The Four Stages of Dialectical Behavioral Therapy for Addiction Recovery

Last Updated: Sep 20th 2019

Reviewed by Brittany Polansky

Dr. Marsha Linehan was an adjunct professor of psychology and psychiatry at the University of Washington, Seattle campus when she first developed dialectical behavioral therapy.  Linehan received a lifetime achievement award for literally writing the book on dialectical behavioral therapy. In the book Linehan lays out the dialectical behavioral therapy that she developed. She designed it specifically to support her patients and others like them change the they way in which they comport themselves in difficult situations. Not only does Dr Linehan work as a professor of psychology and psychiatry but she also runs a private practice and continues to research new and innovative ways to treat and offer hope to those who suffer from mental health disorders and drug or alcohol addiction.

 

Dialectical behavior therapy, or DBT, is in the same family as cognitive behavioral therapy. Like cognitive behavioral therapy treatment, DBT focuses in on a person’s individual behaviors through individual therapy sessions with a qualified therapist as a means of making changes to behavioral habits, but they also can use group therapy sessions for skills training exercises and lessons. Linehan originally designed DBT for treating her borderline personality disorder patients. Borderline personality disorder is one of the serious mental illnesses that can sometimes have side effects of a patient experiencing intense and chronic suicidal ideation. Because DBT helps to offer people suffering with mild to severe mental health hope, it has become one of the most utilized psychological treatments and standard in plans of care at many South Florida rehab centers especially as they treat those who suffer from  chronic suicidal ideation, borderline personality disorder, and other dual diagnosis. Dialectical behavior therapy has offered hope to people in so many ways some of the dual diagnosis that may find this type of therapy useful are:

  • Those with dual diagnosis substance abuse
  • Depression
  • Generalized Anxiety Disorder
  • Post Traumatic Stress Disorder, or PTSD
  • Eating Disorders
  • And Others

 

The Four Stages of Dialectical Behavior Therapy

  • 1st Stage of DBT: In the first stages of therapy a patient spends time addressing the chaos that is within them, the chaos that brought them to the therapy they are about to begin. It is likely that at this stage their behavior is chaotic and so is their emotional state. It is likely that when it all comes down to hit the patient feels out of control.  
  • 2nd Stage of DBT: The 2nd stage of dialectical behavioral therapy sees the person who is struggling from an addiction to drugs or alcohol still struggling with the addiction and the chaos but they are starting to feel more capable of controlling their reactions to situations that trigger them. This doesn’t mean that they are free from feeling the trigger, they still experience the struggle, but they are able to choose a more constructive reaction with the help of DBT. In this second stage of the therapy the idea is to bring the patient out of any silent pain they may have, trauma or neglect they are still dealing with, shoved down pain or emotion.
  • 3rd Stage of DBT:  Now that the person who first approached dialectical behavioral therapy, someone addicted to drugs and alcohol, who has made it through a residential detox treatment plan, is no longer suffocating under the same weight of chaos and fear that they were. The first two steps have offered them new ways of behaving. They have started to live free of that dangerous frenetic chaos of the heart and the mind of  and have instead started to change those destructive habits. They are building new habits and new rituals – new grooves in their brain to help them have a standard practice of having control over their habits and behaviors. This sort of control is what will allow them to safely pick up those stuffed away emotions, or to begin to truly understand the weight of childhood trauma, neglect, or whatever kind of pain they are holding close.
  • 4th Stage of DBT: Many people choose to engage with the fourth stage of dialectical behavioral therapy because for them a spiritual component to healing feels not only helpful, or valuable but absolutely necessary. The idea of a higher power is absolutely a motivating factor for many people. There are also many who decide that the fourth stage of DBT is not for them and they are not seeking out that spiritual connection within DBT. Dr. Marsha Linehan designed the fourth stage of DBT to play that role of spiritual connect, to help patients set a goal of spiritual fulfillment within the plan of their healing

 

It doesn’t matter if you are suffering from an addiction to alcohol, meth, or oxycodone, treatment at almost any drug rehab facility in Florida will offer some time of behavioral therapy. Dialectic behavioral therapy is just one of many different types of therapies, all designed to help a patient become more self aware of their emotions and reactions and to alter their behavior and self perception. 

Contact us today for help ending your addiction.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky

Brittany PolanskyBrittany has been working in behavioral health since 2012 and is a Primary Clinician at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.