Bridging DBT & the 12 Steps: How They Complement Each Other
DBT and addiction recovery • Written by: Monument Recovery
It’s not often you hear DBT and AA mentioned in the same breath. While at a glance they may seem to be on opposite ends of the addiction recovery spectrum, they’re actually two parts of the same whole and compliment each other beautifully.
At Monument Recovery, DBT is woven into the treatment process alongside the 12-step philosophy, giving clients a more holistic recovery experience. We sat down with Monument’s Clinical Director, Bradley Wagner, to explore the intersection of the 12-Steps and DBT.
Understanding DBT: The Foundation of Emotional Regulation
"What I love about DBT is these are practical, everyday, real-life coping skills that our clients can not only learn in treatment but also take home with them and learn how to self-regulate."
The foundation of DBT was grounded in trying to help individuals who were highly suicidal and lacked the ability to regulate their emotions. Since then it has been adapted for a host of mental health conditions. Including substance use disorders. At its core are 4 main tenets.
1. Distress Tolerance – Surviving the Crisis Without Making It Worse
When you’re unable to internally manage your emotions, people with addictive tendencies will often turn to external sources as a way to cope. DBT teaches distress tolerance skills that provide alternatives. “We teach people how to lower and reduce their anxiety through different skills, like TIP, which is temperature change, intense exercise, paced breathing, and progressive muscle relaxation,” explains Bradley.
2. Emotional Regulation – Understanding & Managing Feelings
Most people who are stuck in a cycle of addiction aren’t that way for no reason. They usually struggle with very intense and overwhelming emotions. Emotional regulation skills help clients name their emotions, identify where they feel them in their body, and respond effectively rather than impulsively. “A lot of our clients live in their emotional mind, meaning they can go from zero to ten instantly. We help them learn how to get out of their emotional minds and into their wise minds.”
3. Mindfulness – Becoming Present & Aware
“Breathwork exercises, using the five senses, and practicing ‘what’ and ‘how’ skills help clients transition out of emotional reactivity.” Mindfulness is a key part of DBT and an area that aligns with many principles in the 12-step approach.
4. Interpersonal Effectiveness – Building Stronger Relationships
Addiction is called the family disease because it effects everyone in the family system. Relationships are damaged and communication becomes nonexistent. A lot of our clients and their family members struggle with listening. DBT helps them communicate in a way that builds self-respect and strengthens relationships.” DBT provides structured techniques like DEAR MAN (Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate) to help clients advocate for their needs. “
The 12 Steps & DBT: The Perfect Pairing
Step 1: Admitting Powerlessness vs. Radical Acceptance
The first step in AA is about acknowledging the reality of addiction. DBT’s radical acceptance principle mirrors this, teaching clients to accept their situation without judgment.
Step 4: Taking a Moral Inventory vs. Mindfulness & Emotional Regulation
The fourth step requires an honest self-inventory, similar to the mindfulness skills in DBT, which encourage self-awareness without shame or avoidance.
Step 9: Making Amends vs. Interpersonal Effectiveness
Making amends requires clear, assertive, and respectful communication—exactly what DBT teaches through its interpersonal effectiveness skills.
Both approaches emphasize self-reflection, acceptance, and taking deliberate steps toward change. “It’s all interconnected,” says Wagner. “Helping clients see the parallels between the 12 Steps and DBT is one of the most rewarding parts of my work.”
A New Perspective on Recovery
If you’re a young adult considering treatment, know that recovery is not a one-size-fits-all process. “You don’t have to choose between DBT and the 12 Steps,” Bradley emphasizes. “They work together, giving you more tools to build the life you want.”
Recovery is about learning, growing, and finding new ways to navigate life. With the right support, you can move forward with confidence—one step, and one skill, at a time.
