Tag: DBT for substance use disorder

Following the initial evidence supporting DBT for suicide and non-suicidal self-injury (NSSI) in the early 1990s, Marsha Linehan and colleagues introduced modifications to target substance use disorders (SUD) as one of the greatest risk factors for fatal outcomes. DBT-SUD developed by adding new principles, strategies, protocols, and modalities to address common problems and complications of addiction, while maintaining all of those from the original model for NSSI. For example, individuals with BPD and SUDs tend to demonstrate “butterfly attachment,” characterized by limited treatment inclination, fleeting commitment, and minimal attachment to providers; whereas those with BPD without SUDS more often show an opposite attachment-seeking pattern. Therefore, a number of Attachment Strategies were added, such as assigning regular phone check-ins to build connection, orienting social networks to help reconnect with “lost” clients, and reinforcement of treatment participation. Some added DBT-SUD modalities include social networking meetings supporting attachment, urine toxicology screening, and pharmacotherapy to provide replacement medication for opioid addiction given its empirical support.

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