If you’ve ever scrolled through a mental health forum or chatted with friends about therapy, you’ve probably stumbled upon the acronyms CBT and DBT. And, let’s be real, the world of psychotherapy can feel like a maze of jargon and technical terms. So, what’s the deal with these two? Aren’t all therapies the same? Well, not quite.
In this article, we’ll dive deep into the two commonly used psychotherapies — Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). We’ll explore their similarities and differences, and help you determine which therapy is more suitable.
What’s Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy (CBT) was developed in the 1960s by psychiatrist Aaron Beck and grew in popularity during the 1980s and 1990s. It is a form of psychotherapy that focuses on the relationship between an individual’s thoughts, feelings, and behaviors. The therapy aims to challenge and unlearn negative self-talk behavior patterns, and help individuals adopt healthier thinking and habits.
Applications of CBT
CBT is widely recognized for its effectiveness in treating anxiety disorders, such as generalized anxiety, phobias, and obsessive-compulsive disorder (OCD). CBT has also been proven beneficial in alleviating symptoms of post-traumatic stress disorder (PTSD), depression, and insomnia.
In recent years, CBT has demonstrated significant benefits for individuals facing eating disorders, body dysmorphic disorder (BDD), and managing mental health aspects associated with chronic health conditions, including multiple sclerosis, fibromyalgia, amyotrophic lateral sclerosis (ALS), and Parkinson’s disease. By challenging negative thought patterns and behaviors, CBT empowers individuals to manage their symptoms, adopt positive lifestyle changes, and enhance their overall quality of life.
What’s Dialectical Behavior Therapy?
Dialectical behavioral therapy (DBT) was developed in the late 1980s by Marsha Linehan and is an extension of CBT. Linehan believed that some individuals require an added emphasis on acceptance and validation of their emotions to see improvement in their quality of life.
DBT) is a transformative treatment for individuals grappling with intense emotions. It equips them with invaluable coping mechanisms and self-regulation techniques. DBT is widely utilized in supporting individuals with borderline personality disorder (BPD), severe mental illnesses, self-harm behaviors, and suicidal behavior. By integrating mindfulness techniques, emotion regulation, distress tolerance, and interpersonal effectiveness skills, this treatment empowers individuals to navigate their emotions and cultivate overall well-being.
Applications of DBT
DBT is effective for BPD, harmful behaviors and suicidal thoughts, substance abuse disorders, anger management, eating disorders, and bipolar disorder.
By emphasizing interpersonal skills, informed lifestyle choices, and conflict management, this approach equips individuals with strategies to navigate emotions and overcome conflicts. As a result, it works well in conjunction with couple and family therapies, and assists children and adolescents with learning disabilities.
Similarities Between CBT and DBT
As DBT is an extension of CBT, these two approaches share several similarities:
- Cognitive Behavioral Techniques: Both are considered cognitive behavioral approaches that aim to identify and challenge negative thoughts and behaviors.
- Goal-Oriented: Both short-term therapies are structured and goal-oriented, offering a clear path to solving current problems and acquiring valuable skills for future challenges. They promote personal growth and boost confidence.
- Homework Assignments: You’ll receive homework to practice learned skills outside sessions, reinforcing what you’ve learned and facilitating progress.
- Evidence-Based: Both have extensive scientific evidence supporting their effectiveness in treating mental health disorders, instilling confidence in the therapy process.
- Focus on the Present: While addressing past traumas and issues, both therapies primarily concentrate on current behavior and situations. They provide practical strategies for positive change and overall well-being.
- Collaborative Nature: Both therapies foster a supportive relationship between you and your therapist. Your therapist serves as a guide and coach, creating a safe space for exploration and facilitating personal growth and transformation.
Key Differences Between CBT and DBT
Within CBT, therapists offer individuals a nurturing environment where they can explore their thoughts and emotions. The primary focus is learning ways to change unhelpful thoughts and behaviors..
DBT, on the other hand, encourages individuals to accept their thoughts, emotions, and behaviors. It aims to help individuals develop strategies to change unhealthy behaviors.
Theoretical Distinctions Between CBT and DBT
CBT is considered a “second wave” of the original CBT treatment. It emphasizes the significant impact of our thoughts on our emotions and actions. This approach highlights the complex interconnectedness of emotions, thoughts, behaviors, and bodily sensations. Essentially, our mental processes shape our emotional responses. During challenging times, we may fall into thought patterns that amplify our discomfort. These thought patterns are synonymous with the term “cognitive distortions”. These distortions can give rise to negative emotions, which then manifest in maladaptive behaviors.
As the “third-wave” of the original CBT treatment, DBT recognizes that difficulty in managing emotions is the underlying cause of negative behaviors. Individuals who struggle with emotional regulation may resort to self-destructive behaviors as coping mechanisms. DBT therapists work with individuals to identify and address these underlying emotions, leading to more adaptive behaviors.
Differences in Therapy Focus and Goals
CBT focuses on reshaping negative thoughts and behaviors. In therapy, therapists help individuals identify and challenge maladaptive thoughts and behaviors, replacing them with constructive alternatives. CBT’s greatest strength is fostering healthier thinking and belief patterns.
- Confronting fears when used to treat anxiety-related, trauma-related, or obsessive compulsive spectrum disorder.
- Cultivating effective problem-solving skills.
- Using calming techniques and role-playing to overcome obstacles.
- Boosting confidence, self-awareness, and self-worth.
DBT builds upon the CBT foundation. However, what sets DBT apart is its focus on finding a balance between acceptance and change, integrating opposing forces. DBT treatment takes a different approach by emphasizing mindfulness and self-validation. The journey involves adopting a more accepting stance that contrasts with the CBT challenge-centric process.
A DBT journey involves these core skills:
- Mindfulness Skills: These skills hone one’s ability to remain grounded in the present, navigating the world calmly and purposefully. By emphasizing mindfulness practices, individuals learn to approach situations without being overwhelmed by raw emotions, fostering constructive actions.
- Distress Tolerance Skills: These techniques are for those high-emotion moments. They allow individuals to self-soothe, rather than being swallowed whole by emotions or shunning them. Ultimately, they enable individuals to make better decisions and act without succumbing to destructive emotional impulses. The components include crisis survival skills, ensuring one avoids exacerbating situations, and reality acceptance skills, which guide responses to life’s more painful challenges.
- Interpersonal Effectiveness Skills: This aspect is all about cultivating healthy relationships. It aids individuals in recognizing their relational needs, empowering them to interact constructively with others. It is where individuals learn about mutual respect, better communication skills, and strategies for managing relationship hurdles.
- Emotion Regulation Skills: DBT offers a roadmap for individuals struggling with intense emotions. It guides individuals to develop skills to acknowledge their emotions and how they should express them in more appropriate ways. Over time, they develop better emotional health.
Comparing Therapy Approaches: CBT vs. DBT
CBT involves personalized sessions between therapist and client, fostering a strong connection. This goal-oriented approach focuses on addressing specific challenges with clear objectives. As clients achieve their goals, therapy concludes, marking a successful journey of growth and transformation.
Unlike CBT, DBT usually takes place in both individual therapy and group skills training. This approach allows for peer support and the use of new-learned skills to build interpersonal skills.
For individuals who become anxious around groups, individual therapy modalities are available. Melissa Galicia, a certified licensed professional counselor specializing in both CBT and DBT, explains that “it generally means more lifting on the therapist since the group motivation is gone, but otherwise, outcomes are positive… DBT can also provide a strong framework for reducing lies and improving honest open communication. As long as the patient is willing, including family means consistent reinforcement of transparency while the patient practices mindfulness, interpersonal growth, and emotional regulation.”
Which Therapy Option is Right for You?
The best way to decide if CBT or DBT is suitable for you is to consult with a mental health professional. During an initial consultation, the therapist will assess your needs based on your unique concerns, personality, and personal preferences.
If you suffer from a combination of mental health disorders or have a history of trauma, DBT may be more effective in treating your condition. Melissa Galica explains that “CBT principles are already integrated into DBT, specifically how CBT works to reframe unhelpful thought patterns.” Ultimately, the therapy’s effectiveness depends on “one’s behavior, active engagement in therapy sessions, and their ability to apply therapeutic insights to real-world situations.”
CBT principles are already integrated into DBT, specifically how CBT works to reframe unhelpful thought patterns.
- Melissa Galica, LPC
If neither CBT or DBT feels right, don’t give up. There are many other types of CBT approaches and talk therapy options that may offer the support and tools you need to manage your mental health. Remember, finding the right therapy approach is a personal process, and it may take some time and experimentation to find the best fit.
How to Find a CBT or DBT Therapist?
If you have decided that CBT therapy or DBT therapy is right for you, the next step is to find a qualified therapist that fits your needs. You can start by asking your primary healthcare physician for recommendations. You can also search online for therapists specializing in these types of therapies. Research studies find that online therapy is just as effective as in-person therapy, so don’t shy away from this option if it suits your needs.
Start Your Healing Journey Today
Both CBT and DBT therapies provide effective tools for managing mental health disorders. The key is to find the right approach for you and to be consistent with your therapy sessions. With patience, determination, and the support of a qualified therapist, you can begin your journey toward healing and improved well-being.
Seeking help isn’t a sign of weakness, but a brave and important step toward self-love. At Grow Therapy, we want to support you in finding the best therapy approach for your unique needs. To allow you easy access to therapy services, we have established an online platform that connects you with highly qualified therapists from the comfort of your own home. Don’t hesitate to reach out and start your healing journey today.
