What are the Six main points of Dialectical Behavior Therapy?

Behavioral therapies such as dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT) are evidence-proven treatments often used in helping those with substance use disorders. DBT is a type of talk therapy, derived from cognitive behavioral therapy, and specifically adapted for people who experience emotions much more intensely. It helps patients understand how their thoughts impact emotions and behaviors. This can be especially helpful for people diagnosed with co-occurring mental health conditions involving emotional dysregulation.

Within substance use disorder treatment, DBT works by helping clients accept the reality of their addiction as well as helping them make changes toward recovery. Dialectical means the combining of opposing forces. This type of therapy teaches clients to accept themselves in their current state of addiction. It validates their emotions and feelings, while at the same time teaching them to accept the fact that they need to make changes to live a healthier and happier life. This type of therapy embraces the idea of having opposing perspectives that can coexist at different points in time.

A pink background with the word DBT Therapy is printed in black represents the six main points of dialectical behavior therapy.

Dialectical behavior therapy also teaches patients to accept that they will have a wide range of emotional feelings that at times will be contradictory. It teaches the patient how to have these conflicting feelings without being caught up in their polarizing effects.

DBT was created to treat symptoms of borderline personality disorder. However, it has since been modified and adapted to help treat other co-occurring mental health conditions. DBT has been proven effective in treating bipolar disorder, eating disorders such as bulimia and binge eating, and post-traumatic stress disorder. It can also be effective in treating symptoms of anxiety, depression, suicidal behaviors, self-harm behaviors and substance use disorders.

Dialectical behavioral therapy’s main goal is to teach patients to live in the moment, learn and develop healthy techniques to cope with stressful situations and learn how to regulate and manage their emotions. DBT learning techniques revolve around individual therapy, group therapy as well as online or over-the-phone therapy. Each avenue of therapy is important in creating a well-constructed treatment plan that touches on varying aspects of the emotional dysregulation in the client.

DBT consists of six main teaching points. Each point moves the client gradually towards a better understanding of themselves and how they can maintain a stable mental and physical state of being.

Infograph showing different teaching aspects of DBT therapy which include mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness.

What are the Six Main points of Dialectical Behavior Therapy?

  • Acceptance and Change – The patient learns to accept the current circumstances of their addiction. However, they also accept that changes need to be made in order to live a healthier life. This balanced way of thinking encourages flexibility and conveys the concept that opposing thoughts can be correct at different moments in time. The patient will develop new strategies to help make positive and lasting changes leading to being able to manage distressing circumstances, emotions and behaviors.
  • Analyzing behaviors, cognitive learning and emotional regulation – The patient will learn to analyze negative patterns and destructive behaviors. They will learn to replace them with a more effective mindset, making more positive impacts on their lives. They will learn to manage their intense feelings by first identifying them and understanding the differences in emotions. Then they will learn coping techniques to help respond to these distressing emotions in a way that prevents the patient from losing control.
  • Interpersonal effectiveness and developing collaboration skills – The patient will learn to communicate effectively with others and learn to work together as a team. They will learn to set healthy boundaries and negotiate in a constructive manner that can empower them and build character. These changes will in turn help the patient improve their relationships and interactions with others.
  • Learning new skill sets – Patient will learn new skills to enhance their capabilities. They will learn how to manage crisis situations, tolerate cravings and urges, and survive distressing events and emotions related to their addiction. Oftentimes these feelings can resort to harmful and destructive behaviors. Patients will learn that they are able to endure, self-soothe and distract themselves from the realities of their addiction.
  • Support and building a life worth living – The patient will learn about the importance of setting meaningful goals and working towards them. This encourages the patient to embrace their character strengths and work towards achievements in order to find self-fulfillment and purpose.
  • Mindfulness – The patient will learn to focus on the present moment which help them pay attention to their thoughts and feelings. Mindfulness skills can help a patient understand his/her own feelings and impulsivity. It allows the patient to detach from the distressing feelings associated with their addiction. This ultimately helps to reduce harm when you are in the middle of an emotional breakdown.
Inforgraph showing six main points of DBT.

Who can most benefit from DBT?

DBT is often used as a treatment for those with co-occurring mental health and substance use disorders. Clients exhibiting the following life-threatening behaviors can most greatly benefit from this type of therapy. Behaviors such as suicidal communications, suicidal ideation, forms of suicide and non-suicidal self-injury, find DBT the most promising. DBT can also be beneficial for clients who regularly come late to therapy sessions, regularly cancel set appointments and clients who are ill-responsive and non-collaborative in working towards goals related to self-fulfillment. In these types of situations, DBT can produce the most significant changes when it comes to treating emotional dysregulation disorders that occur alongside a drug addiction.

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Stages of Treatment

Clients usually go through four main stages of DBT treatment. In stage 1, the patient is usually very miserable as they are still in a vulnerable phase of recovery. Their behaviors may be out of control and they may be engaging in dangerous actions such as trying to kill themselves and using drugs. The goal of this first stage is to regain control over the addiction.

In stage 2, the patient is now in control of their urges and behaviors but continues to suffer in silence. This may be due to past traumas and invalidation. The goal of stage 2 is to move the patient from feeling low to one of a full emotional experience.

In stage 3 the patient is now learning to live without the emotional weight of their addiction. They are able to set goals for the future and find meaning and fulfillment in new activities and hobbies.

Not all clients go through this last stage of treatment. In stage 4, some patients seek to find a deeper meaning in life.

Pros and Cons of DBT Therapy


  • DBT is an evidence-based treatment. It has proven to be effective in helping to treat people diagnosed with substance use disorder, alcohol use disorder and co-occurring mental health disorders.
  • DBT works to reduce anxiety and depression while increasing a sense of self-worth and respect.
  • In DBT, patients will have direct access to clinicians due to its popularity and availability during the rehab treatment process.
  • In group sessions, patients are able to learn and practice coping techniques in a safe and supportive environment.
  • DBT is also beneficial for other types of mental health conditions that involve emotional dysregulation and mood disorders.


  • DBT is a long process and requires a long-term commitment from patients. It requires patients to do a lot of homework and self-reflection on their own when not engaging in therapy or other forms of addiction treatment.
  • For some patients, the skills that need to be learned can be overwhelming and daunting. This part of the healing process is not easy but necessary.
  • DBT is very structured and requires the patient to follow strict boundaries during the treatment process.
  • DBT doesn’t have any formal means of action to process the trauma that some patients experience. 

Reach out to Hotel California by the Sea

We specialize in treating addiction and other co-occurring disorders, such as PTSD. Our Admissions specialists are available to walk you through the best options for treating your addiction.

Treatment for Substance Use Disorder and Co-occurring Mental Health Disorder

Substance use disorders and alcohol use disorders often present alongside a co-occurring mental health condition. Treating these conditions simultaneously is the key to a successful recovery journey. Our co-occurring mental health treatment program at Hotel California by the Sea provides an extensive and dedicated approach to addiction recovery. This includes tackling the psychological and emotional challenges that often come with a drug or alcohol addiction.

We offer all levels of care including detox, residential, PHP and IOP treatments to accommodate clients in all stages of their recovery. Unique treatment methods including dialectal behavior therapy have shown results in treating our clients with extreme mood disorders. At Hotel California by the Sea, we specialize in treating co-occurring mental health conditions. Other treatments such as CBT, EMDR therapy, and marriage and family therapy offer our clients a deeper insight into the root causes of their addiction. These therapies are effective in teaching our clients the necessary coping skills needed in order to manage their cravings and emotions associated with their addiction.

We understand that there is no one-size-fits-all when it comes to addiction treatment. Each client will receive individualized care to help them overcome their addiction and mental health disorders.