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Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are two types of psychotherapy (“talk therapy”) that are commonly used in the treatment of a variety of mental health ailments. Through both CBT and DBT an individual will work with a mental health professional to learn how to process, cope with, and integrate challenging experiences as well as teach applicable coping mechanisms, and helpful skills to enable an individual to effectively manage future challenges when they arise. While not the primary focus of either, both CBT and DBT can delve into one’s past to help provide a clearer understanding of how certain situations may have influenced and had an impact on an individual’s current circumstance. Dialectical behavior therapy is actually a specific form of cognitive behavioral therapy that emphasizes the psychosocial aspect of treatment. In order to be able to truly understand how CBT and DBT differ, it is helpful to glean an understanding of each form of therapy, respectfully. 

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy is a structured, short-term, goal-oriented therapy that is focused on the present. In CBT, a therapist will encourage his or her client to discuss his or her troubling thoughts and/ or feelings. Cognitive behavioral therapy typically focuses on specific problems and utilizes a goal-oriented approach. The steps of CBT include, as provided by Psychology Today, the following:

  1. Identify troubling situations and/ or conditions in your life (i.e. divorce, a medical condition, anger, grief, etc.). 
  2. Become aware of your emotions, thoughts, and beliefs connected to these troubling situations.
  3. Identify inaccurate and/ or negative thinking that may be contributing to your troubles.
  4. Reshape inaccurate and/ or negative thinking. In order to help facilitate this step, a therapist may encourage you to ask yourself if your view of the situation is based off of an inaccurate perception of the situation or off of facts. 

Cognitive behavioral therapy is based on the notion that thoughts and behaviors influence feelings; therefore shifting the way one thinks and reacts to situations can subsequently improve one’s emotional demeanor. Depending on the needs of the individual, the number of CBT sessions range from five to twenty sessions. 

Dialectical Behavior Therapy

Dialectical behavior therapy was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT employs many of the same components of CBT, but places greater emphasis on the social and emotional aspects. DBT relies heavily on mindfulness skills originating from Zen and Buddhist practices. Dialectical behavior therapy consists of four primary behavioral skill modules, which include: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT includes individual therapy sessions, group skills training sessions, and phone crisis coaching between sessions (if needed). Through DBT clients learn to rely on specific mindfulness techniques that enable them to live with pain in the world and accept the way things are in any given moment instead of having to endure the suffering that comes when trying to change them. 

Primary Difference

The fundamental difference between CBT and DBT is that CBT focuses on how thoughts, feelings and behavior influence one another, while DBT places primary emphasis on mindfulness practices, emotional regulation and learning to accept pain. DBT helps individuals learn to experience and accept the pain that is inevitably experienced in life, without trying to change it. CBT seeks to provide individuals with the ability to identify damaging thoughts, and teaches an individual how to redirect those thoughts.