Cognitive Behavioural Therapy (CBT) Vs. Dialectical Behavioural Therapy (DBT): What Is The Difference?

If you're someone who is struggling with anxiety, chronic stress, or depression and has been recommended therapy, you must already be aware of Cognitive Behavioural Therapy (CBT), a form of psychological treatment that works towards alleviating symptoms. However, have you also heard of Dialectical Behavioural Therapy (DBT), another type of psychotherapy designed to treat more complex mental health conditions?

In this article, we will break down each of these therapies, help distinguish between the two, and determine which works best for different types of mental health conditions.

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What Is Cognitive Behavioural Therapy (CBT)?

The American Psychological Association (APA) describes CBT as a form of psychological treatment that is said to be effective for a range of problems, including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness.

This type of therapy focuses on challenging negative thoughts and behaviours, says Dr Sanjay Garg, Consultant - Mental Health and Behavioural Sciences, Fortis Hospital, Anandapur. Some of the key strategies involve:

• Learning to recognise the negative thought processes that are creating problems and reevaluating them in light of reality.
• Better understanding the behaviours and motivations of others.
• Making use of problem-solving skills to cope with difficult situations.
• Learning to develop confidence in one’s own abilities.

What Is Dialectical Behavioural Therapy (DBT)?

DBT is a comprehensive treatment that is effective for treating complex mental health problems. It is an evidence-based treatment that emphasises mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, explains Dr Garg. Unlike CBT, it does not aim to change negative thinking patterns but focuses on accepting the emotions and finding ways to cope with them.

DBT is considered a more modern approach to therapy. It was developed in 1993 by Prof. Marsha Linehan to help people with emotional disorders, especially borderline personality disorder. Research suggests that it has been shown to be effective for treating a variety of mental health issues, including suicidal thoughts, substance abuse, eating disorders, and depression.

Also Read: From Surviving to Thriving: How Daily Mental Health Practices Can Change Lives

How Does CBT Differ From DBT?

“CBT primarily uses cognitive restructuring and behavioural techniques,” says Dr Garg, adding that cognitive restructuring involves identifying and challenging negative thought patterns, while behavioural techniques focus on changing behaviours through exposure, relaxation, and problem-solving.

He adds, “DBT uses a wider range of techniques, including mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills training. Mindfulness involves being present in the moment without judgement, while distress tolerance focuses on coping with difficult emotions and situations. Emotion regulation involves managing intense emotions, and interpersonal effectiveness involves improving communication and relationship skills.”

When Should You Opt For CBT Vs. DBT?

Given the kind of techniques involved in different therapeutic approaches, CBT is often preferred for conditions like mild to moderate depression, anxiety disorders (e.g., generalised anxiety disorder, panic disorder), and phobias, he says.

On the other hand, DBT is preferred for more complex conditions like borderline personality disorder, complex trauma, and substance abuse. It focuses on mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

However, it's important to note that the best therapy for a particular individual can depend on various factors, including the severity of the condition, the individual's preferences, and the therapist's expertise, the doctor concludes.