DBT Versus CBT: A Comparison

If you’re living with mental health challenges, various treatment options may be recommended to help relieve symptoms. These treatment options could include various types of talk therapy, including Dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT). These two therapy methods are used by mental health professionals to treat a range of mental health disorders, including depression, anxiety, eating disorders, and substance use disorders. Both DBT and CBT typically involve regular therapy sessions with a mental health professional. 

Although DBT and CBT are similar types of therapy that can help people cope with various problems, they differ in some important ways. In rare cases, DBT and CBT may be used together. Depending on the problems you’re facing, you may want to speak with a mental health professional and try different types of talk therapy. To start, it may be beneficial to learn more about CBT and DBT are and what each method entails. 

What is cognitive behavioral therapy (CBT)?

To understand the differences between CBT and DBT, it can be helpful important to first recognize the characteristics of CBT. CBT, or cognitive behavioral therapy, is a widely used form of talk therapy that aims to help individuals understand how their thoughts affect their emotions and behaviors. 

CBT often focuses on helping people identify and change negative thinking patterns and behaviors, while encouraging healthier ways to cope. By changing unhealthy thought patterns, CBT may help improve emotional well-being and overall mental health.

Some of the key elements of CBT include:

Challenging and reframing negative thoughts and beliefs can help a person develop more balanced and useful thought patterns. This process may involve identifying cognitive distortions and replacing them with more rational and accurate thoughts.

Psychological activation

Engaging in certain activities and new behaviors may help improve mood and counteract mental health challenges. By participating in enjoyable or meaningful activities, individuals may be able to break the patterns of negative thinking associated with mental health disorders.

Problem-solving

Applying problem-solving strategies may help individuals approach real-life challenges. This component can help individuals break down problems into manageable steps, think about possible solutions, and use strategies to solve specific challenges.

Goal setting

Establishing specific, measurable, achievable, relevant, and time-bound (SMART) goals may help improve therapy progress. Setting clear and attainable goals promotes motivation, commitment, and a sense of accomplishment as individuals work towards their desired outcomes.

A mental health professional may guide the CBT process through individual or group sessions. The process might involve setting goals, learning coping skills, and practicing new behaviors.

What is dialectical behavior therapy (DBT)?

Dialectical behavior therapy (DBT), on the other hand, is a type of therapy that may be helpful for individuals who experience intense emotions, including those with bipolar disorder or borderline personality disorder (BPD). As a modified version of CBT, DBT helps people learn how to manage stress, control emotions, and improve interpersonal relationships.

DBT focuses on essential skills that work together to promote overall well-being. Some of the main components of DBT include:

Mindfulness

Mindfulness involves paying attention to the present moment without judgment. By practicing mindfulness, individuals can become more aware of their thoughts, feelings, and actions. This may help them respond more effectively to challenging situations. 

Emotion control

Emotion control is the ability to understand, manage, and express emotions in a healthy way. DBT teaches skills for recognizing and labeling emotions as well as changing unwanted emotions. Through controlling emotions, people with mental health challenges can start to feel more emotionally balanced and stable.

Interpersonal effectiveness

Interpersonal effectiveness focuses on building and maintaining positive relationships with others. DBT can help individuals communicate better, set boundaries, and assert their needs while respecting themselves and empathizing with others. These skills may lead to stronger relationships and reduced conflict.

Distress tolerance

Distress tolerance involves learning to cope with emotional distress without resorting to harmful behaviors. DBT teaches strategies like self-soothing and distraction to help individuals manage difficult emotions and situations. 

DBT skills may be developed through individual therapy, group skills training, and phone coaching. Through practice in various settings, individuals can experience long-lasting change and improved emotional well-being.

The effectiveness of DBT and CBT for mental health disorders

CBT has been shown to be effective in treating depression and various mental health disorders, including anxiety, depression, and post-traumatic stress disorder. CBT has also been used to treat eating disorders and substance use disorders as it may help affected people resist cravings and identify potential triggers. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Like CBT, DBT can effectively address a variety of mental health challenges, including anxiety disorders. However, the specific focus on emotional control and interpersonal effectiveness in DBT can be especially helpful for those living with BPD or similarly severe conditions.

Main differences in DBT vs. CBT

CBT and DBT are both evidence-based forms of psychotherapy, but they differ in their focus, techniques, and target populations. Here's a summary of their main differences: 

Theoretical foundation

CBT is based on the cognitive model, which posits that thoughts, feelings, and behaviors are interconnected and that changing unhelpful thought patterns may improve emotions and behavior. DBT is a specific form of CBT that includes elements from other therapeutic approaches, including Zen Buddhism and acceptance-based therapies. DBT therapy was first developed to treat borderline personality disorder and has since been used to treat other mental health conditions. 

Focus

CBT focuses on identifying and changing negative thought patterns and beliefs to improve emotional well-being and behavior. DBT emphasizes the dialectical process, which seeks to balance acceptance with the need for change. This approach may help individuals develop emotional control, distress tolerance, interpersonal effectiveness, and mindfulness skills. 

Techniques

CBT uses various techniques, including cognitive restructuring, behavioral experiments, and exposure therapy, to help individuals challenge or modify their thought patterns and behaviors. DBT may involve specific skills training modules, including mindfulness, interpersonal effectiveness, emotion control, and distress tolerance. DBT can also include individual therapy, group therapy for skills training, phone coaching, and therapist consultation teams. 

Target clients

CBT is a versatile therapy that can be applied to a wide range of mental health conditions, including anxiety disorders, depression, eating disorders, and obsessive-compulsive disorder among others. DBT was initially developed for individuals with borderline personality disorder, but it has since been adapted for other groups of people (like those with substance use disorders, eating disorders, and complex PTSD.)

Can DBT and CBT techniques be combined?

DBT and CBT are sometimes blended, depending on the individual and the mental health disorder being treated. Both therapies emphasize identifying and changing undesirable thought patterns and behaviors. 

DBT builds upon the principles of CBT but goes a step further by focusing on the interpersonal aspects, self-awareness, and the dialectical balance of acceptance and change. Combining these therapies could provide a well-rounded treatment approach, addressing a wider range of challenges for people with certain mental health challenges. Combining elements from both CBT and DBT might be especially helpful for those experiencing difficulties with emotion control, interpersonal challenges, and co-occurring disorders.

A qualified mental health professional can provide guidance in using CBT or DBT techniques for specific needs. The flexibility of these therapy options can allow individuals and their therapists to create personalized coping strategies.

Choosing the right therapy for your mental health needs

When seeking therapy for mental health challenges, you may want to understand the differences between CBT and DBT. You can then discuss the most appropriate treatment with a mental health professional. Both therapies are considered types of talk therapy aimed at helping individuals cope with emotional and psychological challenges.

To determine which therapy is best for you, consider your specific needs and symptoms. If you have difficulty with emotional control, interpersonal relationships, or self-harming behaviors, DBT may be more suitable. For addressing negative thought patterns and beliefs, CBT might be a better fit.

Seeking therapy has become easier through platforms like BetterHelp, which provides online therapy sessions. Teletherapy offers convenience and flexibility, allowing you to attend sessions from the comfort of your home. For someone with mental health challenges, seeking care from home can reduce feelings of stress and anxiety often associated with office-based therapy sessions. It can also save time by eliminating the need for a commute.  

Research in the field of mental health has confirmed the effectiveness of cognitive behavioral therapy (CBT) when delivered online. A recent study demonstrated the ability for internet-based CBT to reduce psychological distress and alleviate symptoms of depression and anxiety. Another study revealed that online DBT can be just as effective as in-person sessions.