Choosing treatment

Dialectical Behavior Therapy (DBT): A complete guide

Published December 13, 2024 · 8 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals.

DBT was developed for borderline personality disorder and adapted for addiction. It teaches skills for managing intense emotions that drive substance use.

Four skill modules

Mindfulness: present-moment awareness and non-judgmental observation. Distress tolerance: surviving crises without making them worse. Emotional regulation: understanding and managing intense emotions. Interpersonal effectiveness: communicating needs and maintaining relationships.

Treatment structure

Weekly individual therapy. Weekly skills group. Phone coaching for crisis situations. Therapist consultation team. Homework and skills practice between sessions.

Who benefits most

People whose addiction is driven by emotional dysregulation. Co-occurring BPD. History of self-harm. Intense emotional reactions to triggers. People who have not responded to CBT alone.

Authoritative sources

This article references guidelines from: SAMHSA · NIDA · ASAM

Frequently asked questions

What is DBT?

A therapy teaching mindfulness, distress tolerance, emotional regulation, and interpersonal skills for managing intense emotions.

Is DBT evidence-based for addiction?

Yes. Particularly effective for addiction with co-occurring emotional dysregulation, BPD, or self-harm.

How long is DBT treatment?

Standard DBT is 6-12 months. Modified versions in residential treatment may be shorter.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.