What’s The Difference Between CBT & DBT?
The first decision you have to make about therapy is to go. After that, you’ll find therapy breaks down into a web of different styles, each treating certain conditions and symptoms better than others. Regarding evidence and talk-based therapies, there are essentially two main ones: Cognitive Behavioral Therapy (CBT) and Dialectic Behavioral Therapy (DBT).
How do you know which is right for you? Let’s break it down.
Cognitive Behavioral Therapy (CBT) in a Nutshell
While DBT is a kind of CBT, CBT is the “standard” kind of therapy people mean when they talk about it in everyday conversation. You meet with a therapist, you talk about your problems, they help guide you through emotions, and ideally, you start to realign your thoughts and behaviors with your values.
CBT attempts to validate the emotions of the client so they can return to the driver’s seat of their life with an unclouded windshield of logic and reason. Sessions are specifically tailored to each client. Therapists draft treatment plans to focus on specific CBT concepts, emotional regulation practices, and values-based assessments necessary for that specific client.
Thoughts, Feelings, & Behaviors
Since the basis of CBT lies in the connection between a person’s thoughts, feelings, and behaviors, there’s a lot of examining the three together. You may come into session because you have a persistent, negative feeling: “I feel deeply alone and overwhelmed by life.”
Your therapist may dig into this feeling by seeing what thoughts and behaviors are associated with it. Maybe you have recurring thoughts like, “I can do it alone.” Or “I shouldn’t need help.” Perhaps you also have isolating behaviors, like turning to your TV when life gets stressful instead of opening up to a friend. Maybe you never learned how to ask for help.
By getting you to change just one of these things into something more positive—trying to reach out to a friend instead of turning inward the next time something overwhelms you—therapists can guide you into new feelings about the world. Now, you feel less alone and like you’re supported, all because you decided to start letting people in. (Something you chose!)
Dialectical Behavior Therapy (DBT) in a Nutshell
Dr. Marsha Linehan was looking for a better treatment for borderline personality disorder (BPD) when she developed DBT. CBT, she found, didn’t treat people struggling with suicidal ideations and self-harm as much as clients needed it. Those with mood disorders, substance-use disorders, eating disorders, and PTSD have also shown improvement through DBT.
DBT focuses on teaching clients specific skills and tools they can use to emotionally regulate in highly activated states. (States they’d normally turn to self-harm or destructive behaviors to cope.) There are fewer digging-into-the-thoughts conversations in DBT.
Distress Tolerance
“Distress tolerance” skills, or skills that help you handle states of distress are key. For example, your counselor will likely work with you on dialectics, the assertion that two seemingly opposite things can be true simultaneously. (Life can be both hard and easy at the same time.)
They will also likely cover “radical acceptance,” the acceptance that life inevitably comes with pain, stress, and other negative events. The good news is that you have coping tools on your side to deal with them.
Some DBT works with skills training groups that meet weekly to cover healthy behavioral skills intended to replace unhealthy ones. These classes may focus on mindfulness, distress tolerance, interpersonal connection, and emotional regulation.
Have a better idea of which you may be interested in? Even if you don’t, speaking with a counselor is a great way to find the best fit for you. Make sure they know your goals for therapy, any recurring symptoms, and previous medical history. Contact us today to schedule a consultation for CBT.
