Knowing that something needs to change and knowing how to respond differently in the moment are two very different things.
Dialectical Behavior Therapy, commonly called DBT, teaches practical skills that can help people slow down automatic reactions, tolerate difficult emotions without immediately trying to escape them, communicate more effectively, and make choices that support recovery.
At Brooks Healing Center, DBT principles and skills may be incorporated into individualized addiction treatment alongside other evidence-based and experiential approaches. The goal is not to eliminate difficult feelings. It is to help patients learn what to do when those feelings, cravings, conflicts, or stressful situations arise.
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Knowing that something needs to change and knowing how to respond differently in the moment are two very different things.
Dialectical Behavior Therapy, commonly called DBT, teaches practical skills that can help people slow down automatic reactions, tolerate difficult emotions without immediately trying to escape them, communicate more effectively, and make choices that support recovery.
At Brooks Healing Center, DBT principles and skills may be incorporated into individualized addiction treatment alongside other evidence-based and experiential approaches. The goal is not to eliminate difficult feelings. It is to help patients learn what to do when those feelings, cravings, conflicts, or stressful situations arise.
Call Admissions 24/7/365
| DBT Skill Area | What It Can Support |
|---|---|
| Mindfulness | Noticing thoughts, emotions, cravings, and physical reactions before acting |
| Distress Tolerance | Moving through difficult moments without making the situation worse |
| Emotion Regulation | Understanding intense emotions and choosing responses more intentionally |
| Interpersonal Effectiveness | Communicating needs, setting boundaries, and managing conflict |
| Used For | Substance use disorders and appropriate co-occurring mental-health symptoms |
| Part of Treatment | DBT skills may complement individual therapy, group work, recovery education, and other treatment approaches |
Recovery requires more than understanding why a pattern exists. Eventually, you have to practice a different response when the familiar trigger, emotion, relationship, or craving appears again.
At Brooks Healing Center, therapy is designed to help patients better understand themselves while developing practical tools they can carry into everyday life.
Call today to learn whether treatment at Brooks may be appropriate for you or someone you love.
Dialectical Behavior Therapy is a form of cognitive behavioral treatment originally developed by psychologist Marsha Linehan. DBT combines strategies focused on acceptance with strategies focused on change.
That balance is where the word “dialectical” comes from.
A person can accept that an emotion, thought, craving, or difficult situation is happening without accepting that they have to act on it. They can acknowledge where they are right now while also working toward something different.
DBT is especially well established in the treatment of borderline personality disorder and chronic emotional dysregulation. It has also been adapted for people with substance use disorders and other behavioral-health concerns.
For addiction treatment, that can mean learning to recognize:
DBT turns those ideas into skills that can be practiced until they become more available during real-life stress.
DBT organizes its primary skills into four areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Together, they help people become more aware of what is happening internally and respond more intentionally instead of reacting automatically.
Mindfulness involves learning to notice what is happening in the present moment without immediately judging, avoiding, or reacting to it.
In addiction recovery, this may mean learning to notice:
Mindfulness creates a small but important space between experiencing something and responding to it.
That pause can create an opportunity to make a different choice.
Some situations cannot be fixed immediately.
A craving may take time to pass. A relationship may remain complicated. Grief may still hurt. Someone may receive bad news, experience conflict, or have a difficult day without being able to make the source of that pain disappear.
Distress-tolerance skills are designed to help people survive difficult moments without making the situation worse.
In recovery, these skills can be particularly useful when a person experiences:
The goal is not to pretend that distress feels good. It is to develop ways to get through it without immediately reaching for alcohol, drugs, or another destructive behavior.
Emotions contain useful information, but intense emotions can sometimes drive impulsive behavior.
Emotion-regulation skills help people identify what they are feeling, understand what may be contributing to the emotion, reduce vulnerability to emotional extremes, and choose responses more intentionally.
This can help patients recognize patterns such as:
Stress → Anger → Impulsive Behavior → Substance Use
or:
Shame → Isolation → Craving → Substance Use
Instead of only addressing the final behavior, DBT helps patients become more aware of the earlier points in the pattern where another response may be possible.
Research examining DBT skills among people with frequent alcohol or substance use has found associations between skills such as mindfulness and emotion regulation and lower substance-use urges, although continued research is needed to better understand these relationships.
Recovery happens around other people.
Relationships can provide support, but they can also become sources of stress, resentment, conflict, pressure, or exposure to substances.
Interpersonal-effectiveness skills focus on communicating needs, setting boundaries, resolving conflict, saying no when necessary, and maintaining self-respect within relationships.
For someone in recovery, this may include learning how to:
These are not abstract communication exercises. They are skills patients may need immediately after treatment.
Substance use can become closely connected to emotional regulation.
A person may drink to quiet anxiety, use opioids to escape emotional pain, take stimulants to push through exhaustion, or repeatedly return to substances when anger, shame, loneliness, or conflict becomes overwhelming.
Over time, the substance itself creates additional problems while the original emotional difficulty may remain unresolved.
DBT helps create alternatives.
Instead of only telling someone not to use, therapy can help them practice what to do when the conditions that previously led to substance use return.
DBT skills may help patients work on:
DBT has been specifically adapted for substance use disorders, particularly for people with significant emotional dysregulation and co-occurring behavioral-health conditions. Research supports its potential usefulness, while the evidence is strongest in certain populations rather than establishing DBT as a universal stand-alone treatment for every substance use disorder.
One of the most important concepts in DBT is that acceptance and change can happen at the same time.
Acceptance does not mean approving of addiction, tolerating unsafe behavior, or deciding that nothing can improve.
It means acknowledging reality accurately enough to respond to it.
Someone might acknowledge:
“I cannot change what happened yesterday.”
And also decide:
“I can make a different decision today.”
A person might recognize:
“I am experiencing a strong craving.”
Without turning that into:
“I have no choice but to use.”
This combination of acceptance and change is central to DBT.
Cravings are not always caused by physical withdrawal.
They can also be connected to:
DBT gives patients a framework for noticing what is happening before the situation progresses automatically from trigger to substance use.
A patient may learn to identify the emotion, notice the urge, tolerate the immediate discomfort, evaluate available choices, and use a coping strategy before acting.
The objective is not to guarantee that someone will never experience another craving. Recovery skills are designed to help a person respond differently when cravings occur.
Substance use and mental-health symptoms frequently affect one another.
DBT was originally developed for people experiencing severe emotional dysregulation and chronic suicidal behavior and has particularly strong evidence for borderline personality disorder. Its applications have since expanded into other behavioral-health settings and populations.
At Brooks, DBT skills may be useful within an individualized treatment plan for patients experiencing addiction alongside concerns such as:
DBT does not replace appropriate psychiatric or emergency care. Brooks evaluates whether a person’s substance use, medical needs, and co-occurring mental-health symptoms can be safely treated within our addiction-treatment setting.
Dialectical Behavior Therapy developed from cognitive behavioral approaches, so DBT and Cognitive Behavioral Therapy share some important similarities.
Both can help people identify patterns and develop healthier responses.
However, their emphasis is somewhat different.
A simple way to think about the distinction is:
They are not competing approaches. Depending on the individual, Brooks may incorporate skills and strategies from both within the broader treatment plan.
| Cognitive Behavioral Therapy (CBT) | Dialectical Behavior Therapy (DBT) |
|---|---|
Cognitive Behavioral Therapy (CBT) often focuses on identifying how thoughts, feelings, and behaviors influence one another and learning to challenge or modify unhelpful patterns. | Dialectical Behavior Therapy (DBT) places additional emphasis on acceptance, mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. |
CBT: How can I identify and change this pattern? | DBT: How can I accept what is happening right now while still choosing a more effective response? |
At Brooks Healing Center, DBT principles and skills can be incorporated into individualized addiction treatment rather than treating every patient as though they need the same therapy in the same way.
Patients may work on DBT-related skills through individual therapy, group work, recovery education, and practical situations that occur throughout treatment.
For example, a patient may practice:
This is where therapy becomes practical.
The goal is not simply to understand DBT terminology. It is to use the skills when life becomes difficult.
DBT is one tool within a larger treatment approach.
Depending on individual needs, treatment at Brooks may also incorporate:
DBT skills may be introduced or reinforced throughout treatment when clinically appropriate.
During medical detox, the immediate priority is safe stabilization. Simple grounding, mindfulness, and distress-tolerance strategies may support the patient while withdrawal symptoms are medically managed.
Residential treatment provides more time and structure for patients to learn therapeutic skills, recognize behavioral patterns, practice emotional regulation, and apply new coping strategies within a supportive environment.
Brooks operates its clinical Partial Hospitalization Program at the Normandy campus.
PHP allows patients to continue intensive therapeutic work while beginning to take on more independence and practice recovery skills outside a 24-hour residential setting.
Eligible PHP participants may use Brooks PHP housing in Tullahoma outside clinical hours.
Brooks also provides sober living in Tullahoma for eligible individuals moving toward greater independence.
Sober living is not a clinical DBT program. However, the coping, communication, boundary-setting, mindfulness, and emotion-regulation skills developed during treatment can continue to be practiced as everyday responsibilities return.
Brooks Healing Center is located on a 36-acre campus along the Duck River in Normandy, Tennessee.
The setting gives patients space to step away from the immediate pressures of everyday life while participating in structured addiction treatment, therapy, recovery education, wellness activities, and community support.
But treatment is not meant to create a life that only works inside Brooks.
The work ultimately has to travel home.
DBT can help patients build skills they can continue using in relationships, employment, recovery meetings, stressful situations, and the ordinary challenges of everyday life.
The real test of therapy is not whether someone can describe a coping skill in a treatment session.
It is whether they can use that skill when:
DBT gives patients practical strategies for those moments.
Recovery does not require a life without stress, difficult emotions, or conflict. It requires developing healthier ways to move through those experiences without automatically returning to the behaviors that caused harm.
The therapies used should reflect the patient’s needs rather than requiring every person to participate in an identical clinical pathway.
Call Brooks Healing Center at 931-486-8824 to learn more about addiction treatment and the therapeutic approaches that may be incorporated into your individualized treatment plan.
DBT stands for Dialectical Behavior Therapy. It is a form of cognitive behavioral treatment that balances acceptance-based strategies with strategies designed to support meaningful behavior change.
The four primary DBT skill areas are mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Yes. DBT has been adapted for substance use disorders and may be particularly useful for people whose substance use is closely connected with emotional dysregulation, impulsivity, relationship difficulties, or difficulty tolerating distress.
The evidence is strongest in certain populations, including people with substance use disorders and co-occurring borderline personality disorder.
DBT does not make cravings disappear. It teaches skills that may help someone notice a craving, tolerate the immediate distress, regulate the emotions surrounding it, and choose a response other than substance use.
No, although the approaches are related.
CBT commonly focuses on identifying and changing unhelpful relationships between thoughts, feelings, and behaviors.
DBT builds on behavioral approaches while placing additional emphasis on acceptance, mindfulness, distress tolerance, emotion regulation, and interpersonal skills.
No.
DBT was originally developed for people experiencing chronic suicidal behavior and borderline personality disorder and has particularly strong evidence in that population. It has since been adapted and studied for other behavioral-health concerns, including substance use disorders.
Brooks incorporates DBT principles and practical DBT skills into individualized addiction treatment when clinically appropriate.
The exact combination of therapies depends on the patient’s substance use, mental-health symptoms, recovery needs, and treatment plan.
DBT emotion-regulation and interpersonal-effectiveness skills are designed to help people better understand intense emotions, communicate needs, set boundaries, manage conflict, and maintain self-respect within relationships.
DBT is one tool within a larger treatment approach. At Brooks, it may complement individual therapy, group therapy, recovery education, relapse-prevention planning, medication management, and other services based on the patient’s individualized treatment plan.
