The Thin Edge of the Wedge. Acceptance, Change, and Behavior Therapy in the Treatment of Addiction. Dialectical Behavior Therapy. Originally developed to treat suicidal behaviors in patients who meet criteria for Borderline Personality Disorder.
Acceptance, Change, and
Behavior Therapy in the Treatment of Addiction
Originally developed to treat suicidal behaviors in patients who meet criteria for Borderline Personality Disorder.
Efficacy demonstrated in other difficult-to-treat populations: dual diagnosis, eating disorders, geriatric depression.
Marsha M. Linehan, Ph.D.
University of Seattle, Washington
Guilford Press, New York, NY, 1993
Standard behavior therapy techniques to induce change
Acceptance strategies to promote the therapeutic alliance and keep patients in treatment
Skills Acquisition: teaching new behaviors
Validating and Reinforcing existing adaptive behaviors
Patients born with greater emotional
Patients grow up in families that fail to
validate private experience.
Drug intoxication changes brain neurochemistry acutely.
Prolonged drug use causes prolonged changes
in brain function.
Developmental effects of growing up in
substance abusing family.
Prolonged drug use causes long-term changes
in social and emotional functioning.
Physiological and neurochemical dysfunction
Emotional, cognitive, behavioral dysregulation
Interpersonal and occupational dysfunctional
36% of DBT group dropped out.
0% of CVT + 12-Step group dropped out.
Acknowledging what is sane, true and valid about a patient’s point of view. Validation must be authentic and genuine. Validation is not synonymous with approval, agreement, or sympathy.
Techniques for focusing the mind are taught and reinforced throughout DBT therapy. Mindfulness is not meditation, nor is it promoted as a path for spiritual growth. It serves as a foundation for many other skills including urge surfing, emotion regulation, observing and describing reality, radical acceptance, and non-judgmental thinking.
Refusing to do what is needed in the moment.
Refusal to tolerate what is happening in the moment. Sitting on your hands. Giving up. Fixing.
Ineffective. Stubborn. Rigid.