Bliss Counselling | How Cognitive and Dialectical Behavior Therapy Works in Recovery
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How Cognitive and Dialectical Behavior Therapy Works in Recovery

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How Cognitive and Dialectical Behavior Therapy Works in Recovery

CBT (cognitive behavioral therapy) and DBT (dialectical behavior therapy) are similar forms of talk therapy, also known as psychotherapy. 

Both forms of therapy will help you to more effectively communicate, and both forms of therapy can help you discover more about the condition you’re using psychotherapy to address. 

Both cognitive behavioral therapy and dialectical behavior therapy are evidence-based, meaning a battery of hard data proves the effectiveness of both forms of talk therapy. 

These psychotherapies are proven effective for treating: 

  • Alcohol use disorder
  • GAD (generalized anxiety disorder) 
  • Insomnia 
  • Major depressive disorder 
  • Panic disorders 
  • Phobias 
  • PTSD (post-traumatic stress disorder) 
  • Substance use disorder 

NAMI shows that roughly 10% of adults in the US will develop a substance use disorder in any given year, with around 20% of American adults also experiencing some kind of mental health condition during that same year. Both substance use disorders and mental health disorders are commonplace, then, and they also frequently co-occur in a dual diagnosis. 

With both of these conditions so prevalent, drug and alcohol rehab centers use therapies like CBT and DBT in combination with medication-assisted treatment to deliver holistic treatment that’s proven effective for treating a range of conditions. 

CBT 101 

Cognitive behavioral therapy is a highly adaptable form of therapy applicable to many conditions from depression and anxiety to substance use disorder and alcohol use disorder. Once you master the basics, you’ll feel capable of more effectively controlling your emotions and your recovery. 

CBT sessions are delivered individually or in a group setting as appropriate. 

Whether one-to-one or as part of a group, you’ll work with a therapist to explore the close and interrelated nature of your thoughts, feelings, and behaviors. 

Cognitive behavioral therapy can help you view things more objectively, and you’ll also discover that you don’t need to allow how you think and feel to govern your behavior. 

CBT is a goal-oriented and skills-based form of therapy with a grounding on logic and reasoning. As you pursue a course of cognitive behavioral therapy, you’ll examine how your thoughts and feelings can influence your behaviors. This is especially valuable in the case of destructive or harmful behaviors.  

Beyond this, CBT will also help you to isolate the people, places, or things that trigger you to engage in self-defeating behaviors.   

Equipped with the ability to identify these triggers, you’ll then create healthier coping strategies for stressors. When triggered in a real-world situation outside the therapy session, you can implement these strategies rather than being guided by the automatic thoughts that can lead to poor behaviors if unchecked. This is perhaps the most powerful way in which CBT can minimize the chance of relapse in recovery.  

DBT 101 

Marsha Linehan created DBT (dialectical behavior therapy) to treat patients with BPD (borderline personality disorder) when working as a psychologist at University of Washington. 

DBT has been used since the 1980s to treat a variety of mental health conditions, including: 

  • Bipolar disorder 
  • Depression 
  • Dual diagnosis 
  • Self-harm 
  • Substance use disorder 
  • Suicidal ideation 
  • Trauma caused by sexual assault 

 When you engage with dialectical behavior therapy, you’ll learn to acknowledge discomfort or pain while still feeling “normal”. By equipping yourself with the skills to cope with life’s stressors, even in hostile environments, you’ll minimize your chances of engaging in negative or destructive behaviors. 

DBT sessions are delivered in a module-based format. 

You’ll empower yourself and your recovery by mastering the following techniques: 

  • Distress tolerance: DBT will teach you to better tolerate stressful situations and to more comfortably deal with volatile emotional issues without relapsing or experiencing symptoms of depression or anxiety 
  • Emotion regulation: Through DBT, you’ll gain a more thorough understanding of your emotions, and you’ll become more capable of resisting the impulsive and emotion-driven behavior you’re trying to eliminate 
  • Interpersonal effectiveness: Dialectical behavior therapy can help you to sharpen your communication skills, improving your interpersonal relationships at the same time 
  • Mindfulness: Instead of getting bogged down in the past or anxious about the future, DBT will help you to focus fully on the present with a mindfulness component to therapy applicable to many conditions 

How CBT and DBT Work for Recovery 

Your treatment provider will advise you whether CBT or DBT is most suitable for treating your condition. 

In the case of a personality disorder, for instance, DBT in combination with medication-assisted treatment is likely the most effective approach to treatment.  

Substance use disorder or alcohol use disorder, on the other hand, often respond best to treatment with cognitive behavioral therapy. 

The core focus of CBT is the interconnected nature of your thoughts, feelings, and behaviors. DBT acknowledges this interconnection, but focuses on mindfulness, acceptance, and emotion regulation. 

CBT is proven effective for treating: 

  • Anxiety disorder 
  • Depression 
  • Panic disorder 
  • PTSD (post-traumatic stress disorder) 
  • Sleep disorder 

DBT was created for the treatment of BPD, and is still commonly used in this area. There is also robust research on the effectiveness of DBT for treating: 

  • Anxiety disorder
  • BPD with substance use disorder 
  • Depressive disorder 
  • Eating disorders 
  • PTSD (post-traumatic stress disorder) 

CBT vs DBT for Treating Alcohol Use Disorder and Substance Use Disorder 

CBT and DBT can both be effectively used to treat alcohol use disorder and substance use disorder. 

A simple course of CBT will help you to pinpoint your triggers for substance use. You’ll also learn to implement coping strategies that don’t involve a chemical crutch. 

With DBT, you’ll dive deeper, examining the core issue. The mindfulness component of DBT can help many people with substance use disorder to better navigate the emotional imbalances confronting them. 

 DBT vs CBT for Treating Co-Occurring Disorder 

DBT is proven effective for treating a variety of mental health conditions, from anxiety and depression to PTSD (post-traumatic stress disorder) and ADHD (attention-deficit hyperactivity disorder). These mental health disorders often co-occur with alcohol use disorder and substance use disorder.  

When DBT is used to treat a dual diagnosis like this, you can address both issues simultaneously through this form of therapy. 

CBB is used even more often for the treatment of dual diagnosis, delivered in combination with medication-assisted treatment if appropriate. There is a strong empirical evidence base demonstrating the effectiveness of cognitive behavioral therapy for treating substance use disorders. 

CBT vs DBT for Treating Anxiety 

Data indicates that CBT is more effective than CBT for treating anxiety. It’s also more effective for treating depressive disorders, phobias. 

CBT has also been shown to alleviate the symptoms of anxiety associated with PTSD (post-traumatic stress disorder) and OCD (obsessive compulsive disorder) in this meta-analysis of studies. 

CBT vs DBT for Treating Bipolar 

Bipolar disorder typically requires integrated treatment combining psychopharmacology with adjunctive psychotherapy. 

 Both forms of psychotherapy are effective for treating bipolar disorder. 

With CBT interventions, you can manage unhelpful thought processes while establishing a relapse prevention strategy for episodes of mania and depression. 

With DBT interventions, you’ll learn to sharpen your focus, improve communication and social functioning, decrease negative, self-defeating behaviors, and more effectively cope with emotional pain. 

 Final Thoughts 

Both CBT and DBT can be effective for treating substance use disorder, alcohol use disorder and a broad spectrum of mental health conditions. 

CBT can help you to recognise the triggers for poor behaviors with the aim of avoiding them, while DBT will empower you with superior emotional regulation and enhanced mindfulness. 

 

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This is a guest post written by Joe Gilmore, a creator on behalf of Renaissance Recovery. Renaissance Recovery is a drug and alcohol rehab in Orange County dedicated to helping clients kick their substance abuse habit and establish long-lasting sobriety. You can view their website at the following link: https://www.renaissancerecovery.com/