Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are very similar forms of talk therapy or psychotherapy. Both CBT and DBT help you to communicate more effectively, while at the same learning more about yourself and the condition you’re addressing with psychotherapy. Each of these therapies is evidence-based. This means there is hard data to draw on showing the effectiveness of CBT and DBT for treating a range of conditions, including:
- Alcohol use disorder
- Substance use disorder
- Major depressive disorder
- Generalized anxiety disorder (GAD)
- Post-traumatic stress disorder (PTSD)
- Eating disorders
- Obsessive-compulsive disorder (OCD)
- Panic disorders
Data from the National Alliance on Mental Illness shows that up to 10% of adults in the United States will suffer from substance abuse disorder in any given year. Roughly 20% of American adults will experience some form of mental health condition in that same year. With substance use disorders and mental health conditions so prevalent – often also co-occurring – therapies like DBT and CBT are a vital component of integrated treatment.
CBT vs DBT: Understanding The Difference
We’ll glimpse first at each of these talk therapies in turn, before comparing and contrasting CBT and DBT, as well as exploring some of the conditions each therapy treats most effectively.
What is CBT?
CBT is a skills-based and goal-oriented therapy. Sessions are delivered either in individual and group settings as appropriate. When you engage with a course of cognitive behavioral therapy, you’ll work with your therapist to study the closely interrelated nature of your thoughts, feelings, and behaviors.
With a sharp focus on reasoning and logic, you’ll probe the way your thoughts and feelings impact your behaviors, particularly when these behaviors are poor or harmful. CBT will also help you to identify the people, places, and things that trigger you into destructive or self-defeating behaviors. As well as identifying triggers, CBT will also help you to formulate healthy coping strategies so you can better navigate the natural stressors of everyday life. This should strengthen your chances of avoiding relapse.
Cognitive behavioral therapy will help you to view things from a more objective standpoint. You’ll also become aware of the fact you don’t need to allow the way you think and feel to govern your behavior. One of the most adaptable forms of behavior therapy, CBT is easily applicable to various conditions, and once you master the fundamentals, you should feel much more in control of your emotions and your recovery.
What is DBT?
DBT is the abbreviated form of dialectical behavioral therapy. Where CBT focuses on thinking or talking your way out of problematic situations and painful issues, the object of DBT is to change the underlying behavioral patterns.
Marsha Linehan, a University of Washington psychologist, created DBT to treat patients presenting with borderline personality disorder (BPD). Since the 1980s, DBT has been applied to a variety of mental health conditions, including depression, bipolar disorder, and substance use disorder, as well as dual diagnosis – more on that below – trauma triggered by sexual assault, self-harm, and chronic suicidal ideation.
Engaging with DBT will help you to acknowledge your pain or discomfort, while at the same time feeling safe and “normal”. You’ll acquire the skills to achieve this even in hostile environments. As a result, you should be much less likely to engage in destructive or otherwise negative behaviors.
DBT sessions are delivered in a series of modules drawing on the following powerful techniques and strategies:
- Mindfulness: You’ll learn to focus fully on the present moment rather than probing the past or worrying about the future
- Interpersonal effectiveness: You’ll discover how to improve your interpersonal relationships through better communication and behaviors
- Distress tolerance: The distress tolerance skills DBT teaches you should equip you to cope with volatile emotions without relapsing
- Emotion regulation: The more you understand the way your emotions function, the more easily you can avoid acting impulsively, and the more easily you can avoid being driven by your emotions. Instead, you’ll learn to master them
- Walking the middle path: Dialectical thinking and validation skills help you to more fully understand alternative perspectives, ideal for working through any problems with your interpersonal relationships
How do these different types of psychotherapy compare, then?
Cognitive Behavioral Therapy vs Dialectical Behavioral Therapy
You should liaise with your treatment provider to determine whether cognitive behavioral therapy or dialectical behavior therapy would make the most suitable form of therapy for your condition(s). As an example, you could be struggling with some form of personality disorder and finding yourself in an ongoing battle against emotion-driven and instinctive responses to stressors. Your treatment provider may recommend DBT as the most beneficial therapy to accompany any medication-assisted treatment.
If, on the other hand, you’re engaged with treatment for a substance use disorder, you may discover that your substance abuse is being triggered by undiagnosed PTSD. With CBT, you’ll find that changing the way you think and behave can improve the way you feel. CBT deals squarely with the way your thoughts, feelings, and behaviors are all interlinked. Although a DBT therapist will touch briefly on these areas, the primary focus of dialectical behavior therapy is mindfulness, emotion regulation, and accepting pain.
CBT is proven beneficial for treating depression. Indeed, CBT is more effective for sending depression into remission than all other forms of therapy. In addition to this, CBT is proven effective for treating mental health issues such as anxiety disorder, sleep disorders, panic disorder, and PTSD.
CBT is strongly grounded on reasoning and logic, equipping you with the skills to deal less emotionally and more objectively with the symptoms of anxiety or depression.
DBT, conversely, draws from the mindfulness skills of Zen Buddhism. Acceptance underpins dialectical behavior therapy rather than change.
CBT vs DBT for Anxiety
Research shows that CBT is more effective than DBT for anxiety, depression, PTSD, and phobias. This 2018 meta-analysis showed that CBT helped to alleviate symptoms in those with anxiety or anxiety-related disorders, including OCD and PTSD.
CBT vs DBT for Bipolar
Bipolar disorder needs treatment with a combination of psychopharmacology and adjunctive psychotherapy. Both CBT and DBT therapy sessions are proven effective for treating the symptoms of bipolar.
Cognitive-behavioral interventions help you to manage unhelpful ways of thinking and will also focus on relapse prevention for both manic and depressive episodes.
Dialectical-behavioral interventions, on the other hand, help those with bipolar to:
- Avoid life-threatening behaviors and thought patterns like suicide attempts
- Sharpen focus
- Improve social functioning and interpersonal relationships
- Reduce behaviors interfering with therapy (absence, not completing homework, urges to quit therapy)
- Decrease negative behaviors that impact quality of life (anxiety, depression, problems at home, work, or school)
- Better tolerating emotional pain and managing emotions more robustly
CBT Therapy vs DBT Therapy for Addiction Treatment
Both of these psychotherapies can be used to treat alcohol use disorder or substance use disorder.
Some research suggests that DBT can be more effective because of the way it dives deep into the root causes underpinning substance abuse. While a basic course of CBT can help you to identify triggers for substance abuse and to formulate healthy coping strategies, with DBT you get the chance to examine the stress itself. The mindfulness component of DBT can also be a powerful tool for addressing the emotional imbalances commonplace in substance abusers.
Also, for patients liable to feel judged or criticized in a traditional CBT session, DBT places a firm focus instead on acceptance and validation. For many grappling with substance use disorder, this is a superior patient-counselor relationship.
DBT vs CBT for Dual Diagnosis
DBT allows you to hone the skills needed to cope with stressors and intense emotions while maintaining smooth relationships. Research shows DBT can be used positively for treating a range of mental health conditions from ADHD and PTSD to anxiety, depression, and bipolar disorder. All of these mental health conditions can co-occur with alcohol use disorder or substance use disorder. DBT will allow you to tackle both the drink or drug problem as well as the underlying mental health disorder.
CBT is used even more commonly for treating dual diagnosis. When used alongside traditional, evidence-based medication-assisted treatment, CBT can help you minimize your chances of relapse, while at the same time helping you to work on any underlying mental health disorders. CBT has a very high level of empirical backing for its effectiveness in treating substance use disorder.
Now, can do you DBT and CBT at the same time?
Well, some people do find it beneficial to explore both forms of therapy, while others benefit from a single form.
Finding CBT and DBT Therapy with TDRC
Here at The District Recovery Community, all our addiction treatment programs are highly personalized. We also offer a dual diagnosis treatment program for anyone suffering from co-occurring addiction and mental health conditions.
As well as using FDA-approved medication-assisted treatment if appropriate, our outpatient treatment programs also draw upon both CBT and DBT.
Regardless of the scope and severity of you or your loved one’s addiction and mental health disorder, we can tailor a treatment program to help you reclaim your old life. All you need to do is call the friendly TDRC team at 844.287.8506 to learn more about what treatment options are available.