Carolina Talkowski
University of Buenos Aires, Argentina
Title: Dialectical Behavioral Therapy and Twelve Step Programs for Substance Use Disorders
Biography
Biography: Carolina Talkowski
Abstract
The comorbidity of substance use disorder (SUD) and borderline personality disorder (BPD) is linked to severe emotional dysregulation, increases the probability of poor treatment outcomes, and the risk of suicide.
Dialectical Behavioral Therapy (DBT) is one of the best treatment available for BPD. On the other hand, the Twelve Step programs are between the best options available for SUD. However, patients with BPD tend to be rejected by non-DBT addiction treatment programs, and patients with SUD tend to be rejected by regular DBT programs. Hence, there is a clear need for interventions that treat both disorders.
DBT requires the dialectical synthesis of acceptance and change, of validation and behaviorism, amongst other polarities. The balance between acceptance and change in DBT is consistent with the philosophical approach found in the Twelve-Step program, as expressed in the Serenity Prayer, made popular by Alcoholics Anonymous since 1935.
The substance use disorder dBT program behavioral targets are: decreasing the use of substances; making abstinence easier to cope with; diminishing cravings; avoiding opportunities to use, and increasing community reinforcement of healthy behaviors. These targets are achieved by DBT skills learning groups and individual therapy, plus family orientation and psychiatric treatment.
The Twelve-Step program promotes the achievement of complete abstinence of all kinds of drugs through the participation in mutual help group meetings and service activities, and writing the steps of the program with the guidance of a sponsor.
This presentation brings DBT and the Twelve Step programs together and explores their complementary aspects.