CBT vs DBT: What’s the difference? Learn what each therapy is and the best one to help heal your family.

CBT and DBT are both common types of cognitive-behavioral therapy, also known as talk therapy, that are based on cognitive-behavioral techniques. They are both meant to help heal individuals with mental health disorders—especially those who struggle with self-destructive behaviors.

While they are based on the same techniques, you may be wondering what really makes them different and which one might be better for your child. This article will address what each form of therapy is, what makes them different from one another, and why we recommend Sunrise as a DBT treatment center for teen girls struggling with mental health disorders.   

What is CBT?

So by changing our thoughts, we are able to ultimately change our feelings and behaviors which can dramatically improve our life.

Cognitive Behavior Therapy, or CBT, was developed in the 1960s by Dr. Aaron T. Beck. In his search to better understand those who struggled with depression, he found that there was an underlying issue that stemmed from what he called ‘automatic thoughts’. These were negative thoughts and beliefs that clients had about themselves, the world, and the future.

These automatic thoughts, or thought distortions, are what Dr. Beck wanted to pinpoint with patients so that they could work on cognitively restructuring their self-defeating thoughts to positive and healthy thoughts.

In order to understand CBT, it’s good to be familiar with the idea that our thoughts determine our feelings which in result determine our behavior. So by changing our thoughts, we are able to ultimately change our feelings and behaviors which can dramatically improve our life.

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CBT is primarily focused on the belief that the way we think is what causes us pain and if we can change that, it will significantly improve our overall well-being. Because CBT heavily relies on talk therapy with the patient and therapist, there needs to be a good relationship established so that the client feels a trust with their therapist. The client also needs to be willing to do the work required to identify the negative thought patterns, and to want to do the work to change them.

What is DBT?

So by changing our thoughts, we are able to ultimately change our feelings and behaviors which can dramatically improve our life.

Dialectical Behavior Therapy, or DBT, was developed by Marsha Linehan in the late 1970s. Using CBT techniques in her therapy, she started to notice that some problems were arising. Patients would get frustrated and quit therapy because they weren’t feeling validated. They felt like the emotions they were experiencing were being minimized.

In result, they didn’t have a strong relationship with their therapist. Linehan realized that acceptance and validation are a strong part of the healing process, so she decided to build on CBT principles and created what is now known as DBT, a mindfulness-based cognitive therapy.

DBT is based on CBT, but along with change, it adds another element that Linehan felt was missing: acceptance and validation. While DBT was initially created to help people with a specific type of disorder, Borderline Personality Disorder (BPD), it is now used to successfully treat many personality disorders and mental health challenges.

The two key differentiators between DBT and CBT are acceptance and validation.

  • Acceptance: DBT requires the patient to accept the feelings they have and to recognize them as real and valid. By accepting that, it makes the change they need to do seem bearable.
  • Validation: When a patient receives validation from their therapist that the emotions they are feeling are real, it helps build a trust in that relationship. Having that trust with your therapist is essential if the client is going to make any changes in his or her life.

By having a good balance of acceptance and change, DBT allows the therapist and client to maintain a good balance within therapy. Rather than focusing on change only, validation was introduced to not downplay the emotions clients were feeling.

The client and therapist work together at finding the ultimate balance of acceptance and change so that neither one is too far on an extreme side. Keeping this balance within therapy sessions is key to help the client get back on a path to emotional and mental healing.   

[DBT] skills allow you to respond in ways that help you cope and handle distress rather than responding in negative or self-destructive ways.

DBT is separated into five skill groups, with the first two (mindfulness and distress tolerance) focusing on acceptance and the third and fourth (emotion regulation and interpersonal effectiveness) focusing on change. The fifth skill (walking the middle path) focuses on finding that balance of acceptance and change.

These skills allow you to respond in ways that help you cope and handle distress rather than responding in negative or self-destructive ways. This is why DBT is incredibly successful in dealing with those who are suicidal or those who have a tendency to self-harm because they learn coping skills that work in a variety of situations.

Another aspect of DBT that sets it apart from CBT is the DBT group sessions. These help the client to have an additional therapy session that includes others who are learning DBT. It provides a level of treatment for an individual that goes beyond just traditional client and therapist sessions. Being able to work with others who are learning the same skills provides a sense of belonging and security that helps eliminate the isolation that CBT can bring.   

CBT and DBT in a nutshell

CBT is focused primarily on reconstructing thoughts so that feelings and behavior are not self-destructive.

DBT builds on CBT by adding a secondary focus—having the individual accept their feelings while also feeling validated that those emotions are real.

CBT is focused primarily on reconstructing thoughts so that feelings and behavior are not self-destructive. The client and therapist relationship plays a large role in whether or not this form of therapy will be successful. CBT has been known to help treat those who struggle with addictions, depression, post-traumatic stress disorder (PTSD), and other related struggles.

DBT builds on CBT by adding a secondary focus—having the individual accept their feelings while also feeling validated that those emotions are real. This helps the client and therapist maintain a healthy balance and establish trust in their relationship which, like CBT, is critical in whether or not the therapy will be successful.

DBT was developed to specifically help those with suicidal borderline personality disorder, but has been widely used to successfully help people with other illnesses including, but not limited to: substance abuse, addictions, depression, anxiety disorders, trauma, and those who self-harm or participate in any self-injurious behavior.

Still not sure the difference between CBT and DBT? Maybe this breakdown will help:

Cognitive Behavior Therapy (CBT)

  • IDEA

    The way we think is what causes us pain, which in result affects our feelings and behavior.

  • MAIN FOCUS

    Reconstruct thought distortions to help change feelings and behavior.

  • HELPS TREAT

    • Depression
    • Post-traumatic Stress Disorder
    • Eating Disorders
    • Trauma
    • Eliminate negative thinking patterns

  • THERAPY ASPECTS

    • Individual sessions
    • Therapists might take on a role of superiority which can be detrimental to their client's progress.

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Dialectical Behavior Therapy (DBT)

  • IDEA

    Introducing acceptance and validation within therapy builds on standard cognitive-behavioral treatment techniques and establishes healthy relationships.

  • MAIN FOCUS

    Learn skills to help make a "life worth living".

  • HELPS TREAT

    • Borderline Personality Disorder
    • Addictions
    • Depression
    • Anxiety
    • Trauma
    • Those who are suicidal or have self-harming tendencies

  • THERAPY ASPECTS

    • Individual sessions

    • DBT skills group sessions

    • DBT therapists view therapy with their clients as a relationship between two equals, which helps create a trusting and healthy relationship.

Is CBT or DBT better for my daughter?

Is CBT or DBT better for my daughter?

It’s a matter of opinion which one is better, but at Sunrise, we know that DBT has proven to help teen girls get better. We are a fully adherent DBT program which means that your daughter will have the chance to practice and live the DBT skills with everyone she interacts with. Practicing self-regulation skills with others who are also learning these DBT skills enhances the treatment process.

Contact us to discuss how Sunrise, a DBT treatment center, uses DBT skills training and evidence-based treatment in therapy and if it will be a good fit for your daughter.