There are a lot of options out there to address emotional problems. Two of the most prominent types of therapy — DBT and CBT — have similar names and approaches. How should you choose between DBT vs CBT?
What Are CBT and DBT?
Cognitive-behavioral therapy (CBT) and dialectical behavioral therapy (DBT) are both forms of psychotherapy. They usually involve meeting once weekly with a therapist with specific training in CBT or DBT. Typically, DBT also involves a weekly group session called a “skills group.” Both CBT and DBT are effective for various mood, anxiety, substance-related, emotional, and behavioral problems.
What Is CBT?
CBT looks at problems in terms of thoughts, emotions, sensations, and behaviors. To address a problem (e.g., anxiety), a CBT therapist will recommend different strategies with a goal of altering the thought processes, emotional experiences, or behaviors that make up the problem. As a result of making these changes, the problem improves.
For example: let’s say you suffer from insomnia. A CBT therapist might examine what you’re thinking, feeling, and doing throughout the day that can affect sleep. She may recommend that you spend less time in bed, or recommend a change in your self-talk around sleep. Changes like these can improve the quality of sleep and decrease the time spent waiting to fall asleep.
What Is DBT?
DBT is a specialized form of CBT. Essentially, that means DBT is CBT. What’s different about DBT is its focus; DBT focuses on helping you learn how to cope with difficult or intense emotions and with the problems those emotions can create.
DBT was originally developed in the 1980s and ’90s to help people who were chronically suicidal and for people who had a condition called borderline personality disorder. However, DBT has been used more broadly since then as we have discovered how useful it is for other problems.
DBT, unlike other forms of CBT, draws on some of the philosophy and practice of Zen Buddhism. It teaches people mindfulness practices that help us understand and manage our emotions.
DBT can be more effective than traditional CBT at reducing emotion-driven behaviors like cutting (a form of self-harm), emotional eating, and some problems with drugs and alcohol.
How to Choose
The most important factor to consider in choosing DBT vs CBT is the type of problem you have. Some problems that are a better fit for CBT are:
- Excessive worry
- Panic attacks
- Post-traumatic stress disorder (PTSD)
- Social anxiety or work anxiety
- Obsessive-compulsive disorder
Some problems that are a better fit for DBT are:
- A habit of cutting people out of your life and later regretting it
- Self-harming behavior, like cutting or hitting yourself
- Unstable or overly intense relationships with others
- Anger problems or anger management
- Fears of abandonment
- Difficulty with chronically intense emotions
Some problems that can be addressed by either CBT or DBT are:
- Drug or alcohol use problems
What CBT and DBT Have in Common
CBT and DBT have many things in common. For example, both therapies:
- strive to create improvement in your current life as soon as possible
- sometimes encourage you to face feelings and situations that are uncomfortable, if it’s safe and healthy to do so
- will ask you to do homework between sessions
- focus on fixing things in your life that aren’t working for you
Consider a consultation
For some people, the decision about which type of therapy to pursue is not obvious. If the best option for you isn’t clear, consider a one-session consultation with a therapist trained in one or both therapies. He or she will be able to give you an informed opinion and explain their recommendation to you.
How to Find a Good CBT or DBT Therapist
- Make sure that the therapist you plan to see has extensive training in whichever type of therapy you have chosen.
- To find a good CBT therapist, consider using the clinical listing at the website for the Association for Behavioral and Cognitive Therapies.
- To find a good DBT therapist, look for someone who has completed training from BTech (also known as “Behavioral Tech.”)
- Experienced DBT therapists often work (or have worked) as part of a full DBT program. (Full DBT programs include individual therapy, skills groups, and phone coaching.)
- There is a clinical directory of DBT programs and therapists available at this site as well.
Feel free to contact us for help finding a therapist to suit your needs — whether you are in the New York City area or not. We are happy to help if we can!