Therapy FAQ

CBT vs. DBT: Choosing the Best Therapy for Your Mental Wellness

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, […]

Therapist Dr. Jaclyn Gulotta By Jaclyn Gulotta, LMHC

Updated on Apr 30, 2024

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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:

  1. Cognitive Behavioral Techniques: Both are considered cognitive behavioral approaches that aim to identify and challenge negative thoughts and behaviors.
  2. 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.
  3. Homework Assignments: You’ll receive homework to practice learned skills outside sessions, reinforcing what you’ve learned and facilitating progress.
  4. Evidence-Based: Both have extensive scientific evidence supporting their effectiveness in treating mental health disorders, instilling confidence in the therapy process.
  5. 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.
  6. 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.

A CBT journey may involve:

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:

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.


  • CBT and DBT have strong connections, originating from their shared roots in cognitive-behavioral techniques. These therapies emphasize goal-setting and applying skills outside of sessions. They prioritize addressing current challenges and behaviors while valuing the therapeutic relationship.

  • CBT highlights the role of thoughts in shaping emotions and behaviors. It promotes self-awareness and problem-solving, empowering individuals to navigate life's challenges. On the other hand, DBT focuses on balancing acceptance and change. It centers on managing emotions, cultivating interpersonal effectiveness, and developing distress tolerance skills. Both approaches offer valuable insights and tools for personal growth and well-being.

  • Seeking guidance from a mental health professional is crucial. They'll personalize recommendations based on your unique experiences, challenges, and personality. Engaging in a conversation with your therapist about the pros and cons of each therapy can bring clarity and understanding.

About the author
Therapist Dr. Jaclyn Gulotta Jaclyn Gulotta, LMHC

Dr. Jaclyn Gulotta is a licensed mental health counselor with over 10 years of experience in the mental health field. She helps individuals overcome numerous issues, including stress and anxiety disorders, self-esteem issues, relationship issues, depression, behavioral issues, and grief.

This article is not meant to be a replacement for medical advice. We recommend speaking with a therapist for personalized information about your mental health. If you don’t currently have a therapist, we can connect you with one who can offer support and address any questions or concerns. If you or your child is experiencing a medical emergency, is considering harming themselves or others, or is otherwise in imminent danger, you should dial 9-1-1 and/or go to the nearest emergency room.

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