Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy in Murfreesboro, Tennessee

Dialectical Behavioral Therapy, commonly called DBT, is a skills-focused form of psychotherapy that helps people manage intense emotions, tolerate distress, improve relationships, and reduce impulsive or self-defeating behaviors that can interfere with recovery.

At Tulip Hill Recovery, DBT may be incorporated into addiction and dual diagnosis treatment for adults whose substance use is connected to emotional instability, trauma, conflict, cravings, impulsivity, or difficulty coping with stressful situations.

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How Dialectical Behavioral Therapy Works

DBT is built on the idea that two seemingly opposite things can both be true at the same time. A person can accept themselves as they are while also working toward meaningful change. This approach can be especially helpful when shame, self-criticism, or emotional extremes make recovery feel unstable.

This balance between acceptance and change is the foundation of dialectical thinking. It helps clients reduce all-or-nothing reactions, understand emotional patterns, and make decisions that better align with their recovery goals.

DBT places strong emphasis on emotional regulation, acceptance, crisis survival, mindfulness, and relationship skills. These areas can be particularly relevant when substance use is tied to interpersonal conflict, rejection, loneliness, anger, fear, or other intense emotional states.

DBT Skills Used in Addiction Recovery

Mindfulness

Mindfulness teaches clients to remain present without judgment. This can reduce emotional reactivity, slow impulsive decisions, and improve awareness of thoughts, feelings, body sensations, and cravings.

Distress Tolerance

Distress-tolerance skills help clients move through emotional crises without turning to substances or other destructive behaviors. Techniques may include grounding, paced breathing, self-soothing, and radical acceptance.

Emotion Regulation

Clients learn to identify emotional patterns, understand what intensifies them, and practice healthier responses to anger, anxiety, sadness, shame, frustration, and other difficult emotions.

Interpersonal Effectiveness

These skills help clients ask for what they need, set boundaries, manage conflict, maintain self-respect, and build healthier relationships without relying on avoidance, aggression, or people-pleasing.

DBT for Addiction and Co-Occurring Mental Health Conditions

Woman practicing mindfulness and emotional regulation skills used in dialectical behavioral therapy

DBT can be an important part of dual diagnosis treatment for people experiencing addiction alongside depression, anxiety, PTSD, borderline personality disorder, trauma-related symptoms, or mood instability.

These conditions can affect emotional intensity, impulse control, relationships, and the ability to cope without substances. DBT gives clients concrete strategies for responding to those experiences without immediately turning to alcohol, drugs, or other harmful behaviors.

Practical skills for real situations: DBT helps clients create more space between an emotion, urge, or trigger and the decision that follows.

How DBT Differs From Cognitive Behavioral Therapy

DBT and CBT are both evidence-based therapies, and they often work well together. However, they emphasize different areas of change.

CBT Focus

Cognitive Behavioral Therapy primarily helps clients identify and change distorted or unhelpful thought patterns that influence emotions and behavior.

DBT Focus

Dialectical Behavioral Therapy places greater emphasis on acceptance, emotional regulation, distress tolerance, mindfulness, and relationship skills.

Learn about Cognitive Behavioral Therapy

What a DBT Session Looks Like

Skills Training Groups

Clients learn and practice mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness in a structured setting.

Individual Therapy Sessions

One-on-one sessions help clients apply DBT skills to personal triggers, relationships, cravings, trauma, and recovery goals.

Behavioral Review

The therapist and client may examine a recent crisis, relapse urge, or conflict to identify triggers, emotions, actions, consequences, and possible alternatives.

Homework and Skill Practice

Clients may use worksheets, diaries, mindfulness exercises, or real-world practice between sessions to strengthen new skills.

How DBT Treatment Progresses

DBT skills are introduced and reinforced according to each client’s treatment needs, level of care, and recovery goals.

Assessment

The clinical team reviews substance use, emotional symptoms, trauma history, relationships, safety concerns, and current coping patterns.

Stabilization

Early work may focus on managing crises, reducing impulsive behavior, tolerating distress, and developing enough stability for deeper therapeutic work.

Skills Development

Clients practice mindfulness, emotional regulation, distress tolerance, interpersonal effectiveness, and relapse-prevention strategies in treatment and daily life.

Continuing Care

Clients strengthen the skills that are most useful for their triggers, relationships, recovery routines, and long-term emotional stability.

Therapies That Complement DBT

Diverse recovery group practicing connection, support, and interpersonal effectiveness skills

DBT is often combined with other evidence-based and holistic therapies to support mental, emotional, physical, and relational healing.

EMDR Therapy

EMDR may help reduce the emotional intensity of traumatic memories that contribute to substance use or emotional instability.

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Cognitive Behavioral Therapy

CBT helps clients challenge distorted thinking, while DBT strengthens acceptance, emotional regulation, and crisis-management skills.

Learn about CBT

Holistic Therapies

Mindfulness, yoga, breathwork, meditation, and movement can reinforce DBT skills by helping clients feel more grounded.

Learn about holistic therapy

Family and Group Therapy

Family and group counseling can help clients practice communication, boundaries, emotional regulation, accountability, and healthier relationship skills.

DBT Skills for Relationships and Recovery Support

Interpersonal stress can become a major relapse trigger. DBT helps clients practice clearer communication, healthier boundaries, self-respect, and more balanced responses to conflict, rejection, and relationship uncertainty.

These skills can also strengthen participation in family therapy, group therapy, peer support, and other parts of the recovery process where communication and emotional regulation matter.

DBT Across Addiction Treatment Programs

DBT skills can be integrated throughout the treatment continuum based on each client’s clinical needs and recovery goals.

Detox and Early Stabilization

DBT-informed support can help clients tolerate discomfort, manage uncertainty, and respond to cravings without acting impulsively.

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Partial Hospitalization Program

PHP provides frequent opportunities to learn and practice DBT skills through individual therapy, group sessions, and structured clinical programming.

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Intensive Outpatient Program

IOP helps clients apply DBT tools while navigating work, school, relationships, triggers, and daily responsibilities.

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Aftercare and Long-Term Recovery

DBT skills continue supporting emotional resilience, relapse prevention, communication, and healthy decision-making after treatment.

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Clinical Oversight and Review

Treatment recommendations are guided by comprehensive clinical assessment, individualized care planning, and evidence-based addiction and mental health treatment practices.

Medically ReviewedDr. Vahid Osman, M.D.Board-Certified Psychiatrist and AddictionologistLast Reviewed: August 18, 2026

Clinically ReviewedJosh Sprung, L.C.S.W.Board Certified Clinical Social WorkerLast Reviewed: August 18, 2026

Frequently Asked Questions About DBT

What is the difference between DBT and CBT?

CBT focuses primarily on identifying and changing unhelpful thoughts and behaviors. DBT includes those principles but adds a stronger emphasis on acceptance, mindfulness, emotional regulation, distress tolerance, and relationship skills.

Is DBT effective for addiction?

DBT can be helpful for people whose substance use is connected to intense emotions, impulsivity, trauma, conflict, or difficulty tolerating distress.

Can DBT help with mental health and substance use at the same time?

Yes. DBT may be used in dual diagnosis treatment to address emotional instability, impulsivity, trauma-related symptoms, and substance use together.

Is DBT offered individually or in groups?

DBT may be provided through individual therapy, skills-training groups, or a combination of both, depending on the treatment program and clinical needs.

Does DBT help with relapse prevention?

Yes. Distress tolerance, mindfulness, and emotion-regulation skills can help clients respond to cravings and emotional triggers without returning to substance use.

Does insurance cover DBT?

Coverage depends on your insurance plan, medical necessity, level of care, network status, and authorization requirements.

Start Dialectical Behavioral Therapy at Tulip Hill Recovery

If intense emotions, impulsive behavior, trauma, or relationship difficulties are affecting your recovery, DBT can provide practical tools for creating greater stability.

Our licensed clinicians develop personalized treatment plans that address addiction, mental health concerns, emotional regulation, and long-term recovery goals.

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