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

  • Mandy D. Owens
  • Erica Nason
  • Elizabeth Yeater
Clinical Case Studies


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.


Case study Borderline personality disorder Substance use disorder Dialectical behavior therapy Gender Case formulation 


Compliance with Ethical Standards

Conflicts of Interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Informed Consent

Informed consent was not required for the client in this case study.


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Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2017

Authors and Affiliations

  1. 1.Health Services Research & Development, Center of Innovation for Veteran-Centered Value-Driven CareVeterans Affairs Puget Sound Health Care SystemSeattleUSA
  2. 2.Texas State UniversitySan MarcosUSA
  3. 3.University of New MexicoAlbuquerqueUSA

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