Reviewed by Vinsent Franke, MBA, AMFT, CADC-II, RA, Founder of iRely Recovery. Updated September 2026.
Intro
When cravings, emotional pain and self-destructive patterns feel impossible to break, dialectical behavior therapy (DBT) offers a structured, evidence-based path forward.
At iRely Recovery in Los Angeles, our residential DBT program gives clients practical skills to tolerate distress, regulate emotions and rebuild relationships, all within a supportive, clinically supervised environment.
Key Points
- Built on acceptance and changeDBT pairs compassionate acceptance of where you are with concrete steps toward change.
- Four skills modulesMindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.
- Adapted for addictionDBT-SUD extends the original protocol to substance use and co-occurring disorders.
- Insurance verificationWe verify your benefits before you decide. Call 818-869-2112.
In Short
DBT at iRely Recovery is the organizing framework of our residential program, teaching mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness for addiction and co-occurring conditions such as BPD, PTSD and depression. Most insurance is accepted. Call 818-869-2112 to begin admissions.
What Is Dialectical Behavior Therapy (DBT)?
Dialectical behavior therapy is a comprehensive cognitive-behavioral treatment developed by psychologist Dr. Marsha Linehan in 1993. It was originally designed for people with borderline personality disorder (BPD) and has since been extensively studied and adapted for substance use disorder, PTSD and other conditions marked by emotional dysregulation.
The word dialectical refers to the therapy’s central tension: accepting yourself exactly as you are right now while working to change the behaviors that are causing harm. People struggling with substance use often swing between self-condemnation (“I am a failure”) and denial (“I do not have a problem”). DBT teaches a third path: compassionate acknowledgment of where you are, paired with concrete steps to move forward.
At iRely Recovery (DHCS License #191516AP), DBT skills training is woven through the residential program as the organizing framework for group sessions, individual therapy and skills coaching, not as an add-on.
Is DBT Effective for Addiction?
Yes. Linehan’s original 1993 trial showed DBT reduced suicidal behavior, hospitalizations and treatment dropout compared with treatment as usual. She and her colleagues then developed DBT-SUD, an adaptation for substance use disorder, and a 2002 randomized trial of opioid-dependent women with BPD found DBT produced significantly better outcomes on drug use than comprehensive validation therapy plus 12-step.
Integrated, Not Standalone
At iRely, DBT works alongside individualized therapy, CBT, medication management when appropriate, family programming and aftercare planning.
Treats the Whole Cycle
This model addresses the full cycle of addiction and any co-occurring condition, rather than managing symptoms alone.
The Four Core DBT Skills Modules
DBT is organized around four modules. At iRely, clients work through all four during residential treatment, with regular skills groups and coaching from clinical staff.
1. Mindfulness
The foundation of every other skill. You learn to observe, describe and participate in your experience without judgment, one-mindfully and effectively. Urge surfing, watching a craving rise and fall without acting on it, creates the gap between craving and action.
2. Distress Tolerance
A toolkit for surviving crisis without making things worse: TIPP (Temperature, Intense exercise, Paced breathing, Progressive relaxation), ACCEPTS distraction skills, IMPROVE the moment, pros and cons, and radical acceptance of reality as it is.
3. Emotion Regulation
Identify and label emotions accurately, understand what they are telling you, reduce vulnerability with PLEASE skills, build positive experiences, act opposite to destructive urges and check the facts of the situation.
4. Interpersonal Effectiveness
DEAR MAN for asking for what you need or saying no, GIVE for keeping relationships, FAST for keeping self-respect, and validation, so relationships support recovery instead of undermining it.
Mindfulness for Recovery
In DBT, mindfulness is a set of trainable skills, not meditation. Observing, describing, participating, staying non-judgmental, focusing on one thing at a time and doing what works give you a way to notice a craving and choose a response. At iRely these skills are woven into every group session.
Distress Tolerance for Crisis Moments
Many clients arrive having used substances as their only distress tolerance strategy for years. These skills do not eliminate pain. They build the capacity to survive it sober. Radical acceptance of addiction (“this is where I am right now”) is the foundation of genuine motivation to change.
Emotion Regulation and Dual Diagnosis
People with substance use disorders often have emotions that come on faster, reach higher intensity and take longer to settle. DBT treats that as a learnable skill gap. For clients with co-occurring depression, anxiety or PTSD, these skills address the dysregulation that fuels both the mental health condition and the substance use.
Interpersonal Effectiveness and Family
Addiction damages relationships and thrives in isolation, conflict and poor boundaries. Our family therapy brings interpersonal effectiveness skills to family members too, so the whole support system learns the same communication framework and the skills carry over after discharge.
DBT vs. CBT: Key Differences
Both are evidence-based approaches that address the link between thoughts, feelings and behaviors. The main differences:
| Feature | DBT | CBT |
|---|---|---|
| Origin | Developed by Dr. Marsha Linehan (1993) for borderline personality disorder, adapted for substance use disorder | Developed by Dr. Aaron Beck in the 1960s for depression and anxiety |
| Core philosophy | Balances acceptance (validation) with change, the dialectic | Focuses on identifying and changing distorted thinking patterns |
| Skills training | Four structured modules taught in group and individual sessions | Mainly individual sessions, with skills often incidental to therapy |
| Mindfulness | Central to all four modules, taught as a formal skill with exercises | Present in some variants (MBCT) but not all |
| Best for | Borderline personality disorder, substance use disorder, PTSD, chronic self-destructive behavior | Depression, generalized anxiety, phobias, OCD, PTSD |
| Group component | Skills groups are a core part of the standard protocol | Not standard, though group CBT exists |
| Duration | Skills curriculum 4 to 8 weeks intensive in residential care, full protocol 6 to 12 months | Typically 12 to 20 individual sessions |
At iRely, DBT is typically the primary framework when emotional dysregulation, BPD traits or chronic self-destructive patterns are present alongside addiction, and CBT techniques are used within individual therapy. The two are complementary, and our clinical team integrates both based on your individualized plan.
DBT for Co-Occurring Disorders
Addiction rarely occurs in isolation, and DBT’s skills directly target the emotional dysregulation beneath many co-occurring conditions:
Borderline Personality Disorder
The original indication for DBT. Our residential setting allows intensive skills practice that is not possible in outpatient care. See our personality disorder treatment.
PTSD
Distress tolerance skills are a prerequisite for trauma processing, so clients stabilize with DBT before moving to trauma-focused work. See our trauma treatment.
Depression
Emotion regulation skills address the behavioral patterns that maintain depression.
Bipolar Disorder
Distress tolerance and emotion regulation help manage mood episodes alongside medication. See our bipolar disorder program.
Anxiety Disorders
Mindfulness and TIPP skills give immediate anxiety regulation tools without the addiction risk of benzodiazepines.
Self-Harm
DBT is the anchor of our self-harm treatment, with safety planning and chain analysis.
When someone has both a substance use disorder and a co-occurring condition, both must be treated at the same time. Treating addiction without the underlying condition leaves the emotional driver of use untouched and raises relapse risk. Our integrated dual diagnosis model addresses both within one residential program.
What to Expect in Your First Week of DBT
DBT can feel unfamiliar, especially if you have mostly experienced 12-step programming or unstructured talk therapy. Here is a realistic picture of the first week:
Days 1 to 2: Orientation and Assessment
Your therapist assesses your history and identifies your primary target behaviors, the patterns DBT will prioritize, such as substance use, self-harm, emotional dysregulation or relationship crises. You receive a skills binder with worksheets for all four modules.
Days 3 to 4: Your First Skills Group
Skills groups are structured like a class, with curriculum, homework and review. The first session introduces mindfulness and the What skills of observing, describing and participating. DBT is skills-based, not insight-based.
Days 5 to 7: First Individual Session
Individual DBT sets the treatment hierarchy: life-threatening behaviors first, therapy-interfering behaviors second and quality-of-life behaviors third. You start a daily diary card of mood, urges and skill use, reviewed at the start of each session.
Skills coaching between sessions is a core part of the standard DBT protocol and what sets it apart from weekly outpatient therapy. To begin admissions for our residential DBT program, call 818-869-2112.
Insurance Accepted for DBT in Los Angeles
Most major insurance plans cover residential DBT treatment as part of behavioral health benefits, and California’s SB 855 requires insurers to cover evidence-based mental health and substance use treatment at parity with medical benefits. Coverage varies by plan.
Call 818-869-2112 to verify your benefits. We will provide a clear breakdown of any out-of-pocket costs before you make any decisions. If you are uninsured or underinsured, our admissions team will discuss private-pay options.
Why Choose iRely Recovery for DBT
iRely Recovery is a residential treatment facility licensed by the California Department of Health Care Services (DHCS License #191516AP) and Joint Commission accredited, at 17524 Napa St in the Sherwood Forest neighborhood of Los Angeles. Our DBT program is delivered by licensed clinicians trained in the standard Linehan protocol and adapted for the residential setting.
Residential Setting
24/7 clinical supervision allows intensive skills practice that is not possible in outpatient settings.
Dual Diagnosis Expertise
Every client receives concurrent mental health and substance use treatment.
Small Groups
Small skills groups keep attention individualized.
Skills Coaching
Between-session coaching is built into the program structure.
Family Involvement
Family members are invited to selected skills sessions and family therapy.
Continuity of Care
Discharge planning begins at admission, and we coordinate with outpatient DBT providers in the Los Angeles area for step-down care.
Frequently Asked Questions About DBT in Los Angeles
What is DBT therapy used for?
Dialectical behavior therapy was originally developed for borderline personality disorder and has since been adapted for substance use disorder, PTSD, depression, bipolar disorder and other conditions. It is particularly effective when emotional dysregulation and self-destructive behavior patterns are involved.
Is DBT effective for drug and alcohol addiction?
DBT has been adapted for substance use disorder as DBT-SUD, and a 2002 randomized trial in opioid-dependent women with BPD found better drug use outcomes than comprehensive validation therapy plus 12-step. At iRely, DBT is integrated with individual therapy, medication management when appropriate, family programming and aftercare.
How is DBT different from CBT?
Both are cognitive-behavioral approaches, but DBT adds a central mindfulness component and a four-module skills curriculum. It explicitly balances acceptance with change, while CBT focuses primarily on changing thought patterns. DBT is the preferred framework when emotional dysregulation, BPD traits or self-destructive patterns are present alongside addiction.
What are the four modules of DBT?
The four skills modules are mindfulness, the foundation for all other skills; distress tolerance, surviving crisis without making things worse; emotion regulation, reducing emotional vulnerability and changing emotional responses; and interpersonal effectiveness, building relationships that support recovery.
How long does DBT take at a residential facility?
The full standard DBT protocol runs 6 to 12 months of outpatient treatment. In residential care, the four-module skills curriculum is compressed into 4 to 8 weeks of intensive daily practice. Clients who complete residential DBT at iRely are connected with outpatient DBT therapists in the Los Angeles area for ongoing skills maintenance.
Does DBT treat both addiction and mental health conditions at the same time?
Yes. DBT is designed for co-occurring conditions, and our dual diagnosis residential program treats addiction and co-occurring mental health conditions simultaneously with DBT as the primary skills framework.
Does insurance cover DBT treatment in Los Angeles?
Most major insurance plans cover residential DBT treatment, and California SB 855 requires insurers to cover evidence-based behavioral health treatment at parity with medical coverage. Call 818-869-2112 for a free benefits verification.
Is DBT only for borderline personality disorder?
No. DBT was originally developed for BPD, but it has been adapted for substance use disorder, PTSD, depression and other conditions. At iRely, DBT is the primary framework for residents whether or not they have a BPD diagnosis.
What happens in a DBT skills group?
Skills groups are structured like a class. A therapist teaches one skill from the current module, reviews homework from the previous session and assigns new homework. Skills groups are a standard component of the DBT protocol and are separate from individual therapy.
Is iRely Recovery licensed and accredited?
Yes. iRely Recovery holds California DHCS residential treatment license #191516AP and is Joint Commission accredited. We are at 17524 Napa St in the Sherwood Forest neighborhood of Los Angeles. For admissions and insurance questions, call 818-869-2112.
Sources
[1] Cleveland Clinic. (2022). Dialectical behavior therapy (DBT). Cleveland Clinic; Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt on May 22, 2025
[2] Corliss, J. (2024, January 22). Dialectical behavior therapy: What is it and who can it help? Harvard Health. https://www.health.harvard.edu/blog/dialectical-behavior-therapy-what-is-it-and-who-can-it-help-202401223009 on May 22, 2025
[3] Dimeff, L., & Linehan, M. (2008). Dialectical behavior therapy for substance abusers. Addiction Science & Clinical Practice, 4(2), 39 to 47. https://pmc.ncbi.nlm.nih.gov/articles/PMC2797106/ on May 22, 2025
[4] CAMH. (2024). Dialectical Behavioural Therapy. CAMH. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/dialectical-behaviour-therapy on May 22, 2025
[5] Dimeff, L., & Linehan, M. (2008). Dialectical behavior therapy for substance abusers. Addiction Science & Clinical Practice, 4(2), 39 to 47. https://pmc.ncbi.nlm.nih.gov/articles/PMC2797106/ on May 22, 2025
[6] Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press.
[7] Linehan, M. M., Dimeff, L. A., Reynolds, S. K., Comtois, K. A., Welch, S. S., Heagerty, P., & Kivlahan, D. R. (2002). Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug and Alcohol Dependence, 67(1), 13 to 26.
Start DBT at iRely Recovery
If cravings, emotional pain and self-destructive patterns feel impossible to break, DBT offers a structured way forward. Call 818-869-2112 to speak with our admissions team, ask your questions and begin insurance verification.
