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Cognitive Behavioural Therapy VS Dialectical Behavioural Therapy

There are two types of behavioural therapy that can treat common cognitive disorders such as depression, anxiety, and OCD. Over the past few decades, thousands of patients have benefitted from these two forms of treatments which involve understanding thoughts and feelings and learning to control and adapt them to current situations.

Cognitive Behavioral Therapy, or CBT for short, is one of the most popular types of psychotherapy. The goal of CBT is to use short-term goals to actively treat the core of the problem, not just the symptoms.

For example, if someone has sleep problems, they may go to a cognitive-behavioral therapist. The therapist will then work with them to treat the thinking and behavioral patterns behind the sleeping problems.

CBT works for issues far beyond just sleeping difficulties; it can be used to address issues such as relational problems, drug and alcohol addiction, anxiety, and depression.

Dialectical Behavioral Therapy, otherwise known as DBT, is built off of many of the foundational ideas behind cognitive-behavioral therapy. Most of the time, dialectical behavioral therapy has two parts: an individual session each week and then group sessions.

During an individual session, the goal with DBT is to work through problems and build solutions. During group sessions (also usually weekly), a therapist teaches a group of people skills and facilitates group growth.

How Does CBT Work?

While that all sounds great, how does it actually work? First of all, one of the most significant benefits of CBT is how fast it starts to work. For a general estimate, you can expect to spend five to ten months going to one session a week for most things that CBT treats.

At each session, the therapist will work not only to understand the problem but help the client understand the problem. More often then not, the chief complaint that brings the client into therapy is not the root issue.

After the root issue is identified, the therapist will help the client learn applicable, healthy strategies to deal with it. Beyond that, the client should acquire a set of skills that they can then use to deal with other problems in the future.

Dialectical Behavioral Therapy, otherwise known as DBT, is built off of many of the foundational ideas behind cognitive-behavioral therapy. Most of the time, dialectical behavioral therapy has two parts: an individual session each week and then group sessions.

During an individual session, the goal is to work through problems and build solutions. During group sessions (also usually weekly), a therapist teaches a group of people skills and facilitates group growth.

How Does DBT Work?

DBT is a very psychosocial therapy, and it can be broken down into three main parts. First, it is centered around support. Support, by a counselor in an individual session and fellow group members in a group session, helps build a person’s strength so they can handle what life throws at them.

Second, it is based on thinking patterns. Instead of just treating problems, DBT works to identify and curtail the thoughts that worsen the problems. Finally, DBT is collaborative. There is usually homework that is gone over with groups, role-playing with counselors and is overall very interactive. For DBT to really work, therapists and clients have to work together.

CBT Versus DBT For Treating Certain Illnesses

Not all therapies work for all disorders or even all people with the same disorder, and the same is true for cognitive behavioral therapy and dialectical behavioral therapy. Typically, cognitive behavioral therapy is used to treat disorders like depression, anxiety, OCD, sleeping problems like insomnia, and PTSD.

DBT, on the other hand, was initially designed to diagnose and treat those with BPD (borderline personality disorder) and can be used to treat disorders and behaviors such as suicidal thoughts/ideation and those who self-harm.

Finally, sometimes DBT works really well for those who have suffered from sexual trauma.

CBT Versus DBT for Treating Addiction

CBT and DBT can both be used to treat addiction; they just go at it to separate ways. CBT will focus on how your thoughts and feelings lead to your behaviors (in this case, addiction.)

On the other hand, DBT focuses on relationships and much more on what you see and do than what you think. Since both can be used to treat addiction, it really takes experimenting to figure out what will be best for you.

CBT Strategies

With a mental health expert or therapist, there are seven different avenues a patient can explore with CBT. Each aspect listed below focuses on a different method, with the same goal:

1. Cognitive restructuring:

This is generally done through a thought journal. With that thought journal, the client and therapist will work to figure out what toxic/unhealthy behaviors and thoughts need to go and how to create new responses

2. Activity scheduling:

This exercise forces people to schedule a time for activities that they otherwise avoid because of their mental health (or other kinds) problems. It can help people get readjusted to what they like to do and who they are

3. Graded exposure:

This kind of treatment is done with the slow and methodical introduction of what the person is afraid of. Over time, with enough controlled exposure, the person can become less fearful

4. Successive approximation:

This is used when someone’s goal is rather overwhelming. Instead of working all at once to complete a big task, the person sets up several small goals with small tasks to complete

5. Mindfulness meditation:

This technique is used to teach clients how to remain in the moment and not be so focused on other things

6. Skills training:

The goal of skills training is to teach a client the skills they need to function and cope with all the various problems life might throw at them

7. Problem-solving:

This is when the therapist works to teach a client how to solve their own problems in life

DBT Strategies

1. Core Mindfulness:

The goal of core mindfulness is to be aware of what is happening and accepting it. After you become aware of what is happening in the current moment, you can better address your own thoughts and feelings about the subject

2. Distress Tolerance:

This is a group of skills that are used to help someone get through especially dark times. When a therapist teaches a client these strategies, they gain skills that they can use for lots of future situations

3. Interpersonal Effectiveness:

Interpersonal effectiveness is learning how you feel so you can better interact with others and build community.

4. Emotional Regulation:

Emotional regulation helps a person learn to recognize and cope with their own emotions without having tons of unneeded secondary reactions.

What Conditions Does CBT Treat?

• Depression
• Anxiety
• Borderline personality disorder
• Anorexia
• Bulimia
• OCD
• Phobias
• Psychosis
• Schizophrenia
• Panic disorder
• Insomnia
• Substance abuse and addiction
• Fibromyalgia
• Irritable bowel syndrome
• Chronic fatigue syndrome

What Conditions Does DBT Treat?

• High-risk patients
• Patients with suicidal behavior/ suicidal ideation
• Patients who self-harm
• Borderline personality disorder
• Mental health disorders that
• Threaten a person’s safety
• Threaten a person’s relationships
• Threaten a person’s work
• Threaten a person’s overall well being
• Inability to regulate emotion
• Substance abuse and addiction
• Impulsive behavior

Pros and Cons of CBT

Each individual has a responsibility, alongside their family and trusted medical professional, to come up with a form of treatment that would best suit them. While CBT is a widely used treatment across many cultures and generations, there are some perceived downsides.

Take a look at the list below which lists the advantages and disadvantages of CBT:

Pros of CBT:

• CBT can treat disorders that medicine or other kinds of treatment could not
• It is a relatively quick process when compared to other kinds of treatment and therapies
• It can be done via various formats, including books, apps, groups, and in person
• It teaches a client practical strategies that can be used over and over again as new problems come up

Cons of CBT:

• It is still a commitment of your time and energy
• People with more complex mental health problems may need more intensive treatment
• You have to deal with thoughts, feelings, and behaviors that can be difficult to process
• The focus is on what the individual can change, so it does not always deal with the impact of outside forces

Pros and Cons of DBT

Similarly to CBT, DBT has its advantages and disadvantages which we have listed below for you:

Pros of DBT:

DBT has a high success rate with disorders like borderline personality disorder.
Because it is skills-based, clients can apply it to their every day lives beyond just one problem.
Safety mechanisms for the patient and therapist can be put into place if needed.

Cons of DBT:

• It can be an overwhelming process
• It requires a fairly substantial time and energy commitment
• It can be risky, so it can only be done with highly trained professionals

How to Decide Which to Use

Deciding which to use really depends on what disorder you have and what you personally want. If you have a disorder that can only be treated by one and not the other, of course, pick that one.

On the other hand, if your disorder can be treated by both CBT and DBT you can use either depending on what you want and need. Some people may recommend that you start with CBT because it is less intense, but that is by no means necessary if you are confident that DBT will work better for you.

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