practiced outside of therapy. In fact, applying skills between treatment sessions is an important part of learning how to use them in everyday situations.
Self-guided practice is not a replacement for professional treatment when substance use or significant mental health concerns are present. Working with a qualified clinician allows DBT skills to be incorporated into a treatment plan based on your individual needs, symptoms, and recovery goals.
How DBT Fits Into Treatment at Redemption
DBT may be incorporated into a broader addiction treatment plan based on each client's clinical needs and recovery goals. Redemption offers structured outpatient treatment through different levels of care, allowing therapy and other clinical services to be coordinated within an individualized plan.
Learn more about our addiction treatment programs in Delaware and the levels of support available during recovery.
Who Can Benefit From DBT for Addiction?
DBT may be appropriate for people whose substance use is connected to intense emotions, impulsive behavior, difficulty tolerating distress, relationship conflict, or other recurring behavioral patterns.
It may also be incorporated into treatment for people experiencing substance use alongside mental health concerns such as anxiety, depression, trauma-related symptoms, or emotional dysregulation.
DBT is not automatically the right therapy for every person in addiction treatment. Redemption develops individualized treatment plans based on each client's symptoms, history, needs, and recovery goals.
Frequently Asked Questions About DBT
DBT for Addiction in Wilmington, Delaware
If emotional distress, impulsive behavior, relationship challenges, or difficulty coping with cravings are affecting your recovery, DBT may be one therapy worth exploring as part of your treatment plan.
Redemption Addiction Treatment Center provides individualized addiction treatment in Wilmington for clients throughout New Castle County and northern Delaware. Our team can help you understand your treatment options and determine which therapies may be appropriate for your needs.
Call (302) 303-8828 to speak with our admissions team.
Individual Therapy Sessions
- Dialectic Behavioral Therapy
- Cognitive Behavioral Therapy
- Trauma Informed Therapy
- Acceptance and Commitment Therapy
- Rational Emotive Behavioral Therapy
- Therapeutic Family Reintegration
- Motivational Interviewing
- Building Life Skills
Group Therapy
- Smaller and more intimate groups
- Trauma Informed Environment
- Anger and Stress Management
- Stages of Change and Barriers
- Self Help Education: 12 Step Modalities
- Relapse Prevention
- Interpersonal Skills and Family Relationships
- Coping with Trauma
- Co-Occurring Disorders
- Gratitude
- Expressive Art Therapy
- Neuroscience Psychoeducation
- Tobacco Education
- HIV/STD Education
Case Management
- Assist in aftercare planning
- Connections to safe, supportive, and reputable sober living homes
- Aid in providing medical leave or short-term disability paperwork to protect your employment (or Occupational Assistance)
- Provide referrals to outside medical providers
- Assist in applying for federal or state funded benefits
- Advocation regarding legal issues
- Assist in Utilizing and navigating Community Resources
