DBT, Family Therapy & the 12 Steps: A Winning Combination for Recovery

One piece of the addiction recovery puzzle that often gets overlooked is the family component. Family therapy can be the bedrock that a foundation for long-term sobriety is built upon. Substance use disorder doesn’t happen in a vacuum. It impacts relationships, communication, and the very dynamics of a family system. If those patterns don’t change, it can be a lot harder to maintain recovery. That’s why integrating family therapy—especially when combined with evidence-based approaches like Dialectical Behavioral Therapy (DBT)—can be a game-changer in preventing relapse.

Why Family Therapy Matters in Recovery

Many people assume that once their loved one stops using, things will automatically get better. That’s a huge misconception. As Monument Recovery’s Clinical Director Bradley Wagner put it, “A huge part of what they’re going to learn in treatment is not to run and not avoid their emotions.” For family members, this means learning how to support a loved one in recovery without enabling or falling back into old, dysfunctional dynamics.

“While the client is here in treatment, their loved ones don’t have the same platform. Oftentimes, they are suffering in silence,” says Bradley. “We always want to give family members a voice and give them an opportunity to express their own wants and needs.” It’s about healing as a system, not just treating one person in isolation.

The Power of DBT in Family Therapy 

Dialectical Behavioral Therapy is an evidence-based approach that helps people regulate emotions, manage distress, and build healthy relationships. And when used in a family therapy setting, DBT can help rebuild relationships in a way that’s supportive for long-term recovery.

“DBT is basically broken up into four different subtypes,” Wagner explained. “There’s distress tolerance, emotional regulation, mindfulness, and interpersonal effectiveness.” These four components are essential in family therapy and play a critical role in preventing relapse.

Distress Tolerance: Handling the Tough Moments

There are going to be difficult moments in recovery. Learning distress tolerance skills helps both the person in recovery and their family members navigate these moments without making impulsive decisions. “We teach people how to lower and reduce their anxiety through different skills,” Bradley noted. This can include things like deep breathing, mindfulness, and understanding how emotions impact behavior. 

Emotional Regulation: Responding Instead of Reacting

Family conflict can be a major trigger for relapse. Many people with substance use disorder live in what DBT calls the ‘emotional mind’—reacting quickly to stress and conflict. Clinical Director Wagner says, “One of the biggest things we [Monument Recovery] teach is how to transition out of the emotional mind into the wise mind…this means recognizing emotions without acting on them impulsively.” 

For families, this means learning how to support a loved one’s recovery without getting caught in old patterns of blame, guilt, or enabling. 

Mindfulness: Staying Present

At the core of DBT is mindfulness, and it’s just as important for family members as it is for the person in recovery. “This helps clients get out of their emotional minds and into their wise minds by using breathwork, five senses exercises, and staying present in the moment.” 

For family members, mindfulness can be a powerful tool in learning to respond rather than react. Instead of immediately jumping into problem-solving or frustration, mindfulness helps create space for healthier interactions. 

Interpersonal Effectiveness: Communicating Clearly

Ever felt that you’re stuck in a loop of misunderstandings? DBT’s interpersonal effectiveness skills help with that. “There’s a lot of selective listening in families,” Bradley said. “DBT helps clients get their needs and wants met while also improving communication with their loved ones.” 

Techniques like DEAR MAN (Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate) teach people how to express their needs without resorting to conflict or avoidance. 

DBT & The 12 Steps

If you’re already familiar with the 12 steps, you might be wondering how DBT fits in. The truth is, they complement each other beautifully. “The 12 steps and DBT are all about learning new ways of thinking, self-awareness, and emotional regulation,” Wagner shared. “They’re interconnected.” By combining DBT with the 12 steps, people in recovery have a full toolkit of coping strategies that can help them stay sober and rebuild relationships at the same time.

A New Way of Life

Addiction recovery isn’t just about quitting substances—it’s about learning new ways to cope, communicate, and build healthy relationships. 

For young adults considering treatment, it’s important to know that healing isn’t just about you—it’s about your support system, too. By working together, you and your family can break old patterns, build new skills, and create a foundation for lasting change.