Dialectical Behavioral Therapy (DBT) and Cognitive Behavioral Therapy (CBT) are both evidence-based treatments for mental health disorders and substance use disorders. They’re a form of talk therapy, which means sessions are a dialogue between you and a certified therapist.
DBT and CBT are some of the most common approaches used in recovery. They’re highly effective: one study found 43% of people who received CBT for depression improved, with 50% of people experiencing a reduction in depressive symptoms [1]. Meanwhile, DBT has been shown to lower suicidal thoughts and attempts, and contribute to lower use of crisis services [2].
The structure, treated disorders, and duration of DBT and CBT differ. Understanding the characteristics of each approach ensures that you choose the right care for you, and get closer to recovery.
What Is DBT?
DBT was initially designed to treat Borderline Personality Disorder. It’s based on the principle that emotional distress is part of life, but that it’s possible to learn how to manage behaviors and reactions. ‘Dialectical’ means combining opposite ideas, which is why DBT blends elements of CBT with mindfulness and is oriented around the concepts of acceptance and change.
Nowadays, DBT is used to help anyone who experiences emotions very intensely. It’s commonly used to treat:
- Anxiety
- Depression
- Self harm
- PTSD
- Suicidal behavior
- Eating disorders
The goal of DBT is to teach emotion regulation. Sessions are carried out both individually and with a group. Your therapist may ask you to keep a diary to record your emotions and actions, and identify patterns. You’ll then work together to limit harmful behaviors, improve your quality of life, and learn new skills. The skills include:
- Distress tolerance to deal with difficult situations and feelings, and respond in a healthy way.
- Interpersonal effectiveness to set boundaries, ask for what you need, and maintain self-worth.
- Emotion regulation to understand and have more control over emotions.
- Mindfulness to be grounded in the present moment, rather than worrying about the past or future.
DBT can be difficult and requires a lot of active input. Sessions usually take place between six months to a year, however, it can be longer depending on the severity of the condition.
One study found that short-term DBT and standard DBT improved suicidality in BPD patients [3]. It’s been reported to reduce anger, impulsivity, and substance abuse [4], and to produce positive outcomes in treatment for eating disorders [5].
Compared to CBT, DBT was found to be more effective for improving executive function among people with anxiety [6].
What Is CBT?
CBT treats mental health disorders by helping you be aware of, and change, how you think and act. It’s a type of structured, problem- and goal-oriented care. It’s mostly rooted in addressing current challenges and finding solutions, as well as unlearning unhealthy thought and behavior patterns, and learning new ones.
CBT is used to treat disorders, including:
- Depression
- Anxiety
- PTSD
- Eating disorders
- Bipolar disorder
- Substance abuse
It can also help if you’re struggling with sleep disorders and chronic pain.
CBT is designed to help you find stability within a relatively short time frame. That does not mean that it’s a ‘quick fix’, but that it supports you to cope without therapy as soon as possible. Some people say CBT is like learning to be your own therapist.
CBT sessions are normally limited to 10-16. During sessions, a therapist uses a question-and-answer structure to give you insight into your own thinking and behaviors, and prompts you to consider new perspectives and responses.
In the UK, nearly 2 million people registered for CBT appointments in 2021 alone [7]. CBT is the most researched form of psychotherapy [8] and has repeatedly been found effective across different conditions, populations, and contexts [9].
CBT has even been proven to help reduce reoffending when given to people who have committed offenses [10].
DBT vs CBT: A Comparison Table
The table below is an overview of the core differences between DBT and CBT.
| DBT | CBT | |
| Summary | Therapy for people who experience emotions very intensely and who want to learn to accept and change their responses. | Therapy to improve awareness around, and change, how they think and act. |
| Created in | 1970s | 1960s |
| Target and timeframe | Looks at past challenges to understand present behaviors; can be a form of ongoing therapy | Challenges currently being faced; not intended as a long-term support system |
| Disorders treated | Anxiety, depression, self-harm, PTSD, suicidal behavior, eating disorders, substance abuse | Depression, anxiety, PTSD, eating disorders, bipolar disorder, and substance abuse |
| Treatment duration | Six months to a year (or longer) | 10-16 weekly sessions |
| Outcomes | Reduce symptoms of mental health and substance use disorder, and gain distress tolerance and emotion regulation | Reduce symptoms of mental health and substance use disorder, gain awareness, and new perspectives around thinking and behaviors |
How to Choose Between DBT and CBT
Choosing the best therapy for you always requires some consideration. Use these questions to get a clearer idea of whether DBT or CBT suits your needs:
- What’s my reason for seeking therapy right now? Is it a short-term problem or a deeper, repeating issue?
- Have I received one (or both) types of therapy before? What was my experience?
- What kind of support do I want? Close and guiding or more independently led?
- How much time can I dedicate to therapy?
- How much work am I willing to do as part of treatment?
- Do I already have a good understanding of my thought patterns and behaviors?
- Have I been diagnosed with a disorder and do I have a co-occurring disorder?
It’s worthwhile to consult a clinician when deciding. They can recommend the therapy that is the most appropriate for you, based on your history and goals.
Expert, Effective Mental Health Treatment at Serenity Now, Davis, CA
We offer residential treatment for mental health disorders. All our care is trauma-informed and we integrate both CBT and DBT as part of our programs. Our licensed team delivers personalized sessions that ensure you’re seen, heard, and heal as best as possible.
Our center in Davis is a calm environment to recover and reconnect with the healthiest version of yourself. We have 24/7 supervision to keep you safe and comfortable, but also we help you develop the tools to be confident and to build high self-esteem.
You deserve serenity. Start your path there today. Contact our admissions team.
Sources
[1] University of Oxford Department of Psychiatry. (January 2016). Study finds CBT offers long-term benefits for people with depression. psych.ox.ac.uk.
[2] Linehan, M. et al. (May 2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry.
[3] Hernandez-Bustamante, M. et al. (January 2024). Efficacy of Dialectical Behavior Therapy in the Treatment of Borderline Personality Disorder: A Systematic Review of Randomized Controlled Trials. Iranian Journal of Psychiatry.
[4] Marshall, L. et al. (June 2024). Effectiveness of Dialectical Behavior Therapy (DBT) in a Forensic Psychiatric Hospital. Journal of the American Academy of Psychiatry and the Law Online.
[5] Anderson, L. Wisniewski, L. (July 2023). Dialectical Behavior Therapy for Eating Disorders: Overview and Application. Eating Disorders.
[6] Afshari, B. et al. (July 2022). Study of the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder. Trends in Psychiatry Psychotherapy.
[7] Royal College of Psychiatrists. (April 2022). CBT helping overcome mental health problems as nearly 2 million appointments take place in 2021. rcpysch.ac.uk.
[8] David, D. et al. (January 2018). Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers.
[9] Fordham, B. et al. (January 2021). The evidence for cognitive behavioural therapy in any condition, population or context: a meta-review of systematic reviews and panoramic meta-analysis. Psychological Medicine.
[10] College of Policing. (March 2018). Cognitive behavioural therapy (CBT). college.police.uk.
Find The Serenity You Deserve
