Dialectical Behavior
Therapy (DBT)
for Addiction in LA
DBT is a skills-based therapy that teaches individuals how to manage intense emotions, tolerate distress, and navigate relationships without turning to substances. At Reign Recovery, DBT skills training is integrated across all levels of care — giving individuals concrete, practical tools they can use every day in recovery.
UNDERSTANDING DBT
What Is Dialectical Behavior Therapy?
Dialectical Behavior Therapy (DBT) is a comprehensive, skills-based psychotherapy originally developed by Dr. Marsha Linehan at the University of Washington. It was created to treat individuals with intense emotional responses who had not responded adequately to standard cognitive behavioral therapy. DBT has since become one of the most extensively researched and widely used therapies in behavioral health.
In addiction treatment, DBT is especially effective for individuals who use substances to manage overwhelming emotions, escape distressing thoughts, or cope with the pain of difficult relationships. Rather than simply addressing the substance use, DBT builds the emotional skills that make sobriety sustainable.
THE CORE PHILOSOPHY
What Does "Dialectical" Mean?
The word "dialectical" refers to the synthesis of opposites — the ability to hold two seemingly contradictory truths at the same time. The central dialectic in DBT is one of the most powerful ideas in addiction recovery:
Acceptance
"I accept myself and my experience exactly as they are right now — without judgment."
Change
"I am also committed to changing my thoughts, emotions, and behaviors to build a better life."
This balance between radical acceptance and the drive for change is the philosophical foundation that makes DBT uniquely effective for individuals in recovery — especially those who have experienced shame, self-criticism, and the feeling that they are fundamentally broken. DBT says:
"You are doing the best you can — and you can also do better."
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THE FOUR DBT SKILL MODULES
The Four Core DBT Skills Modules
DBT is built around four distinct skill modules — each addressing a different dimension of emotional and behavioral functioning. Together, they form a comprehensive toolkit for managing the challenges of recovery and building a life worth living.
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Mindfulness is the foundation of all other DBT skills. It teaches the ability to observe and describe experiences without judgment — to be fully present in the current moment rather than caught in thoughts about the past or future.
Observing thoughts and feelings without acting on them
Describing experience with accuracy and without judgment
Participating fully in the present moment
Reducing reactivity to cravings and triggers
IN RECOVERY
"I notice I am feeling a strong craving right now. I can observe this feeling without acting on it. It will pass."
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Distress tolerance skills are crisis survival tools — strategies for getting through painful moments without making things worse. For many individuals in recovery, the inability to tolerate distress without substances is the core vulnerability to relapse.
TIPP skills: Temperature, Intense exercise, Paced breathing, Paired muscle relaxation
ACCEPTS: Activities, Contributing, Comparisons, Emotions, Pushing away, Thoughts, Sensations
Radical acceptance of reality as it is
Half-smiling and willing hands to reduce suffering
IN RECOVERY
"I cannot change what just happened. I can accept it and use my skills to get through this moment without using."
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Emotional regulation skills teach individuals to understand, name, and change the emotional responses that drive destructive behavior. This module directly addresses the emotional dysregulation that underlies so much of addiction — particularly in individuals with co-occurring mood disorders or trauma histories.
Identifying and naming emotions accurately
Understanding the function of emotions
Reducing vulnerability to emotional mind through PLEASE skills
Building positive experiences and accumulating mastery
Opposite action to change unwanted emotions
IN RECOVERY
"I am feeling shame. I can name it, understand where it came from, and act opposite to what shame tells me to do — hiding — by reaching out instead."
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Interpersonal effectiveness skills teach individuals how to navigate relationships skillfully — asking for what they need, setting limits with others, and maintaining self-respect — all while preserving important relationships. Relationship difficulties are a major trigger for relapse, making these skills critical in recovery.
DEAR MAN: Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate
GIVE skills for relationship maintenance
FAST skills for maintaining self-respect
Setting and communicating healthy limits
IN RECOVERY
"I can ask for what I need clearly and confidently without aggression or passive behavior — and I can say no when I need to protect my recovery."
CBT VS. DBT
How DBT Differs from CBT
CBT and DBT are related — DBT was developed as an evolution of CBT — but they differ in important ways. Both are used at Reign Recovery and are often delivered together for maximum effectiveness.
Cognitive Behavioral Therapy (CBT)
Focuses on identifying and restructuring cognitive distortions
Primarily structured around changing thought patterns
Strong emphasis on behavioral change and skills practice
Typically delivered in individual therapy format
Best for: distorted thinking, relapse prevention, anxiety
Dialectical Behavior Therapy (DBT)
Focuses on acceptance and change dialectic
Four structured skill modules: mindfulness, distress tolerance, emotional regulation, interpersonal effectiveness
Includes individual therapy and separate skills training group
Telephone coaching between sessions in full DBT model
Best for: emotional dysregulation, BPD, chronic relapse, trauma
DBT and CBT Together at Reign Recovery
Many individuals benefit most from both CBT and DBT delivered in combination — using CBT to restructure harmful thought patterns while using DBT to build the emotional regulation and distress tolerance skills that support sustained recovery. Our clinical team determines the right blend for each individual at intake and throughout treatment.
The Research Behind DBT
DBT is one of the most extensively studied psychotherapies in the world. Multiple randomized controlled trials have demonstrated its effectiveness for substance use disorders, borderline personality disorder, depression, PTSD, and eating disorders.
Research specifically on DBT for substance use disorders has shown significant reductions in drug use, higher treatment completion rates, and better outcomes at 12-month follow-up compared to standard care. The Substance Abuse and Mental Health Services Administration (SAMHSA) recognizes DBT as an evidence-based treatment for addiction.
WHO DBT HELPS
Who Benefits Most from DBT in Addiction Treatment?
DBT was specifically developed for individuals with intense emotional responses and behavioral dysregulation. In the context of addiction treatment, it is particularly effective for:
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Individuals who experience emotions more intensely than most and find them difficult to manage without external coping, including substances.
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Those with complex or developmental trauma who use substances to manage hypervigilance, dissociation, or chronic emotional pain.
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Individuals who have struggled to maintain sobriety despite motivation and effort — often because emotional dysregulation drives them back to use
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DBT was originally developed for BPD and remains the gold-standard treatment. BPD and substance use disorder frequently co-occur.
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Those who experience conflict, instability, or loss in relationships are the primary drivers of substance use and emotional crisis.
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DBT's emotional regulation and distress tolerance skills directly address the emotional states underlying depression and anxiety disorders.
FREQUENTLY ASKED QUESTIONS
DBT for Addiction in Los Angeles — Common Questions
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DBT stands for Dialectical Behavior Therapy. It was developed by Dr. Marsha Linehan and is an evidence-based treatment originally designed for borderline personality disorder. It has since been proven effective for substance use disorders, depression, PTSD, eating disorders, and any condition involving emotional dysregulation and impulsive behavior. In addiction treatment, DBT is particularly effective for individuals who use substances to manage intense or overwhelming emotions.
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The four core DBT skill modules are: (1) Mindfulness — developing present-moment awareness and non-judgmental observation; (2) Distress Tolerance — crisis survival skills for getting through painful moments without making things worse; (3) Emotional Regulation — understanding, naming, and changing unhelpful emotional responses; and (4) Interpersonal Effectiveness — navigating relationships, setting limits, and asking for needs while maintaining self-respect. All four modules are addressed at Reign Recovery through individual therapy and group skills training.
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Unlike traditional talk therapy, DBT is highly structured and skills-based. Rather than primarily focusing on exploring and processing past experiences, DBT teaches concrete, learnable skills that individuals practice between sessions and apply in real-world situations. DBT typically includes both individual therapy and a separate skills training group. The skills are taught didactically, practiced with homework assignments, and refined over time — making it more similar to learning a practical craft than conventional psychotherapy.
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Yes. DBT has research support for a broad range of substance use disorders including alcohol use disorder, opioid dependence, stimulant use, and polysubstance use. The skills taught in DBT — particularly distress tolerance and emotional regulation — address the core emotional vulnerabilities that drive substance use regardless of the specific substance. DBT is especially effective when emotional dysregulation is a central driver of use.
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Yes. DBT is covered under most major insurance plans when delivered as part of a clinically necessary addiction treatment program. At Reign Recovery, DBT skills training is integrated throughout our residential inpatient program, which is covered by Blue Cross Blue Shield, Aetna, Cigna, United Healthcare, Anthem, and other major plans. Our admissions team verifies your specific coverage confidentially and at no cost as the first step of the admissions process.
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Yes — and many individuals benefit from both. CBT focuses on identifying and restructuring the cognitive distortions and thought patterns that drive substance use. DBT builds the emotional regulation and distress tolerance skills that make those changes sustainable. The two approaches are highly complementary and are frequently delivered together at Reign Recovery, with the clinical team tailoring the combination to each individual's specific presentation and needs.
Build Skills for Lasting Recovery
Our admissions team is available 24/7
to provide confidential assessments.
Verify insurance coverage, and help determine the most appropriate level of care.
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Los Angeles, California
Our Los Angeles facility offers a peaceful and structured environment where individuals can focus on healing, growth, and long-term recovery.