Dialectical Behavior Therapy for Multiple Treatment Targets: A Case Study of a Male with Comorbid Personality and Substance Use Disorders

Dialectical behavior therapy has accrued substantial evidence as a treatment for individuals with borderline personality disorder. However, there are only two randomized clinical trials with individuals with comorbid substance use disorders. This case study presents Michael, a male client who sought treatment for his alcohol use, difficulties at work, and struggles with making and maintaining relationships. Michael engaged in dialectical behavior therapy that simultaneously addressed his substance use with comorbid borderline personality disorder. With this approach, the client exhibited reductions in substance use, suicidal ideation, self-harm, and increases in skillful behaviors. Results highlight the importance of continuing assessments with clients and using this information to inform therapy as well as provide an example of how trainees, with close supervision, can implement dialectical behavior therapy with a client with comorbid borderline personality and substance use disorders.