There are many types of therapy used to treat mental health issues. Two of the most widely used therapeutic methods include Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). CBT and DBT belong to a class of treatments that fall under psychotherapy, more commonly recognized as talk therapy. This helps individuals solve problems, change behavior, and improve their overall wellbeing.

These two types of therapy have many things in common, but they also have significant differences. Here, we’ll discuss CBT vs. DBT and how each type of therapy can help individuals in need.

What is CBT?

CBT or cognitive behavioral therapy is a type of psychotherapeutic intervention that helps people recognize negative thinking patterns and how these impact their behaviors. With the help of a therapist, one can restructure their thoughts and behaviors in healthier ways.

While CBT is most often used to treat individuals with mental health conditions, this type of therapy is not exclusive to them. Others can also take advantage of CBT to improve their thoughts and behaviors that may be affected by problems in life, such as stress and other more specific circumstances. CBT can also be used by people of all ages.

What are the Similarities Between CBT and DBT?

CBT and DBT therapy are closely related. DBT actually stems from CBT, branching out to include more techniques in mindfulness and emotional regulation.

Both CBT and DBT involve talking to a therapist about negative thoughts and challenges in life. For instance, teens may be stressed about the many responsibilities they have to juggle and start to form overly-negative perceptions about themselves and the world. Such problems can be treated through talk therapy, where you discuss your thoughts and feelings with a professional.

Whether a person chooses CBT or DBT, they will encounter the same fundamental ideas about feelings, behaviors, and thoughts. More specifically, these therapies focus on the relationship between thoughts and actions and aim to help people increase self-awareness, reassess self-destructive behaviors, and form better habits.

Both treatments also emphasize the therapeutic relationship between the therapist and client and typically require homework or assignments in between sessions.

What are the Differences Between CBT and DBT?

Even though CBT and DBT are similar in many ways, they also have some fundamental differences that make them suitable for treating different conditions.

Goals

One of the key differences between CBT and DBT is the goal of the therapy. CBT aims to redirect thought patterns. This is done by increasing the patient’s awareness when they make negative interpretations, followed by developing alternative ways of thinking and behaving to reduce psychological distress.

On the other hand, DBT is more focused on managing the relationship between acceptance and change. Its goal is to help clients adopt positive mental and behavioral changes through the process of validation and acceptance. This type of therapy also aims to help individuals regulate intense emotions and improve interpersonal relationships.

Philosophies

The emphasis on reasoning and rationale in CBT comes from its roots in stoic philosophy and the Socratic Method, which encourages critical thinking and draws out underlying assumptions. It helps individuals with conditions such as anxiety and depression see their issues from a more logical perspective.

DBT is based on mindfulness techniques that are found in Buddhist and Zen practices. This type of therapy emphasizes accepting things as they are rather than forcing change.

Sessions

Another main difference between the two therapies is how sessions are conducted. CBT is typically completed in short intervals as the therapist focuses on specific problems raised by the patient. This allows clients to work towards a set goal, which, once met, concludes the need for CBT. In contrast, DBT occurs over longer periods of time. This allows both the therapist and the client to see the context underlying the need for treatment.

In CBT sessions, therapy is almost always in a one-on-one setting. While the same approach is used for DBT, group interventions are more common in the latter. Both methods will give clients tasks to work on outside of therapy to supplement the treatment process.

Uses

Depending on the client’s concern, CBT or DBT may be the more suitable form of treatment.

CBT is generally used to improve the symptoms of mental health conditions like depression, anxiety, phobias, and PTSD. It is effective because it teaches the patient how to challenge negative thoughts and behaviors and replace them with more helpful ones. This can reframe one’s thinking during experiences involving anxiety or depression.

While DBT was developed primarily for BPD, it is also used for the effective treatment of multiple diagnoses that cause difficulty with emotional regulation, distress tolerance, interpersonal relationships, and impulsivity.

In some cases, a combination of both types of therapy may be used to treat symptoms.

How to Know CBT or DBT is Right for You?

CBT emphasizes the relationship between thinking and behavior, making it suitable for people who are dealing with specific problems. It is an effective way of reworking thought patterns to produce positive behavioral results. On the other hand, if an individual has difficulty managing and regulating emotions, then DBT may be a more appropriate approach.

However, it is important to remember that each illness or set of symptoms responds differently to treatment techniques. Seeing a licensed professional will help you determine the best treatment options, whether you are diagnosed or not. Consulting a therapist will also provide direction on how you can use your resources and skills in the recovery process.

CBT vs. DBT FAQs

Which is better for treating anxiety?

Some studies[*] have found that CBT can greatly reduce symptoms of anxiety compared to DBT. CBT alleviates anxiety by interrupting and changing the pattern of worried thoughts that feed it. This also helps reduce avoidant behaviors associated with anxiety.

Which is better for treating depression?

Other research2[*] has shown that CBT is an effective treatment for depression, which is also supported by the previously mentioned study. CBT treats depressive symptoms by helping the patient recognize and adjust their negative thinking patterns and behavior.

What are the limitations of DBT?

While DBT has many advantages, it also has several limitations.

DBT needs a significant time commitment from both the client and the therapist. Some patients may find it difficult to adhere to the treatment given its long time frame. Additionally, not everyone may be receptive to doing the work required outside of therapy for extended periods. Others may find that adhering to the DBT manual’s guidelines is too rigid.

This type of therapy also requires rigorous training to implement. This has, in effect, led to research studies with small sample sizes. Some of these lack the necessary post-treatment follow-ups to draw more conclusive results on its effectiveness.

The Bottom Line

CBT and DBT therapy methods are both helpful in treating individuals experiencing various mental illnesses. Deciding which one is best for you will depend on your specific symptoms and what type of treatment you are most comfortable with. Learning as much as you can about these methods is an important stepping stone to your wellbeing.

Remember, consulting a mental health professional is the best way to determine the best type of therapy for your needs.

For more CBT resources, check out our CBT worksheets. Our worksheets provide visual and written engagement to support different modalities of learning, which can enhance traditional talk or play therapy.

References:

1. Afshari B, Hasani J. Study of dialectical behavior therapy versus cognitive behavior therapy on emotion regulation and mindfulness in patients with generalized anxiety disorder. 2020
2. Walter D, Buschsieweke J, Dachs L et al. Effectiveness of usual-care cognitive-behavioral therapy for adolescents with depressive disorders rated by parents and patients – an observational study. 2021 August 24