By Any Means Necessary: The Recovery Mindset That DBT, ACT, and CBT Actually Teach
There is a phrase that gets used a lot in recovery circles. Sometimes it is said quietly, almost to oneself, in a moment of real desperation. Sometimes it is said with a kind of fierce clarity that only comes when a person has finally decided they are done fighting themselves.
The phrase is: “By any means necessary.”
It carries weight. It means: I will do whatever it takes. I will use every resource available to me. I will not let pride, discomfort, or old habits stop me from making this change.
What is striking is that this idea, this mindset of determined, flexible, full-effort action, is not just recovery street wisdom. It is embedded in the most rigorously studied therapies in modern mental health and addiction treatment. DBT, ACT, and CBT each have their own version of it. And the research behind each one shows that this kind of determination, applied skillfully and grounded in healthy values, is one of the most powerful predictors of lasting recovery.
At Crow's Nest Ranch Outpatient in Truckee-Tahoe, California, we see this capacity in every client who walks through our doors. Our job is not to give it to them. Our job is to help them find it in themselves.
What "By Any Means Necessary" Actually Means in a Clinical Context
Before going further, it is worth naming one important distinction.
The phrase "by any means necessary" in its original usage implies that any action is acceptable if it achieves the goal. In addiction recovery, that framing is dangerous. Plenty of people have tried to get through withdrawal, grief, or a hard day by any means available, and those means included the very substances or behaviors that brought them into treatment.
What clinical science has developed is something more precise and more powerful: use any effective, healthy, and values-consistent strategy available. The determination stays the same. What changes is the boundaries around the actions. As psychologist and DBT founder Marsha Linehan put it, the goal is not survival at any cost. It is building a life worth living, using every skill you can access to get there [1].
That reframe is not a limitation. It is the whole game.
DBT: "Do What Works"
Dialectical Behavior Therapy was developed in the late 1980s by Marsha Linehan at the University of Washington. It was originally designed for individuals with borderline personality disorder and chronic suicidality, many of whom also struggled with substance use. It has since become one of the most well-supported therapies in the addiction treatment field [2].
At the center of DBT is a concept called effectiveness, which is one of the core mindfulness skills in the curriculum. The principle is straightforward: choose behaviors based on whether they actually move you toward your goals, not based on whether they feel fair, seem easy, or match what you have always done.
In plain language, DBT's version of "by any means necessary" is: do what works.
If calling a friend at 11 pm keeps you sober, call. If leaving a party early keeps you sober, leave. If using a TIPP skill, which stands for Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation, breaks a crisis state before it becomes a relapse, use it. If going to bed two hours early removes a high-risk window, go to bed. DBT does not ask whether any of these things feel comfortable or impressive. It asks only whether they work.
A landmark randomized controlled trial published in the Archives of General Psychiatry found that patients who received DBT showed significantly greater reductions in substance use and better overall functioning compared to control groups, outcomes that held up at two-year follow-up [3]. A separate study published in the American Journal on Addictions found that DBT was specifically effective for patients with co-occurring substance use and borderline personality disorder, a population historically considered very difficult to treat [4].
The skill, in other words, is not just a slogan. It has a measurable clinical impact.
ACT: Do What Moves You Toward Who You Want to Be
Acceptance and Commitment Therapy, developed by psychologist Steven C. Hayes, takes a related but distinct approach. Where DBT asks "what works," ACT asks something a layer deeper: "what is workable in the service of your values?"
ACT is built on a concept called psychological flexibility, which is the ability to stay in contact with the present moment, accept difficult thoughts and feelings without being controlled by them, and take action guided by what genuinely matters to you rather than by urges, fears, or avoidance [5].
For someone in recovery, a core ACT question becomes: "Is what I am about to do moving me toward the person I want to be, or away from them?"
This matters because ACT research consistently shows that psychological inflexibility, the tendency to be rigidly controlled by thoughts, feelings, and urges rather than by chosen values, is one of the strongest predictors of continued substance use [6]. Conversely, building psychological flexibility through ACT has shown measurable improvements in abstinence rates, quality of life, and treatment engagement.
A study published in Behaviour Research and Therapy found that ACT produced significant improvements in psychological flexibility and that those improvements directly predicted better long-term outcomes across a range of mental health conditions including substance use disorders [5].
ACT's version of "by any means necessary" might sound like: take whatever workable, values-aligned action is available to you right now. The word workable is doing important clinical work there. It means actions that move you forward without creating new damage. It means willingness to feel discomfort while doing the right thing anyway. It is not passive acceptance. It is committed, value-driven action in the face of difficulty.
CBT: Use Every Healthy Coping Strategy Available
Cognitive Behavioral Therapy is the most widely practiced evidence-based therapy in the world, and in addiction treatment it remains a foundational modality. CBT's contribution to this mindset is built around two core ideas: coping flexibility and behavioral activation.
Coping flexibility is the ability to draw from a wide range of coping strategies depending on what the situation actually requires, rather than defaulting to a single habitual response [7]. Research by psychologist George Bonanno at Columbia University found that people who demonstrate coping flexibility, meaning they can shift strategies as circumstances change, show significantly better outcomes in the face of stress, loss, and adversity than those who rely on a fixed set of responses [7].
Behavioral activation addresses one of the most common traps in early recovery: waiting to feel ready before taking healthy action. CBT research consistently shows that taking action, even when motivation is low, produces the emotional and neurological changes that increase motivation over time, not the reverse [8]. A CBT therapist working with someone in recovery might say: use every healthy coping strategy available before acting on an urge. Not some of them. Not the ones that feel easy. Every one that is available and appropriate.
A comprehensive review published in the American Journal of Psychiatry confirmed that behavioral therapies, including CBT, produce robust and durable outcomes in substance use treatment, particularly when clients are actively engaged in learning and practicing coping skills [9].
The Common Thread: This Capacity Is Already in You
What is striking about all three of these frameworks, DBT's effectiveness, ACT's committed action, and CBT's flexible coping, is that none of them is designed to install something new in a person. They are designed to help a person access and develop something that is already there.
Psychologist Ann Masten at the University of Minnesota has spent decades studying resilience in human development. Her research found that resilience, the capacity to adapt and recover in the face of adversity, is not a rare trait found only in exceptional individuals. She called it "ordinary magic." It is, she found, a basic feature of human development, present across populations and contexts, and it activates most powerfully when people have access to supportive relationships, clear values, and practical skills [10].
Recovery researcher William White found something similar in his studies of long-term recovery: the people who sustain it are not the ones who were somehow different from the start. They are the ones who found, accessed, and continued to use every resource available to them, internal and external, to keep moving forward [11].
The determination already exists. The question is whether a person has been given the structure, the skills, and the support to direct it.
How Crow's Nest Ranch Outpatient Helps You Find It
Our role is not to fix a broken person. It is to work alongside a whole person who has been through something hard, and to help them access the resilience, the flexibility, and the determination that brought them here in the first place.
We use DBT skills training to help clients identify what actually works, not what seems fair or feels comfortable, but what genuinely moves them toward the life they want to be living. We use ACT to help clients get clear on their values and take committed action toward them, even when anxiety, cravings, or old thought patterns are loud. We use CBT to build the flexible coping toolkit that makes the difference between a difficult moment and a relapse.
And we situate all of that clinical work inside a holistic program that includes yoga, martial arts, outdoor adventure therapy, neurofeedback, EMDR, and personal training, because we know that the body and the environment are part of the recovery system too. Skills learned in a difficult hike or in a Muay Thai class transfer. The confidence that comes from doing something hard transfers.
We also know that no two people in recovery are the same. Person-centered care is not a marketing phrase for us. It is the clinical framework through which every treatment plan is built. Research from Ryan and Deci on self-determination theory consistently shows that people who experience autonomy, competence, and genuine connection in their treatment are significantly more likely to sustain recovery long-term [12]. That is what we are building toward in every session, every group, every conversation.
You already have the determination. You are here. We will help you turn it into a skill set, a value system, and a life that can hold it.
Are you ready to take that next step?
Let’s talk!
At Crow's Nest Ranch Outpatient in Truckee, California, every aspect of our clinical program is designed around a single belief: the capacity for change is already inside the person sitting across from us.
Sources Cited:
[1] Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press.
[2] Dimeff, L. A., & Linehan, M. M. (2008). Dialectical behavior therapy for substance abusers. Addiction Science and Clinical Practice, 4(2), 39-47. https://doi.org/10.1151/ascp084239
[3] Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757-766. https://doi.org/10.1001/archpsyc.63.7.757
[4] Linehan, M. M., Schmidt, H., Dimeff, L. A., Craft, J. C., Kanter, J., & Comtois, K. A. (1999). Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. American Journal on Addictions, 8(4), 279-292. https://doi.org/10.1080/105504999305686
[5] Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25. https://doi.org/10.1016/j.brat.2005.06.006
[6] Hayes, S. C., Wilson, K. G., Gifford, E. V., Bissett, R., Piasecki, M., Batten, S. V., Batten, S. V., & Gregg, J. (2004). A preliminary trial of twelve-step facilitation and acceptance and commitment therapy with polysubstance-abusing methadone-maintained opiate addicts. Behavior Therapy, 35(4), 667-688. https://doi.org/10.1016/S0005-7894(04)80014-5
[7] Bonanno, G. A., & Burton, C. L. (2013). Regulatory flexibility: An individual differences perspective on coping and emotion regulation. Perspectives on Psychological Science, 8(6), 591-612. https://doi.org/10.1177/1745691613504116
[8] Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., Gallop, R., McGlinchey, J. B., Markley, D. K., Gollan, J. K., Atkins, D. C., Dunner, D. L., & Jacobson, N. S. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74(4), 658-670. https://doi.org/10.1037/0022-006X.74.4.658
[9] Carroll, K. M., & Onken, L. S. (2005). Behavioral therapies for drug abuse. American Journal of Psychiatry, 162(8), 1452-1460. https://doi.org/10.1176/appi.ajp.162.8.1452
[10] Masten, A. S. (2001). Ordinary magic: Resilience processes in development. American Psychologist, 56(3), 227-238. https://doi.org/10.1037/0003-066X.56.3.227
[11] White, W. L. (2007). Addiction recovery: Its definition and conceptual boundaries. Journal of Substance Abuse Treatment, 33(3), 229-241. https://doi.org/10.1016/j.jsat.2007.04.015
[12] Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68-78. https://doi.org/10.1037/0003-066X.55.1.68