Dialectical Behavior Therapy is a form of therapy, originally developed by Marsha Lineham, for the treatment of borderline personality disorder. Borderline personality disorder is a mental illness, classified in the DSM-V TR as a set of persistent character traits including emotional dysregulation, self-harming behaviors, brief intense interpersonal relationships, suicidal ideation, and a serious preoccupation with the fear of abandonment.
The first goal of DBT is to treat suicidal and self-harm behaviors, as these are the greatest risks in treatment. The second goal is to manage those behaviors that interfere with treatment, such as emotional outbursts directed towards the therapist, and resistance to treatment suggestions. Finally, DBT therapists work to help clients reign in the symptoms that are causing distress and disruption in their lives.
DBT began strictly for the treatment of borderline personality disorder, but recently has been investigated as a treatment for substance disorders like alcoholism. Borderline personality disorder is not uncommon amongst alcoholics, nor are many of the related traits like self-harm, depression, and suicidality.
DBT is based on the premise that invalidating environments and genetics work together to develop these traits in individuals. Because of these factors, these individuals are more readily brought to a state of physiological arousal, a state which takes them longer than others to resolve. DBT attempts to give clients the skills they need to handle the stresses and strains of life.
Alcoholics, even those who are not borderline, also tend to be more emotionally erratic, using alcohol to cope. When you take the alcohol (their sole coping mechanism) away, they need to be taught how to handle fears, stress, anger, and other emotions they have learned to avoid.
To guide the client through the process of relearning how to cope, the therapist will even communicate over the phone with the client, in-between sessions. And, rather than take the client out of stressful situations, the therapist will talk the client through them, increasing confidence in their new abilities. This form of therapy, thus far, seems to be promising in addressing the challenges alcoholics face, when entering a life of sobriety.