Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

CHAPTER 27Dialectical Behavior Therapy forIndividuals with Borderline PersonalityDisorder and Substance Use DisordersM. ZACHARY ROSENTHALTHOMAS R. LYNCHMARSHA M. LINEHANDialectical behavior therapy for substance use disorders (DBT-SUD) is a comprehensivepsychosocial treatment for substance users with borderline personalitydisorder (BPD). DBT-SUD is an extension of standard dialectical behaviortherapy (DBT; Linehan, 1993a, 1993b), a treatment for BPD that hasbeen investigated to the extent that the treatment can be considered “wellestablished”according to criteria outlined by Chambless and Hollon (1998). Itis the subject of several well-controlled randomized clinical trials (RCTs) forthe treatment of BPD, and efficacy has been demonstrated across independentresearch teams (Koons et al., 2001; Linehan, Armstrong, Suarez, Allmon, &Heard, 1991; Linehan et al., 1999; Linehan, Dimeff, et al., 2002; Verheul et al.,2003). Across studies, the evidence suggests that DBT is an efficacious treatmentfor reducing a variety of problems associated with BPD, including selfinjuriousbehavior, suicide attempts, suicidal ideation, hopelessness, depression,bulimia, and substance use.This chapter provides an overview of the modifications of standard DBTthat comprise DBT-SUD. The philosophy and theory behind DBT-SUD, thebiosocial model of BPD, as well as treatment modes and functions, skill mod-615