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date: 15 December 2019

Abstract and Keywords

This chapter discusses Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD), which expands standard comprehensive DBT to treat individuals with co-occurring Borderline Personality Disorder (BPD) and SUDs—a particularly high-risk population. It explores the compassionate formulation of addictive behaviour that underlies the treatment model, and describes the DBT-SUD treatment structure, e.g., addictions-focused skills and guidelines for targeting substance use within the DBT treatment target hierarchy. It covers strategic modifications of DBT-SUD as applied to the DBT case management strategies, and specific suggestions for overcoming common addictions treatment obstacles. It reviews the challenges of synthesizing replacement drug medications and drug toxicology screening with DBT, working with individuals who are prescribed potentially addictive medications, and avoiding substance use contagion among group members. It reviews research supporting DBT-SUD and preliminary studies of DBT-SUD with non-BPD populations, and suggests that DBT-SUD modifications can help to better target substance use within general DBT practice settings.

Keywords: dialectical behaviour therapy, DBT, borderline personality disorder, BPD, substance use disorders, addiction, skills, medication, lying

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