What is the Difference Between CBT and DBT?

Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are two of the most common treatments for mental health challenges. Although CBT and DBT have many similarities, the two approaches are quite different.

For example, Cognitive Behavioral Therapy focuses on identifying and reframing unhelpful thoughts, while Dialectical Behavioral Therapy was created to teach people how to deal with challenging emotions and unstable moods. CBT focuses more on learning to think rationally while DBT prioritizes developing emotional regulation, stress management, and social skills.

Even though both types of therapy are highly effective, one type may be better suited for you, depending upon your individual needs. Understanding CBT and DBT and the goals, approaches, and benefits of these therapeutic approaches can help you determine the best type of therapy for you.

What Is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy focuses on identifying and changing destructive or disturbing thought patterns that negatively affect your behavior and emotions. CBT does this by focusing on changing automatic negative thoughts. Treatment with CBT can help you reframe unhelpful thoughts into helpful ones, which can help improve your behavior.

Automatic negative thoughts are a form of negative self-talk that occurs without you even being aware that you are forming the thought. More often than not, automatic negative thoughts are irrational beliefs that disturb your mental well-being. Most automatic negative thoughts are related to your life experiences and are fears or messages that you’ve internalized for years. When they occur, automatic negative thoughts can trigger anxiety, sadness, frustration, guilt, anger, or unworthiness.

Some common types of automatic negative thinking include:

  • Always/never thinking. This happens when you believe that something that happened will always repeat itself or that you’ll “never” get what you want.
  • Focusing on the negative. This occurs when you reflect on only the bad aspects of a situation and ignore the good aspects.
  • Fortune-telling. This automatic negative thinking occurs when we predict the worst possible outcome of a situation.
  • Mind-reading. Mind-reading happens when you think you know what others are thinking even though they haven’t told you directly. Usually, your assumptions are wrong.
  • Emotional reasoning. Believing automatic negative thoughts without ever questioning them is a typical example of emotional reasoning. This automatic negative thought can also include thinking “with your feelings” instead of your brain.
  • Should-statements. These statements, which can also include ``must,” “ought,” or “have to,” can cause you to feel guilty and “beat yourself up” when you don’t do what you think you should have done.
  • Labeling. You can prevent yourself from seeing the situation clearly when you attach a negative label to yourself or someone else (i.e., jerk, arrogant, irresponsible, or stupid).
  • Personalizing. This type of thinking occurs when you correlate non-harmful events with negative personal meaning. An example is thinking you did something wrong because your boss didn’t talk to you this morning.
  • Blaming. When you blame something or someone else for the challenges in your life, you victimize yourself and make doing anything about your situation very difficult.

Therapists call these automatic negative thoughts cognitive distortions. CBT focuses on identifying, challenging, and replacing these thoughts with more objective, helpful, and realistic thoughts.

What Is Dialectical Behavioral Therapy?

Dialectical Behavioral Therapy is a type of behavioral therapy. Like CBT, DBT is based on the idea that when you think and feel better, you behave better. Unlike CBT, however, DBT focuses more on the emotional component of mental health challenges.

In DBT, the primary goals are to teach you how to cope with stress in a healthy way, to regulate your emotions, live in the moment, and improve your relationships with others. DBT can help you accomplish these goals by teaching you four key strategies: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. As you learn and apply each of these skills, you’ll be better equipped to identify and change self-destructive thoughts that negatively affect your day-to-day life and close relationships.

  • Mindfulness can help you slow down and pay attention to your thoughts, feelings, impulses, and sensations. Focusing on the present moment can help you stay calm and use healthy coping skills when dealing with emotional pain.
  • Distress tolerance. In addition to helping you effectively handle a crisis, improving your distress tolerance can help you deal with challenging situations in a more positive way. Distress tolerance can also help you manage intense emotions.
  • Emotional regulation. Recognizing and coping with intense negative emotions can help you have more positive emotional experiences, making you less vulnerable to emotional distress and impulsive behavior.
  • Interpersonal effectiveness. Interpersonal skills such as listening and communicating more effectively can help you deal with difficult situations and individuals by establishing and maintaining healthy boundaries.

What Are The Differences Between CBT and DBT?

CBT and DBT are intended to treat different types of mental health challenges. Even though DBT seeks to build upon the foundation of CBT and enhance its effectiveness, the two approaches have different goals, techniques, philosophies, and types of sessions. Some of the most common differences between CBT and DBT include:

  • The Treatment Focus. CBT primarily focuses on helping you accomplish your goals around thinking and behavior. The core focus of DBT is to help you regulate your emotions so you can have better, healthier relationships. Additionally, CBT focuses on reasoning and rationale, while DBT relies heavily on mindfulness skills which are commonly used in Buddhist and Zen practices.
  • Both CBT and DBT can help improve your quality of life, but the two approaches have different goals. Cognitive behavioral therapy’s ultimate goal is to think and behave better, while DBT can help you better manage stressful situations and emotions.
  • Accomplishing your goals and improving your quality of life is the focus of CBT. Though CBT can help improve your relationship with others, it’s primarily about helping you think and behave better.
  • DBT focuses on connecting with people. In addition to helping you stay calm during emotionally charged situations, DBT teaches psychosocial skills that allow you to improve how you interact with others.
  • Skills Taught. Since CBT focuses on connecting thoughts, feelings, and behaviors, the specific skills taught depend on your needs. In contrast, DBT follows a set curriculum that teaches emotional regulation, acceptance, distress tolerance, and interpersonal skills.
  • Length of Treatment and Type of Sessions. CBT sessions generally last for a few weeks. DBT sessions can last for months. DBT typically involves a group therapy component to practice interpersonal skills. CBT can include group therapy but talking to your peers is not a standard or essential part of treatment.
  • Conditions They Help Treat. Research shows that CBT is a highly effective treatment for depression, anxiety disorders, obsessive-compulsive disorders, post-traumatic stress disorders, and phobias. DBT has been clinically proven effective for borderline personality disorders, eating disorders, self-harm, and substance use disorders. Since CBT focuses on changing problematic thinking and DBT focuses on regulating intense emotions, the two therapies have different uses.

CBT & DBT Near You

Here at Meta Addiction Treatment, we know that life can take a toll on you. Not knowing how to properly handle stress, negative emotions, unhelpful thoughts, and challenging situations can lead you down a dark path. DBT can help you manage challenging emotions, while CBT can help you identify and reframe unhelpful thoughts. Both types of treatment can help improve the quality of your life.

Don’t let negative emotions and unhelpful thoughts continue to wreak havoc on your life. Contact us today if you’re ready to do the work it takes to live a thriving, sober, and purposeful life.

Lily Hegel

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