The promise of third-wave behavioral therapies in the treatment of substance use disorders
Open accessAbstract
Substance use disorders are common and frequently complex, with overlapping medical, legal, social and psychiatric problems. Innovative treatment models to address the full range of problems in new ways using common principles are needed. Third wave behavior therapies such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT) comprise novel approaches and methods that have great potential to address complex substance abuse cases. These treatment models derive from contextual and behavioral science and have a common emphasis on developing empirical, principle-driven methods for approaching unwanted or distressing psychological and physical experiences common to substance use and other disorders. Randomized controlled trials targeting substance use with ACT and DBT have been conducted across varying populations, including various target substances (opiates, methamphetamine, polysubstance) and settings (prisons, methadone clinics, residential treatment, and outpatient). Despite methodological heterogeneity, ACT and DBT have compared favorably to passive and active control conditions. Further research is needed, however, with larger samples and active control conditions, along with studies of treatment mechanisms, to inform and shape theoretical models and substance abuse treatment protocols for enhanced efficacy.
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Third-wave treatment among users of different substance categories produced a significant reduction in drug use and better retention than treatment as usual.
“Third-wave treatment among users of different substance categories also produced encouraging results in which there was a significant reduction in drug use but also a better retention than in treatment as usual (56).”
From Mobile intervention for individuals with psychosis, dual disorders, and their common comorbidities: A literature review (2019) · cites this paper as [56]
The Dialectical Behavior Therapy section reports that, compared with community treatment as usual, participants receiving DBT had better retention (64% versus 27%) and significant reductions in drug use. But that trial enrolled polysubstance-dependent people with co-morbid borderline personality disorder; the claim omits this restriction and suggests the result applies broadly to users of different substance categories. (LLM, conf=0.87)
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Jo, D., Qiu, L., Zvolensky, M. J., & Buckner, J. D. (2026) · Substance Use & Misuse · doi:10.1080/10826084.2026.2711947
- Authors
- Stotts, A. L., & Northrup, T. F.
- Affiliations
- The University of Texas Health Science Center at Houston (US)
- Corresponding author
- Stotts, Angela L
- Venue
- Current Opinion in Psychology
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 2
- Pages
- 75-81
- ISSN
- 2352-250X (ISSN-L)
- PMC
- PMC4674809
- OpenAlex
- W2007227690
- Cited by
- 70
- References
- 30
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 3 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 9 · 2019: 9 · 2018: 5 · 2017: 3 · 2016: 1 · 2015: 4
- FWCI
- 0.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Department of Biotechnology, Ministry of Science and Technology, India
- National Institutes of Health (5p50da009262-20)
- National Institute on Drug Abuse (#P50 DA009262, R01DA019436)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- substance use disorders, acceptance and commitment therapy, dialectical behavior therapy, addiction treatment, polydrug use, opioid use, methamphetamine use, therapeutic mechanisms, treatment efficacy
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