Dialectical Behavior Therapy (DBT) at Shine
Clinically reviewed by Joe Papa, LICSW · Licensed Independent Clinical Social Worker
Addiction is often driven by emotional pain that feels impossible to manage without substances. DBT builds the skills to change that, serving Saugus, Lynn, Revere, Malden, Chelsea, and the greater North Shore.
Confidential. No pressure. We'll explain your options clearly.
What Is Dialectical Behavior Therapy?
A powerful, skills-based therapy originally developed for people who feel emotions more intensely than others.
Dialectical Behavior Therapy (DBT) was developed by Dr. Marsha Linehan at the University of Washington. Originally designed for individuals with borderline personality disorder, DBT has since been extensively adapted and studied for addiction treatment, where its core focus on emotional regulation and distress tolerance makes it particularly effective.
The word "dialectical" refers to the balance between two seemingly opposite goals: accepting yourself as you are while also working to change. DBT does not ask you to white-knuckle through pain or pretend your emotions are not real. It teaches you to feel your feelings without being controlled by them, and to build a life where substances are no longer the only way to cope.
At Shine Wellness & Recovery, DBT is woven into every level of care, from PHP and IOP to standard outpatient, delivered by licensed clinicians who understand that for many people in recovery, emotional dysregulation is not a character flaw. It is a skill deficit. And skills can be learned. We serve individuals and families across Saugus, Lynn, Revere, Malden, Chelsea, Medford, Everett, and the greater North Shore.
Built for emotional intensity
DBT was specifically designed for people who experience emotions more intensely than average, a profile that is extremely common among people struggling with addiction.
Acceptance and change
DBT does not force a choice between accepting yourself and changing. It teaches both at the same time, which is exactly what recovery requires.
Skills you use in real life
DBT skills are practical and portable. They work in the moment a craving hits, in the middle of a conflict with a family member, and in the quiet moments when the urge to escape is loudest.
What the Research Says About DBT for Addiction
The evidence is strong, and it comes from NIDA, SAMHSA, and major clinical trials.
of individuals receiving DBT for addiction remained in treatment through 12 months, compared to only 27% in standard community treatment, per NIDA-funded research
Source: National Institute on Drug Abuse (NIDA), 2022
of individuals using DBT reported better emotional regulation and fewer incidents of substance use, according to SAMHSA
Source: Substance Abuse and Mental Health Services Administration (SAMHSA)
relapse rate for DBT participants compared to 36% for those in traditional therapy, a 50% reduction in relapse risk, per NIH-reviewed randomized controlled trials
Source: National Institutes of Health, randomized controlled trial review
These outcomes reflect real people across communities like Saugus, Lynn, Revere, Malden, and Chelsea, where emotional pain and addiction intersect daily. DBT does not just reduce substance use. It gives people a different relationship with their own emotions, which changes everything.
The Four Core Skills of DBT
Four modules. Each one targeting a different dimension of the emotional experience that drives addiction.
DBT is organized around four core skill modules. Each one addresses a different aspect of the emotional and behavioral challenges that underlie addiction. At Shine, all four are integrated into our clinical programming across every level of care.
Mindfulness
The foundation of all DBT skills, learning to observe your thoughts and feelings without being controlled by them.
Mindfulness in DBT is not meditation for its own sake. It is a practical skill for observing what is happening inside you, your cravings, your emotions, your automatic reactions, without immediately acting on them. It creates the space between feeling and behavior where recovery lives. For people with addiction, mindfulness helps recognize triggers as they arise and make a conscious choice about how to respond.
Distress Tolerance
How to survive a crisis without making it worse, or turning to substances to escape it.
Distress tolerance skills are designed for the moments when the pain is overwhelming and the urge to use is loudest. They do not fix the problem causing the pain, they help you get through it without doing something you will regret. Techniques include distraction, self-soothing, improving the moment, and pros-and-cons analysis. Research from SAMHSA shows that distress tolerance skills can reduce substance cravings by 25% during high-stress events.
Emotion Regulation
Understanding your emotions, where they come from, what they are telling you, and how to change them when they are driving you toward use.
Emotion regulation is the heart of DBT for addiction. Many people use substances to manage emotions that feel too big, too persistent, or too painful to bear. DBT teaches you to identify what you are feeling and why, reduce emotional vulnerability by building a life worth living, and change emotions that are not serving you, rather than numbing them.
Interpersonal Effectiveness
How to ask for what you need, say no to what you do not, and maintain relationships without sacrificing yourself or your recovery.
Relationship stress is one of the most common triggers for relapse. Interpersonal effectiveness skills teach you how to navigate conflict, set boundaries, maintain self-respect, and ask for what you need, all without damaging the relationships that support your recovery. For many clients, these skills address patterns that have driven substance use for years.
DBT and Trauma-Informed Care
At Shine, DBT is always delivered through a trauma-informed lens, because emotional dysregulation and trauma are deeply connected.
DBT was originally developed for individuals with complex trauma histories, people who experience intense emotional pain and have learned, often through years of difficult experience, to manage that pain through self-destructive behaviors including substance use. At Shine, we understand this. All DBT is delivered through a trauma-informed lens.
This means your therapist does not pathologize your emotional intensity. They understand it as a response to real experiences, and they meet you where you are. Safety and trust are built before the deepest skill work begins. And the DBT you receive at Shine is tailored to your specific history, your specific emotional patterns, and your specific recovery goals.
Emotional Dysregulation Is Not a Character Flaw
Many people with addiction have been told their whole lives that they are "too much" or "too sensitive." DBT reframes this, not as weakness, but as a skill deficit that can be addressed. At Shine, your emotional intensity is understood, not judged.
Integrated with CBT and MI
DBT at Shine works alongside Cognitive Behavioral Therapy (CBT) and Motivational Interviewing (MI) as part of a comprehensive clinical model, each approach reinforcing the others for deeper, more durable outcomes.
DBT Is Part of Every Level of Care at Shine
Whether you are in PHP, IOP, or Outpatient, DBT skills are woven into your treatment from day one.
Partial Hospitalization Program (PHP)
All four DBT skill modules are covered in PHP, the most intensive level of outpatient care. Daily skill-building in group and individual sessions gives clients the strongest foundation for managing emotions and cravings in early recovery.
View therapy details →Intensive Outpatient Program (IOP)
DBT skills are practiced and deepened in IOP as clients begin re-engaging with daily life, where emotional triggers and interpersonal challenges become more present and the skills are tested in real time.
View therapy details →Outpatient Program (OP)
In our standard outpatient program, ongoing DBT work maintains and deepens the four core skill modules as clients build long-term emotional stability and recovery.
View therapy details →Frequently Asked Questions, DBT at Shine
Joe Papa is a Licensed Independent Clinical Social Worker and member of the Shine Wellness & Recovery clinical team. All clinical content on this site is reviewed by Joe to ensure accuracy and alignment with current evidence-based practice standards in addiction treatment and behavioral health.
View Full Bio →