[The Use of Dialectical-Behavior Therapy in the Treatment of Substance Use Disorders]

The treatment of substance use disorders (SUD) remains a persistent challenge. Dialectical behavior therapy (DBT) is a multimodal cognitive-behavioral treatment approach that integrates acceptance- and change-oriented strategies and was originally developed to address severe emotion dysregulation. In the context of SUD, DBT-based adaptations and skills-oriented formats are particularly used to target emotion regulation, distress tolerance, mindfulness and relapse prevention. Aim: The aim of this review was to synthesize the current state of research in order to explore and evaluate the use and effectiveness of DBT-based interventions for SUD.

A systematic literature search in databases, Google Scholar and Semantic Scholar identified 13 relevant studies from the period 2010 to 2024, which were narratively synthesized.

Despite methodological limitations, the findings suggested that the DBT-based formats used, in particular DBT skills training (DBT-ST), might improve emotion regulation, distress tolerance and adaptive coping strategies. Additionally, there was evidence for beneficial effects on substance use, abstinence and craving. Furthermore, several findings suggested promising treatment acceptance and adherence, although these results depended on the context and study design.

Overall, it can be concluded that DBT-ST, in particular, may be a suitable intervention option for individuals with SUD. However, further robust studies with standardized diagnostic procedures, longer follow-up periods and active control groups are needed to more precisely determine its specific efficacy and indications.