Mountain View Health — Cognitive & Dialectical

CBT & DBT Therapy

Cognitive & Dialectical
Therapies in Seattle

Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) used as skills for cravings, relapse prevention, and distress tolerance within outpatient addiction treatment at Mountain View Health in Seattle.

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CBT & DBT Skills
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Seattle, WA

Understanding CBT & DBT

What is Cognitive & Dialectical Therapy?

Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are two talk therapies used in addiction treatment. Both help you identify and change the patterns of thought, emotion, and behavior that lead to substance use.

Cognitive Behavioral Therapy

CBT is a structured, goal-oriented therapy based on the connection between thoughts, feelings, and behaviors. It helps clients recognize the distorted thinking patterns that fuel cravings and substance use, and replace them with more accurate, balanced perspectives.

In practice, CBT sessions focus on identifying specific triggers, challenging automatic negative thoughts, and building healthier coping strategies. Clients build concrete skills they can use between sessions.

Dialectical Behavior Therapy

DBT was originally developed by Dr. Marsha Linehan and combines the change-focused tools of CBT with acceptance-based strategies drawn from mindfulness practice. The word “dialectical” refers to the balance between accepting yourself as you are and actively working toward change. DBT teaches four core skill sets:

Mindfulness — staying present and aware
Distress tolerance — getting through cravings and hard moments without using
Emotion regulation — understanding and managing intense feelings
Interpersonal effectiveness — communicating needs and setting boundaries

Our Approach

Built On Practical Skills

The clinical team uses CBT and DBT as skills inside addiction treatment. Together they help you recognize the thought patterns behind cravings, tolerate distress, and build healthier responses to triggers.

CBT Techniques

Reshape unhelpful thought patterns that fuel cravings and substance use with structured, skills-based Cognitive Behavioral Therapy.

DBT Skills Training

Build mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness — the four core DBT skill sets.

Plans Based on Your Assessment

Your assessment shapes how CBT and DBT skills fit into your care, and the plan is reviewed as you progress.

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Our Approach

How CBT & DBT Are Used In Addiction Treatment

Cognitive Behavioral Therapy and Dialectical Behavior Therapy are taught as practical skills within outpatient addiction treatment. The clinical team draws on both as your needs change.

CBT Skills For Recovery

Spotting the triggers that lead to drinking or drug use
Challenging thoughts that make relapse feel inevitable
Planning ahead for high-risk situations
Building healthier coping strategies for cravings

DBT Skills For Recovery

Distress tolerance for cravings and hard moments
Mindfulness to stay present when urges rise
Emotion regulation without turning to substances
Interpersonal skills for setting boundaries

Who It Helps

Who Benefits From CBT & DBT

CBT and DBT help most when distorted thinking, intense distress, and habits around using make recovery harder.

Cravings & Triggers

Ideal for clients who notice cravings rising in certain places, moods, or moments. CBT helps identify and reshape the thinking that fuels them.

Relapse Prevention

For clients who want a plan before a high-risk moment arrives. CBT and DBT build concrete steps for what to do when urges rise.

Distress That Pushes Toward Use

For those who reach for a substance when emotions run high. DBT’s skill-building framework provides concrete tools for getting through those moments.

Relationship Challenges

Individuals who struggle with conflict, boundaries, or communication benefit from DBT’s interpersonal effectiveness skills.

Early Recovery

Clients in the first weeks of treatment who need practical tools they can use between sessions, not only during them.

Ongoing Recovery

Clients in later recovery who need cognitive tools to manage cravings, reframe high-risk thinking, and build a sustainable sober life.

Common Questions

Frequently Asked Questions

What is the difference between CBT and DBT?

Cognitive Behavioral Therapy (CBT) focuses on spotting and changing the thought patterns that lead to cravings and substance use. Dialectical Behavior Therapy (DBT) builds on CBT by adding skills in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. CBT fits best when distorted thinking and avoidance drive use, while DBT helps most when intense distress is what pushes you toward using.

How long does CBT or DBT therapy take to work?

The timeline depends on your level of care, how often you attend sessions, and how much you practice skills between sessions. Skill-building takes consistent practice. Your care team reviews your progress with you and adjusts the plan as your recovery changes.

Does insurance cover CBT and DBT therapy?

Coverage depends on your plan and your level of care. Mountain View Health offers free benefits verification before you start, which shows what your plan covers for PHP, IOP, and OP. Verification is not a guarantee of coverage, because your insurer makes the final decision.

Is CBT or DBT better for addiction recovery?

Both are used in addiction treatment, and the right choice depends on what drives the substance use. CBT helps you identify the thoughts and triggers that lead to drinking or drug use and build healthier coping strategies, so it fits relapse prevention well. DBT often fits when intense distress and impulsive reactions push you toward using.

Can CBT and DBT be done through telehealth?

Yes, for the virtual intensive outpatient program, which serves adults anywhere in Washington. Both therapies translate well to virtual sessions, though some clients prefer in-person work at our Seattle clinic.

What do CBT and DBT help with in addiction treatment?

In addiction treatment, CBT and DBT are skills-based therapies. They help you recognize triggers, plan for cravings, build relapse prevention habits, tolerate distress without using, and set boundaries with the people around you.

What happens in a typical CBT or DBT session?

A CBT session starts with a check-in and agenda-setting, followed by reviewing homework, working through a specific thought pattern, and assigning new exercises. DBT sessions often include a diary card review, targeted skills work, and rehearsal of strategies for upcoming challenges.

How do I know if CBT or DBT is right for me?

The best way to know is a clinical assessment. During your assessment at Mountain View Health, the clinical team will discuss your substance use, history, and goals, then recommend where to start. Generally, CBT may be a strong starting point for thoughts that lead to cravings; DBT may fit better if distress and impulsive reactions lead to use.

Benefits Verification

Free Verification.
No Obligation.

Benefits verification is free, carries no obligation, and starts from a secure form. Admissions explains what your plan covers so you know your next step.

How The Process Works

01
Secure Submission
Provide your basic policy info through our secure form. Submitting it is confidential and carries no obligation.
02
Admissions Review
Admissions checks what your plan covers for partial hospitalization, intensive outpatient, and outpatient care.
03
Clear Guidance
If your plan can be run, a written breakdown usually arrives within 1 to 2 hours. It is not a guarantee of coverage.