DBT for Substance Use: Radical Acceptance, Grief, and Recovery-Interfering Behaviors

Kirby-Reutter

United States Department of Homeland Security

Key Points

  1. It’s helpful to conceptualize addiction as an unhealthy relationship in the same way it’s possible to develop an unhealthy dependence on a real person. Since giving up an addiction is like losing a relationship or even a best friend, grief counseling is sometimes necessary to help clients work towards a state of radical acceptance.
    DBT is also highly compatible with other forms of recovery, including motivational interviewing and the 12 steps.
  2. Learning to manage recovery-interfering behaviors is the DBT version of relapse prevention, which is a critical aspect of substance abuse treatment. The following DBT interventions assist with relapse prevention: diary cards, between-session support, and chain analyses, which help clients identify the vulnerabilities, triggers, urges, and behaviors that lead to relapse.
  3. DBT has 3 mindsets related to recovery: addict mind, clean mind, and clear mind.
    Addict mind is actively engaged in the addictive behavior and isn’t concerned with recovery, abstinence, or sobriety.
    Clean mind recognizes the need for physical sobriety but erroneously assumes that maintaining sobriety will be an effortless process. Therefore, clean mind fails to acknowledge and prepare for triggers that result in relapse.
    Clear mind is the synthesis of the other 2 minds. Clear mind recognizes the need for maintaining sobriety while simultaneously recognizing the ongoing addictive tendencies, urges, and triggers that could potentially result in relapse.

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DBT for Substance Use: Radical Acceptance, Grief, and Recovery-Interfering Behaviors

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