Comparing Cognitive Behavioral Therapy and Dialectical Behavior Therapy

Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are two forms of psychotherapy that have gained widespread popularity over the past few decades. While both are evidence-based therapies that are effective in treating a range of mental health conditions, they differ in their approach and techniques. Though DBT is technically a subtype of CBT, with both harnessing changes in thoughts and behavior patterns, DBT does differ from other forms of CBT—we’ll just call those other types “CBT” here—in important ways.  CBT seeks to give people the ability to recognize when their thoughts and actions might become troublesome, and gives them techniques to modify those thoughts and adopt more effective actions. DBT helps people find ways to accept themselves, feel safe, and manage their emotions to help regulate potentially destructive or harmful behaviors. 

What is Cognitive Behavioral Therapy (CBT)?

CBT is a type of psychotherapy that focuses on changing negative or distorted thinking patterns, beliefs, and behaviors. The goal of CBT is to help individuals develop healthier thought patterns and behaviors by identifying and challenging negative or irrational beliefs. The underlying assumption of CBT is that our thoughts, feelings, and behaviors are interconnected, and that changing one of these components can lead to changes in the others. 

CBT is a structured and goal-oriented therapy that typically involves a series of lessons. During these lessons, individuals work to identify and challenge negative thinking patterns and try out new behaviors. This is done through a variety of techniques, including cognitive restructuring, behavioral activation, and exposure therapy. CBT has been found to be effective in treating a range of mental health conditions, including anxiety, depression, insomnia, and stress. 

What is Dialectical Behavior Therapy (DBT)?

DBT was developed to treat individuals who experience emotions very intensely. It’s a common therapy for people with borderline personality disorder (BPD). DBT combines cognitive-behavioral techniques with mindfulness-based approaches to help individuals regulate their emotions, improve their interpersonal relationships, and develop coping skills. The term “dialectical” refers to the fact that DBT balances acceptance and change-oriented strategies. 

DBT is a structured therapy that typically involves weekly individual therapy sessions, skills training groups, and phone coaching. The skills taught in DBT include mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills are designed to help individuals cope with difficult emotions and develop healthier ways of relating to others. While DBT was originally developed to treat individuals with BPD, it has been found to be effective in treating a range of mental health difficulties, including suicidal behavior, self-harm, substance use disorders, eating disorders, and post-traumatic stress disorder (PTSD). 

Key Differences Between CBT and DBT

  1. Target population: CBT can be used to treat a wide range of mental health conditions such as depression, anxiety, social anxiety, panic, substance use, and insomnia. DBT was specifically developed to treat individuals who have difficulty managing and regulating their emotions, with conditions such as borderline personality disorder (BPD) self-harm, suicidal behaviors, PTSD, substance use disorder, eating disorders including binging and bulimia, depression, and anxiety. 
  2. Focus: While both therapies focus on changing unhelpful thinking patterns and behaviors, DBT places a greater emphasis on learning to tolerate strong emotions—and employs distraction techniques which are expressly ruled-out in most other CBT models, emotional regulation, and effective interpersonal. 
  3. Structure: CBT is typically a briefer series of lessons, while DBT is a longer-term therapy that can last up to a year or more. 

Selecting a Therapy

Both CBT and DBT are evidence-based therapies that have been shown to be effective in treating a range of mental health conditions. The choice of therapy will depend on individual needs and preferences. For those who struggle with depression, anxiety, panic, insomnia, or substance use, CBT may be a good fit. If a person’s problems are related to emotional regulation or chaotic interpersonal relationships, DBT may be a better fit.  

In many cases, the best way to determine which therapy is right for you is to consult with a mental health professional.