DBT for Substance Use Disorders

Are you tired of the cycle of using, quitting, and relapsing?

You're not broken—you're stuck in a pattern that needs different tools

Maybe you've tried to quit before. Maybe you've been through treatment, promised yourself this time would be different, made it days or weeks or even months—and then found yourself using again. The shame crashes over you. The disappointment from people you love feels unbearable. And the voice in your head says you'll never be able to stop, that you're weak, that you're a failure.

But here's what that voice doesn't tell you: willpower alone isn't enough when you're dealing with a substance use disorder. You're not failing because you're weak. You're struggling because you haven't learned the specific skills you need to manage the emotions, situations, and urges that drive your use.

Are you using substances to cope with overwhelming emotions?

You might not have started using to escape—maybe it was social, recreational, or something that just helped you relax. But somewhere along the way, substances became your go-to solution when life felt like too much. When anxiety spikes, when depression settles in like fog, when anger feels like it might consume you, when loneliness aches—using is what makes it stop, at least temporarily.

The problem is that substances work too well in the moment. They numb the pain, quiet the noise, slow down racing thoughts, or give you energy when depression has drained you. Your brain learns: this is how I cope. This is how I survive overwhelming feelings.

But the relief never lasts. The problems are still there when you come down. Often they're worse—more shame, more consequences, more reasons to use again. You're caught in a cycle where substances are both the problem and the solution, and you don't know how to feel your feelings without them.

Do you feel like substances control your life?

It started as a choice, but now it doesn't feel like one anymore. You think about using constantly—when you'll use next, how you'll get what you need, whether you have enough. You've tried to cut back or quit, but the cravings are relentless. The urges feel physical, undeniable, impossible to resist.

Maybe you've lost things that mattered—relationships, jobs, opportunities, trust. Maybe you're watching your life get smaller as substances take up more space. You cancel plans, isolate yourself, spend money you don't have, take risks you never thought you would. You barely recognize yourself anymore.

You want to stop, but you don't know how to live without using. The thought of facing life—with all its pain, boredom, stress, and discomfort—without substances feels impossible. You're exhausted from the cycle but terrified of breaking it.

Are you dealing with self-destructive behaviors beyond substance use?

For many people, substance use isn't the only challenge. Maybe you also struggle with self-harm, eating disorders, risky sexual behavior, or suicidal thoughts. Maybe when you can't use substances, you turn to other harmful behaviors to cope.

These behaviors all serve a similar purpose: they're attempts to manage unbearable emotions with the only tools you have. But they keep you trapped in cycles of shame, secrecy, and escalating consequences. You need more than abstinence—you need an entirely different way of coping with what you feel.

How DBT-SUD helps you break the cycle

DBT for substance use disorders is an evidence-based treatment that addresses both your substance use and the underlying emotional struggles that drive it. Unlike traditional addiction treatment that focuses solely on stopping use, DBT-SUD teaches you how to build a life worth living—one where you don't need substances to cope because you have better tools.

When you're ready to get started, we work with you through multiple levels of support: individual therapy where you receive one-on-one coaching, skills training groups where you learn concrete techniques with others who understand, and phone coaching between sessions when you need real-time support during cravings or crises. This comprehensive approach gives you support exactly when you need it most.

How DBT-SUD works

We start by keeping you safe and working toward abstinence. In individual therapy, you and your therapist will identify what cues your use, what urges feel like, what happens right before you decide to use. You'll learn to track these patterns and interrupt them before they lead to use. We use diary cards to monitor your urges, substance use, and the skills you're practicing, so you can see your progress clearly.

Next, we teach you skills that replace substance use. In weekly skills groups, you'll learn four sets of life-changing skills: Mindfulness helps you stay present instead of escaping into substances. Distress Tolerance gives you ways to survive cravings and crises without using. Emotion Regulation teaches you to understand and manage feelings without numbing them. Interpersonal Effectiveness helps you communicate needs, say no, and build relationships that support your recovery instead of undermining it.

We also add specific skills for substance use. DBT-SUD includes modules specifically designed for addiction:

• Clear Mind practice helps you recognize and respond to early warning signs before relapse happens.

• Dialectical Abstinence means you commit to complete abstinence while also having a plan for what happens if you slip—because we know recovery isn't always linear.

• Community Reinforcement helps you build a life filled with natural rewards that compete with the artificial rewards of substances.

We help you build a life worth living. This is the ultimate goal—not just stopping substances, but creating a life that's so meaningful, connected, and satisfying that using becomes less appealing than living. We work with you to identify your values, set goals, and take actions that move you toward the life you actually want. Recovery isn't just about what you stop doing—it's about what you start doing instead.

Why choose DBT-SUD at our clinic?

We specialize in treating substance use with emotion regulation difficulties. Our therapists are trained specifically in DBT-SUD, which means we understand that your substance use is intertwined with how you manage emotions, relationships, and stress. We don't just treat the addiction—we treat the whole picture. Many of our clients come to us after traditional addiction treatment didn't work, and DBT-SUD gives them the missing piece: skills to manage the emotions that drove their use in the first place.

Our therapists understand the complexity of recovery. We know that recovery isn't a straight line. We know that shame and perfectionism are barriers to healing. We know that "just say no" doesn't work when you're in emotional crisis. Our team has extensive training in treating co-occurring disorders, trauma, and the kinds of emotional intensity that make recovery feel impossible. We meet you with compassion, not judgment, every step of the way.

We use evidence-based treatment that gets results. DBT-SUD has strong research support showing it reduces substance use, increases treatment retention, and improves quality of life. Studies show that people who complete DBT-SUD have lower relapse rates and better long-term outcomes than traditional addiction treatment alone. We're committed to using approaches that actually work, and we track your progress so you can see the changes happening.

Frequently Asked Questions

How long will treatment take?

Standard DBT-SUD involves a commitment of at least six months to a year. This includes weekly individual therapy, weekly skills group, and access to phone coaching. We know this sounds like a long time, but substance use disorders develop over months or years—changing these patterns takes time and consistent practice. Many clients continue with some level of DBT support even longer as they build their recovery. The good news is that most people start seeing meaningful changes within the first few months.

What if I'm not ready to quit completely?

We practice Dialectical Abstinence, which means we hold two truths at once: we believe complete abstinence is the goal AND we know that slips can happen in recovery. We ask you to commit to not using, while also creating a plan for what happens if you do use. We don't kick you out of treatment for relapsing—instead, we help you learn from it and get back on track.

Can I do DBT-SUD if I also struggle with mental health issues like depression, anxiety, or trauma?

Absolutely. In fact, that's exactly what DBT-SUD is designed for. Most people with substance use disorders also have co-occurring mental health conditions—the research shows about 50-75% do. DBT-SUD treats both simultaneously. We don't make you get stable from substances before we address your depression or trauma. We work on everything together, because they're all connected. Many clients tell us this integrated approach is what finally helped them succeed when other treatments hadn't.

What if I've tried treatment before and it didn't work?

Many of our clients have been through traditional addiction treatment—sometimes multiple times—before finding DBT-SUD. What makes this different is that we address why you use, not just the use itself. If previous treatment focused only on stopping substances without teaching you how to manage the intense emotions that drove your use, you were set up to struggle. DBT-SUD gives you the emotional regulation skills that other treatments often miss. It's not that you failed before—it's that you didn't have the right tools yet.