Dialectical Behavior Therapy · Southern Maine
When emotions hit like weather, DBT teaches you to ride them out
Dialectical behavior therapy was built for people whose emotions arrive fast and hard, the same overwhelm that so often sits underneath drinking and drug use. At Portland Treatment, DBT skills are woven through PHP, IOP, and outpatient care for clients across York and Cumberland County.
Confidential · Free benefits check · Answered 24/7
The short version
- What it is: a skills-based therapy for intense emotion, originally developed by Dr. Marsha Linehan.
- Why it fits addiction: most relapses happen in moments of emotional overload, not calm reflection.
- How you get it: built into group and individual sessions, not a separate program or extra fee.
Accredited & Licensed
LegitScript Certified
Joint Commission Accredited
Maine DHHS Licensed
Psychology Today Verified
Is DBT for you?
People usually find DBT when willpower has already failed them
If any of these sound familiar, DBT is worth asking about in your assessment. None of them disqualify you from treatment, they're exactly what the therapy was built around.
You use to come down from a feeling
Rage, panic, shame, grief, the substance is the off-switch. DBT replaces the off-switch with skills.
Your emotions feel disproportionate to events
Small conflicts spiral into hours of distress. That's not weakness; it's a nervous system that was never taught regulation.
You've relapsed after a blowup, not a craving
If your last relapse followed an argument or a wave of shame rather than a party, emotion regulation is the missing piece.
You've hurt yourself to cope
DBT was designed first for self-harm. It offers concrete alternatives for the moments when pain demands an exit.
Relationships keep detonating
Interpersonal effectiveness training teaches you to ask for what you need and hold boundaries without burning bridges.
You've been told you're 'too sensitive'
DBT calls this emotional vulnerability, and treats it as a trainable trait, not a character flaw.
The four skill modules
DBT is a curriculum, not a personality transplant
You learn it the way you'd learn anything physical: in sequence, with repetition, and with coaching while you use it on real life. Each module builds on the one before it.
Mindfulness
Notice the wave before it breaks
The foundation everything else sits on. You practice observing a thought, urge, or feeling without immediately obeying it, the gap between trigger and action where recovery actually lives.
In group: guided grounding, urge-surfing a craving to its peak and back down.
Distress Tolerance
Survive the crisis without making it worse
Short-term, in-the-moment skills for the hours when you cannot fix the problem, you can only get through it. TIPP temperature techniques, distraction, self-soothing, and radical acceptance of a reality you didn't choose.
In session: building your personal crisis plan, the literal list you pull out at 2 a.m.
Emotion Regulation
Turn the volume down over weeks, not minutes
Longer-arc work: naming emotions accurately, reducing vulnerability through sleep, food, and movement, and acting opposite when a feeling is pointing you somewhere that ends in relapse.
Between sessions: diary cards that track urges, emotions, and skill use so progress is visible.
Interpersonal Effectiveness
Get what you need without a wreck
Scripts for the conversations that used to end in a drink: asking for help, saying no to using friends, repairing family damage, and keeping self-respect intact while you do it.
In group: rehearsing the actual phone call or kitchen-table talk before you have to make it.
Medically reviewed
Benjamin Crocker, MD
Psychiatrist · Clinical Assistant Professor of Psychiatry, Tufts University School of Medicine · MD, The Ohio State University · Residency & fellowship training at the University of Michigan and LAC+USC Medical Center
Last reviewed August 2026. Read our editorial standards & clinical review process
DBT vs. CBT
Two toolkits, one goal, and most clients use both
You don't have to choose between them. Your clinician draws from each depending on whether the moment calls for changing a thought or surviving a feeling.
| CBT | DBT | |
|---|---|---|
| Core target | Thoughts, catching and testing the beliefs that drive use | Emotions, tolerating and regulating the feelings underneath use |
| Best known for | The most researched therapy for substance use disorder | Self-harm, borderline personality disorder, and emotional overwhelm |
| Tools you'll use | Thought records, trigger maps, refusal rehearsal, behavioral experiments | Diary cards, TIPP skills, radical acceptance, DEAR MAN scripts |
| Feel of a session | Collaborative detective work on your thinking | Skills class plus coaching, closer to a practice than a talk |
| At Portland Treatment | Standard in individual and group sessions across PHP, IOP, and OP | Standard in individual and group sessions across PHP, IOP, and OP |
Curious about CBT? Read about our CBT program →
Starting treatment in Portland?
We'll check your benefits free in minutes, MaineCare and most major plans accepted.
The evidence
Born in the research lab, built for hard cases
DBT didn't start as a general wellness trend, Marsha Linehan developed it for people other therapies were failing. Each source below links to the study or federal reference it comes from. Research describes group averages, not a promise about any one person's outcome.
Fewer opioid-positive tests
In a randomized trial of opioid-dependent women with borderline personality disorder, DBT produced significantly greater reductions in opioid use than comparison treatment, confirmed by urinalysis.
Source: Linehan et al., American Journal of Psychiatry (2002)Cochrane-reviewed
A Cochrane review of 75 trials concluded DBT reduces self-harm and improves emotional regulation compared with treatment as usual in people with borderline personality disorder, a population with very high rates of co-occurring substance use.
Source: Storebø et al., Cochrane Database of Systematic Reviews (2020)NIDA-recognized
The National Institute on Drug Abuse lists DBT among evidence-based behavioral therapies, noting it was designed to reduce self-harm behaviors including drug use.
Source: National Institute on Drug Abuse, Principles of TreatmentDBT near Portland, Maine
Skills-based care twenty minutes from downtown
Finding a therapist trained in DBT is hard enough in Southern Maine; finding one inside an addiction program that takes your insurance is harder. Our Biddeford center includes DBT skills groups and DBT-informed individual therapy in every level of care, with no waitlist and no separate charge.
Clients come to us from Portland, South Portland, Saco, Scarborough, Westbrook, Old Orchard Beach, Kennebunk, and Sanford, and when the drive isn't workable, virtual sessions keep the skill practice going.
What a DBT week can look like here
- Skills group: learn one new skill, review how last week's went in real life.
- Individual session: apply the skill to your specific week, the argument, the anniversary, the paycheck.
- Diary card: track urges, emotions, and skills used so you and your clinician can see the trend, not guess at it.
- Coaching between sessions: support for using a skill in the moment it's actually needed.
Insurance
In-network with almost every plan.
Portland Treatment is in-network with Anthem, UMR/UnitedHealthcare, Aetna, Harvard Pilgrim, Martin's Point, TRICARE and MaineCare, Cigna is our only out-of-network plan. In-network means contracted rates, lower coinsurance and no balance bill. We verify your benefits free, in minutes, with no obligation.
Free, confidential, no obligation
Or read the coverage guide for your plan, Anthem rehab coverage, Cigna rehab coverage, MaineCare rehab coverage and other accepted insurance plans.
DBT questions
- What is dialectical behavior therapy for addiction?
- DBT is a skills-based therapy that teaches mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. It was originally developed by Dr. Marsha Linehan for people with intense, hard-to-regulate emotions, and it's now widely used in addiction treatment because emotional overwhelm is one of the most common relapse triggers.
- Does DBT work for substance use disorder?
- Research supports it. A randomized trial published in the American Journal of Psychiatry (2002) found DBT significantly reduced opioid use in opioid-dependent women with borderline personality disorder, and the National Institute on Drug Abuse lists DBT among evidence-based behavioral therapies. It works best combined with other treatment, including medication when indicated.
- What's the difference between DBT and CBT?
- CBT focuses on identifying and changing the thoughts that drive substance use. DBT focuses on tolerating and regulating the intense emotions underneath it. Most clients benefit from both, and our clinicians draw from each depending on what you're facing.
- Where can I get DBT for addiction near Portland, Maine?
- Portland Treatment includes DBT skills training in PHP, IOP, and outpatient programs at our Biddeford center, about twenty minutes from downtown Portland. It's part of your program, not a separate service or extra fee.
- Do I need a borderline personality disorder diagnosis to benefit from DBT?
- No. Although DBT was developed for BPD, its skills, distress tolerance, emotion regulation, interpersonal effectiveness, help anyone whose substance use is tied to emotional overwhelm, trauma, or unstable relationships.
- Is DBT covered by insurance or MaineCare?
- Yes, in nearly all cases, because it's delivered as part of your treatment program. We accept MaineCare and most major commercial plans, and we verify your benefits for free with no obligation.
Sources & references
- 1. Linehan et al., American Journal of Psychiatry (2002)
- 2. Storebø et al., Cochrane Database of Systematic Reviews (2020)
- 3. National Institute on Drug Abuse, Principles of Treatment
- 4. Substance Abuse and Mental Health Services Administration (SAMHSA), treatment overview
This page is educational and is not medical advice. Research findings describe group averages; individual results vary. If you are in crisis, call or text 988, or dial 911 for an emergency.
Keep exploring
Related care at Portland Treatment
Levels of care
- Partial hospitalization program (PHP) in Biddeford
Our most structured day treatment, five days a week, home each night.
- Intensive outpatient program (IOP) in Southern Maine
Nine-plus clinical hours a week with day and evening tracks.
- Virtual IOP for anywhere in Maine
The same IOP curriculum by secure telehealth, statewide.
- Outpatient program (OP) for ongoing recovery
One to two sessions a week that fit around work and family.
How we treat
- Cognitive behavioral therapy (CBT)
Practical tools for the thoughts that drive use and relapse.
- Individual therapy in Biddeford
One-on-one counseling with the same clinician each week.
- Group therapy sessions
Small clinician-led groups with people in the same fight.
- Family therapy and support
Bringing partners, parents and adult kids into the work.
Where we serve
- Addiction treatment in Biddeford, Maine
Our home clinic, in the mill district off Route 111.
- Addiction treatment for Portland, Maine
A 20-minute drive down I-95 from the Portland peninsula.
- Addiction treatment for Saco, Maine
Minutes across the river from our Biddeford clinic.
- All Southern Maine areas we serve
Every city and town within driving distance of Biddeford.
The feeling passes. The skills stay.
Learn them with us.
855-449-7674Answered 24 hours a day, 7 days a week. Free and confidential.