In recent years, addiction specialists have implemented different forms of psychotherapies to treat substance abuse disorders and various addictions. They help patients struggling with addiction address the underlying psychological, emotional, and environmental factors contributing to their substance abuse.
While there are tens of effective, evidence-based psychotherapies (EBP) out there, today’s post will focus on comparing only three of them in detail: DBT vs CBT vs ACT. Read on to understand their key differences in addiction treatment.
Table of Contents
Understanding DBT (Dialectical Behavior Therapy)
DBT stands for Dialectical Behavior Therapy. It’s a comprehensive and structured approach to therapy that helps individuals develop practical skills for managing their emotions and leading a more fulfilling life.
The ‘dialectical’ part of DBT refers to the idea of balancing opposites. In DBT, your therapist works with you to find a balance between acceptance and change. You learn to acknowledge that you need to accept yourself and situations as they are, while also working towards improving yourself.
As for the ‘behavior’ part of DBT, that’s because this form of psychotherapy focuses on behaviors and actions rather than thoughts or feelings. DBT teaches you to develop skills that work on harmful behaviors. You’re able to cope with distressing situations more effectively as well.
Interestingly, DBT is a form of CBT (cognitive behavioral therapy) as it incorporates techniques from the latter. However, DBT places a greater emphasis on how patients interact with their environment and other people.
How Does DBT Work?
DBT is an evidence-based psychotherapy approach that helps patients accept their thoughts, feelings, and behaviors without judgment. Therapists work to validate each patient’s experience and challenges while simultaneously supporting them in making positive changes.
As such, DBT focuses more on the emotional and social aspects of the patient’s life. By doing so, it helps them better understand and accept difficult emotions—rather than suppressing or avoiding dealing with them.
DBT then has the potential to induce what is known as neuroplasticity. In other words, it can physically change the brain through therapeutic learning. This therapy remaps connections between neurons, helping patients develop new ways of thinking, feeling, and behaving.
What Are the Stages of DBT?
The process of DBT involves several stages. In the initial stages, therapists assess the individual’s treatment needs and collaborate with them to develop a personalized treatment plan. This stage builds a solid foundation for the rest of the therapy process.
- Stage 1: Behavioral Dysregulation
Stage 1 includes teaching individuals skills. It manages intense emotions, impulsive behaviors, and interpersonal conflicts. Through this stage, the emphasis is on developing mindfulness, distress tolerance, and emotion regulation skills. Patients enhance their emotional stability and reduce harmful behaviors as well.
- Stage 2: Addressing Underlying Issues and Trauma
In Stage 2, individuals continue to build upon the skills learned in Stage 1 while also addressing the underlying issues and past traumas that contribute to ongoing distress. Therapists work to deepen the individual’s understanding of their emotions and behaviors. They also help the patient identify patterns of thinking and develop coping strategies for challenging situations.
- Stage 3: Addressing Ordinary Problems in Living
Stage 3 focuses on applying the skills learned in therapy so far to everyday life situations. Patients are expected to work on managing their responsibilities, maintaining healthy relationships, and finding balance in their daily routines. In this stage, individuals integrate skills into daily functioning.
- Stage 4: Achieving Self-Actualization
During the final stage, individuals need to build a life worth living by pursuing meaningful goals, values, and aspirations. Therapists focus on autonomy, independence, and self-empowerment, with individuals continuing to apply DBT skills as needed to navigate life’s challenges.
Who Is DBT For?
Originally, DBT was developed to help people with borderline personality disorder (BPD). It’s since proved to be effective in treating various mental health issues, including:
- Addiction and substance abuse disorder
- Mood and eating disorders
- Anxiety
- Depression
Understanding CBT (Cognitive Behavioral Therapy)
Cognitive Behavioral Therapy (CBT) is a widely used form of psychotherapy that focuses on the connection between thoughts, feelings, and behaviors. CBT emphasizes the role of thoughts (cognitions) in influencing the patient’s emotions and behaviors. The therapy suggests that our thoughts can significantly impact how we feel and behave in different situations.
In addition to the ‘cognitive’ part, CBT incorporates behavioral techniques to bring about change. This includes identifying and modifying behaviors that contribute to distress or interfere with achieving your personal goals.
CBT is typically conducted collaboratively between the therapist and the individual seeking treatment as well. They work together to set specific, measurable goals for therapy. They then work towards achieving them through structured interventions.
How Does CBT Work?
CBT works by identifying cognitive distortions or irrational thinking patterns that contribute to negative emotions and behaviors. When patients become aware of these distortions, they develop more balanced and realistic ways of thinking.
Additionally, CBT teaches practical skills and techniques that these patients can use to cope with challenges more effectively. Some examples may include:
- Relaxation techniques
- Problem-solving skills
- Assertiveness training
- Communications skills
Finally, while CBT may explore past experiences and their influence on present behaviors, it focuses mainly on current problems. CBT helps patients find solutions in the present moment.
Who Is CBT For?
CBT has been extensively researched and demonstrated to be effective for a variety of mental health problems, including substance abuse disorders.
Most commonly, CBT is used to treat anxiety and depression. Psychotherapy treats anger problems, panic attacks, bipolar disorder, and substance abuse, among other issues – and those can include:
- Obsessive-Compulsive Disorder (OCD)
- Hoarding
- Eating disorders
- Post-Traumatic Stress Disorder (PTSD)
- Sleep disorders
- Phobias
- Marital issues
What Are the Common Methods of CBT?
In addiction therapy, CBT employs various methods to address the underlying thoughts, emotions, and behaviors associated with addictive patterns. Below are just some examples of the most commonly used CBT methods.
1. Cognitive Restructuring
With cognitive restructuring, individuals work with therapists to identify and challenge negative thought patterns contributing to their addiction. By reframing these thoughts and beliefs, individuals can develop healthier coping mechanisms and reduce the likelihood of relapse.
2. Exposure Therapy
Exposure therapy addresses cravings and triggers associated with substance use. Through gradual and controlled exposure to stimuli that evoke cravings, individuals learn to tolerate discomfort. They develop alternative responses to cravings instead.
3. Journaling
CBT for addiction often requires patients to record their thoughts. It involves documenting automatic negative thoughts related to substance use and challenging them with evidence-based reasoning. Patients become more aware of their triggers and develop strategies to cope with cravings.
Understanding ACT (Acceptance and Commitment Therapy)
Acceptance and Commitment Therapy (ACT) is a lesser-known form of CBT, however, that doesn’t make it any less effective as a therapy. This type of psychotherapy focuses on helping individuals accept what’s beyond their control and commit to actions that align with their values.
And so, the word ‘acceptance’ in the acronym stands for the patient’s ability to accept difficult thoughts, emotions, and sensations rather than controlling them. They learn to make room for these emotions instead of struggling against their unpleasant experiences.
Additionally, mindfulness techniques are central to ACT. Patients learn to cultivate present-moment awareness and non-judgemental observation of their experiences. Practices such as meditation and mindful breathing enhance the patient’s psychological flexibility and resilience in stressful, day-to-day challenges.
How Does ACT Work?
ACT depends on the Hexaflex model, which is made up of six core processes:
- Acceptance: The willingness to experience unwanted thoughts and feelings.
- Cognitive Defusion: Patients distancing themselves from unhelpful thoughts. It involves them learning to step back from and observe thoughts without believing or acting on them.
- Contact with the Present Moment: Individuals learning mindfulness and being fully present.
- Self-as-Context: Refers to patients observing oneself as the context for experiences.
- Values: Individuals identify what’s most important to them in life. Clear values will help guide their actions toward achieving their deepest aspirations.
- Committed Action: Patients take purposeful steps in alignment with the aforementioned values.
Interestingly, ACT often employs experiential exercises to illustrate certain concepts. These may include visualization, role-playing, sensory awareness, and time travel exercises.
Who Is ACT For?
The American Psychological Association (APA) recognizes ACT as an empirically supported treatment suited to deal with a number of mental health conditions. As such, the therapy can help treat the following issues:
- Depression, anxiety, and chronic pain
- Psychosis
- Obsessive-Compulsive Disorder (OCD)
ACT is also helpful for those who aren’t able to deal with their problems head-on. In ACT, patients learn how to be more self-compassionate and accept their challenges better.
Choosing the Right Therapy for You at Illinois Recovery Center
At Illinois Recovery Center, we understand that picking the right therapy to treat your or a loved one’s substance abuse disorder can be a dilemma.
We hope that by learning the differences between the most common therapies (DBT vs CBT vs ACT), you have a clearer overview of which psychotherapy is most suited for your needs.
Of course, you can always contact us and have our medical professionals assist you if you still have further questions or concerns.
