Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). Research has now shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders. This therapeutic modality has been researched extensively to provide a skills-based strategy for managing thoughts and feelings that lead to destructive behaviors.
DBT includes four sets of behavioral skills:
- Mindfulness: The practice of being fully aware and present; being in the moment.
- Distress Tolerance: How to tolerate discomfort and pain in difficult situations using radical acceptance.
- Interpersonal Effectiveness: Learning the interpersonal skills to ask for what one wants, set boundaries for things they do not want, all while maintaining self-respect and healthy relationships with others.
- Emotional Regulation: Identifying troubling emotions and feelings and learning how to change and manage them, as to not be dictated by these emotions and feelings.
Eye Movement Desensitization & Reprocessing (EMDR)
EMDR is an evidenced-based therapy that has proved to be highly effective in the treatment of dual diagnosis clients suffering from trauma. Combined with talk therapy, EMDR utilizes guided eye movement to relieve and diminish negative effects from trauma, obsessive/compulsive behaviors, addiction, and other emotional and behavioral issues. The eye movement and other components of EMDR combine to “reprocess” memories that are “stuck” in areas of the brain, often inaccessible to the conscious mind. This activity alleviates anxiety around traumatic events, allowing for new pathways for healing. Therapists certified in EMDR treatment support clients, encouraging healthier, more rational thoughts and emotions, which allow for better coping with daily challenges.
The term “mood” describes a pervasive and sustained emotional state that may affect all aspects of an individual’s life and perceptions. Mood disorders are pathologically elevated or depressed disturbances of mood that include full or partial episodes of depression or anxiety. A mood episode is a cluster of symptoms that occur together. Symptoms of mood disorders are consistent and affect daily life. Examples of mood disorder diagnosis:
- Major depressive disorder (MDD)
- Bipolar I or II disorders
- Disruptive mood dysregulation disorder
- Premenstrual dysphoric disorder
- Persistent depressive disorder
- Seasonal affective disorder (SAD)
Everyone has feelings of sadness and disappointment. But depression’s main symptom is that of an intense, pervasive, and persistent feeling of sadness, hopelessness, and frustration that impairs social and occupational functioning. Untreated, moderate to severe depression symptoms can lead to suicidal thoughts or attempts, even psychotic thinking and behavior. Some symptoms of depression include loss of interest in activities, difficulty sleeping or sleeping too much, loss of energy, feelings of fatigue, significant weight loss or significant weight gain, and difficulty with clarity of thought/focusing.
Anxiety disorders are the most common group of psychiatric disorders. The term anxiety refers to the sensations of nervousness, tension, apprehension, and fear that emanate from the anticipation of danger, which may be internal or external. Anxiety disorders describe different clusters of signs and symptoms of anxiety, panic, and phobias.
Post-Traumatic Stress Disorder (PTSD)
PTSD begins with an individual experiencing a psychological traumatic stressor. Instead of focusing on that stressor during that initial experience, a person can carry that experience around with them for years, experiencing feelings like anxiety and sadness over and over again. This trauma ultimately impacts how people exist in the here and now, and their understanding of reality. People often turn to drugs and alcohol in an attempt to numb recurrent flashbacks and feelings.
Cognitive Behavioral Therapy (CBT)
CBT is a commonly used method of talk therapy, also called psychotherapy. Clients meet with certified therapists to discuss their upbringing, history with mental illness and addiction, and other relevant topics. Once the therapist learns more about the causes and triggers of a client’s addiction, they will help them recognize negative thoughts and behaviors, helping them better identify and respond to challenges. This type of therapy is helpful for treating mental health disorders, including depression, PTSD, and anxiety.
Somatic Experiencing (SE)
Those struggling with PTSD often battle their internal fight or flight responses, turning to alcohol and drugs to numb emotional pain and flashbacks. Somatic experiencing is a method of therapy that brings clients back to the present. Throughout treatment, clients learn to address and manage feelings, thoughts, and sensations associated with trauma.
Equine therapy incorporates horses into the therapeutic process, giving clients an opportunity to relax, reflect, and be vulnerable in a peaceful environment. Equine therapy can help build confidence, trust, empathy, emotional awareness, social skills, and problem-solving skills. It also helps clients control their drug and alcohol cravings. Equine therapy is not usually a client’s only method of treatment, but a complementary treatment. Through interacting and working with horses, dual diagnosis clients can learn to build trust and relationships.
Music releases dopamine in the brain, a chemical that instantly boosts the mood and increases the sense of wellbeing. Music makes people feel better, making it a welcome addition to mental health and addiction treatment. Music therapy uses different genres of music to induce various feelings emphasized in the music itself. For example, blues music can help clients learn to accept how relationships have been affected by substance abuse. Honest lyrics can help clients become introspective, analyzing negative behaviors and coming to terms with how past actions have been influenced by addiction or mental health disorders. Music therapy can also be fun, providing an upbeat atmosphere and a thought-provoking alternative to traditional therapies.
Art therapy is often used in conjunction with traditional therapy methods to help clients express their creativity and imagination. Through painting, drawing, dancing, sculpting, and more, clients have the chance to express themselves in a healthy, productive way. Art therapy can be used in group therapy or individual therapy sessions to help clients express feelings they normally are not able to articulate. Art therapy is helpful for those struggling with addiction, as it provides a way to understand and cope with feelings and behaviors surrounding addiction and mental health disorders.
Spirituality and Meditation
Spirituality and meditation allow for connection with something greater than oneself. Faith is just one route to that connection, and we don’t push spirituality in a religious context. Meditation is a pathway to discovering one’s true, authentic self, organizing thoughts, wants, and needs in a healthy way.
Yoga and Exercise
Dual diagnosis treatment addresses a client’s addiction and mental illness together. Yoga and exercise therapy can be very helpful in this treatment, as it is a holistic approach that focuses on a person’s body, mind, and spirit at the same time. Yoga and exercise therapy have many benefits, including stress and pain relief, time for self-reflection, healthier habits, increased stamina and strength, and boosted self-confidence. For addiction, yoga and exercise can be used to reduce withdrawal symptoms, inhibit cravings, and prevent relapse.