Third Wave Behavioral Treatment for Comorbid SUD and Emotional Disorders

Emotional disorders are highly comorbid with substance use disorders (SUD). Despite the increasing availability of evidence-based and integrative treatment modalities for SUD/emotional disorder(s) comorbidities, access to these treatments remains low and there is a critical need to improve existing treatments and develop novel, evidence-based interventions. Third wave, cognitive-behavioral therapy (CBT) interventions, which conceptually include Acceptance and Commitment Therapy, mindfulness-based interventions, Dialectical Behavioral Therapy, Metacognitive Therapy, and transdiagnostic approaches (e.g., Unified Protocol) offer an alternative approach to traditional CBT treatment strategies for the integrative treatment of comorbid SUD/emotional disorders. This chapter provides an overview of the extant literature on third wave, integrative interventions for comorbid SUD/emotional disorders. A synthesis of the relevant research is provided, and putative mechanisms of change in third wave interventions are presented. Case formulations, clinical implications and considerations, and limitations and suggestions for future directions are discussed.