Understanding the Differences Between Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT)

by | May 17, 2022 | Recovery

Understanding the Differences Between Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT)

Various therapy modalities are available to address different mental health and substance use disorders (SUD). Both cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) are frequently used in a wide range of treatment settings. The names and abbreviations may sound similar, but they are different.

What Is Cognitive Behavioral Therapy?

Merriam-Webster Dictionary defines CBT as psychotherapy that combines cognitive therapy with behavior therapy by identifying faulty or maladaptive patterns of thinking, emotional response, or behavior and substituting them with desirable patterns of thinking, emotional response, or behavior.

CBT is a structured, didactic, hands-on, goal-oriented form of therapy. The therapist and client work collaboratively toward changing thinking patterns and behavior to improve mood and beneficial changes in the way the client lives their life.

The mental health illness determines the specific treatment methods used, but the basic, underlying principle remains the same: thoughts, feelings, and behaviors are all connected and have an impact on wellbeing.

The History of CBT

The father of CBT, psychiatrist Aaron Beck, developed this form of psychotherapy after noticing that his patients with depression frequently verbalized thoughts that lacked validity. He also noticed classic cognitive distortions in these patients. As a result, Beck began to view depression as more of a cognitive disorder than a mood disorder. As a result of his clinical observations and empirical findings, he developed a cognitive theory of depression. Cognitive Therapy for Depression was published in 1979 and was an innovation in psychotherapy.

Soon, other clinicians noticed and began developing specific treatment protocols for other psychiatric disorders. Behavioral strategies were incorporated, and the term cognitive therapy changed to CBT. Today CBT is widely used in many treatment settings and is one of the most researched psychotherapies.

CBT in the Treatment of SUDs and Mental Health Disorders

CBT is effective alone or in combination with other methods for treating SUDs. In CBT, the provider assists the client to become aware of and change maladaptive patterns of behavior, develop healthier coping skills, and increase motivation to change. These skills are all powerful tools for seeking recovery from SUDs. CBT can also help prevent relapse because of its focus on cognitive triggers for substance use and by assisting people in building a new set of coping skills. CBT focuses on practical strategies and the here and now rather than the past.

CBT is also used to treat mental health problems such as anxiety disorders, depression, and obsessive-compulsive disorders. It can effectively help people with mental health disorders become more aware of negative or inaccurate thinking patterns. People learn practical coping skills to manage these situations, and patients learn to respond to challenges more effectively.

 What Is DBT, and Who Benefits the Most?

DBT falls under the CBT umbrella and was developed from Marsha Linehan’s attempts to treat suicidal women with multiple problems. After researching and combing through available literature, she put together evidence-based CBT interventions to target suicidal behaviors. Unfortunately, the interventions were so focused on changing cognition that many patients stopped treatment because they felt invalidated, criticized, and misunderstood.

Linehan continued her research and began to incorporate interventions that included acceptance of the patients while also helping her patients accept themselves, their thoughts, their emotions, the world around them, and others.

The word “dialectical” in DBT means a synthesis of opposites. Linehan and her patients did just that as they balanced and synthesized acceptance and change-oriented strategies. What was born was an evidence-based, cognitive-behavioral treatment for patients with borderline personality disorder (BPD). DBT  has been applied to different patient populations, but most randomized clinical trials have focused mainly on women with BPD. However, there is promising research on the use of DBT with people with eating disorders and depressed elderly patients.

What Makes DBT Unique?

DBT does take elements from other cognitive-behavioral therapies. However, it is unique in that it is an emotion-focused treatment. One of the main goals of DBT is to improve a patient’s quality of life by helping them regulate emotions and decrease actions that are tied to dysregulated emotions.

The dialectical philosophy also makes DBT unique from other CBT treatments. In this philosophy, reality consists of opposing forces in tension, and each force is incomplete on its own. In DBT, focusing only on change did not work as it was an incomplete approach. However, focusing only on acceptance is an incomplete intervention as the patient does need to experience some behavioral changes. In DBT, there is movement and flow with the therapist varying their style. Skills such as mindfulness and radical acceptance are taught in DBT.

DBT for Substance Use Disorder Treatment

We know that DBT is effective for some mental health disorders, but what about SUDs? DBT has been developed for the treatment of SUDs. Some clinical trials have shown that DBT treatment decreased substance abuse in patients with BPD. It may also be effective for patients with other co-occurring mental health disorders.

The Importance of Seeking Treatment

Untreated SUDs and mental health disorders can lower a person’s quality of life and even damage physical health. Seeking the best treatment facility that practices both CBT and DBT will help you in your recovery.

Both cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) treat substance use disorders and co-occurring mental health disorders. Understanding the difference between the two therapies and finding the right treatment plan is key to your recovery. Sober Life is here to offer you the help and support you need. We focus on your strengths as we provide evidence-based therapy and treatment. We understand everyone’s road to recovery does not look the same, and we customize your treatment plan to meet your needs. You can come to our downtown San Diego location for partial hospitalization, intensive outpatient, or outpatient. Flexibility in treatment is vital in today’s busy world, so we also offer virtual outpatient treatment. Regardless of what level of care you need, you will receive customized treatment tailored to your individual needs. Call Sober Life at (619) 542-9542 to learn more about how we can help you on your journey.

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