The day-to-day toolkit for the moments recovery actually gets hard — distress tolerance, emotion regulation, mindfulness, and relationship skills, taught and practiced inside an evidence-based intensive outpatient program.
DBT — dialectical behavior therapy — was developed in the late 1980s by Marsha Linehan to treat clients with borderline personality disorder who weren't responding to standard talk therapy. It worked. Then researchers tried it on substance use disorders, eating disorders, mood disorders, and complex PTSD. It worked there too.
DBT is now one of the strongest evidence-based therapies for addiction recovery. Inside Awkward Recovery's intensive outpatient program in Austin, DBT skills are the day-to-day toolkit — what you reach for when a craving hits at 9pm, when a family member texts something that wrecks you, when the urge to use shows up wearing a different costume than usual.
What DBT isn't: a personality rewrite. It's a skill set. The same way you'd learn to drive or use a spreadsheet — practice, fail, practice again, integrate. The skills only work if you use them, which is why DBT inside IOP isn't passive lectures. It's drill, application, debrief.
Linehan organized DBT around four skill sets. Awkward Recovery teaches all four inside IOP.
Not the wellness-app kind. The clinical kind: noticing what's happening in your mind and body without immediately reacting to it. The foundation skill — everything else depends on it. Without mindfulness, you can't catch the urge before you act on it.
DBT shows up in three ways across our intensive outpatient program:
DBT isn't a once-a-week breakout at Awkward Recovery — it's integrated into our IOP as the foundation the rest of the program is built on. Structured skill teaching, live practice in a smaller cohort, homework that carries the work between sessions. This is where the toolkit gets built.
Your individual therapist helps you apply the skills to your specific recovery — what worked, what fell apart, what to try next. Some clients use diary cards to track skill use and target behaviors between sessions.
When something comes up in process group — an interpersonal conflict, an emotion that hijacks the room, a craving — your therapist names the skill that fits and walks you through using it then and there. Practice in the moment, not just in theory.
The four physiological reset moves for intense distress: cold water on the face, intense exercise for one to three minutes, paced breathing (longer exhale than inhale), paired muscle relaxation. Calms the body when the brain can't think.
The practice of noticing a craving rise, peak, and fall without acting on it. Cravings are time-limited; the urge to use peaks around 20 to 30 minutes and decreases. You ride it like a wave.
When an emotion's urge isn't serving you (shame says hide; depression says lie in bed; anger says burn it down), you do the opposite. Carefully. Repeatedly. Until the emotion shifts.
Not approving of reality; just stopping the fight with it. Don't waste energy on "this shouldn't be happening" — use that energy to implement a skill that works.
The assertiveness script for asking for what you need: Describe, Express, Assert, Reinforce, stay Mindful, Appear confident, Negotiate. It sounds mechanical because it is — and it works when you can't think clearly enough to wing it.
Most insurance plans cover IOP-level care, which includes the DBT skills group and individual sessions delivered inside it. We'll quickly verify your benefits — no cost, no commitment.
DBT inside IOP handles most adult presentations where substance use overlaps with emotion dysregulation. Sometimes it doesn't. Honest signs you need a higher level of care first:
In any of these cases, residential or partial hospitalization comes first, then IOP after stabilization. We refer when that's the right call. No ego. No sales pitch.
No. DBT shares some roots with CBT but adds mindfulness, distress tolerance, and the "dialectical" frame — holding two opposite truths at once (you're doing the best you can AND you need to do better). CBT changes thought patterns; DBT changes how you survive the in-between moments.
The four modules cycle through over about 24 weeks in standard DBT. Inside IOP, you get the skills compressed and applied immediately — most clients have functional fluency in 8 to 12 weeks. Mastery is years; the foundation is months.
No. DBT was designed for BPD but adapted decades ago for substance use, mood disorders, PTSD, eating disorders, and general emotion regulation. The skills are population-agnostic.
A diary card is a daily tracking sheet — emotions felt, skills used, target behaviors (urges, self-harm, substance use) marked or not. Standard in full DBT programs. Inside our IOP, diary cards are optional for most clients and required for some, depending on what you and your therapist are tracking.
Both. Group is where the skills get taught and practiced; individual is where they get applied to your specific life. Skill-group-only DBT exists but isn't full DBT — the integration work matters.
Yes. DBT meets the APA's "well-established" treatment criteria. For BPD, substance use disorder, suicidal ideation, and several mood disorders, it's a first-line recommendation backed by multiple randomized controlled trials.
A few of Austin's standalone DBT programs run year-long outpatient DBT for clients without substance use concerns. Inside IOP, you get the skills delivered alongside the substance use work — which is the right call when both are happening, because separating them slows everything down.
Most insurance plans cover IOP-level care, which includes the DBT skills group and individual sessions delivered inside it. Verify your benefits — (512) 616-0809 or online.
If DBT is what's been missing from your recovery — or what's worked partially before but you need to do it inside a more structured program — that's what our intensive outpatient program is built for. The intake call sorts the right starting point. Confidential. No commitment.
Confidential. No sales pitch.