What is the Difference Between DBT vs. CBT?

Updated on 10/5/2023

Both cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are popular forms of psychotherapy. They have similar goals: to modify behavior. 

• CBT is a widely used and accepted form of talk therapy. It focuses on changing the thought patterns that negatively affect your emotions, which, in turn, affect how you behave.
• DBT uses cognitive-behavioral principles at its core, too. But it challenges you by asking you to try and cope with stress, negative thoughts, and emotions by living in the moment. When you mindfulness skills and DBT techniques, you’ll develop constructive thought patterns that result in positive behaviors. When DBT works, you’ll learn how to balance your emotions, so your behavior patterns can be improved. 

The overall goal of both CBT and DBT is to help find a better quality of life while maintaining healthy, functioning relationships. The main difference between CBT and DBT is that CBT therapy is heavily focused on changing and improving the relationship between your thoughts and behaviors while DBT balances change with learning how to validate yourself, others, and the world. Change + Validation is the core dialectic of DBT.

It’s worth mentioning again that while DBT helps you create a constructive action plan, it’s still built upon CBT’s foundational principles⁠— modifying negative thought patterns. Because after all, we do as we think.

In some senses, DBT does go a step further than CBT. It asks you to problem solve, then accept and come to terms with uncomfortable feelings and thoughts. Thus, the emphasis moves away from what you think or feel about a situation or relationship, and instead asks you to challenge and change any unhealthy or self-destructive behaviors that stem from those thoughts.

We’ll review the differences in more detail below and then dive into each type of therapy so you can better understand the two.

What Are the Core Differences Between DBT Therapy vs. CBT?

Both CBT and DBT are considered forms of talk therapy. However, the differences between DBT and CBT are key to consider.

CBT practices will teach you how your thoughts, feelings, and behaviors influence each other. The hyper-focused and goal-oriented practices of CBT or cognitive behavior therapy are meant to offer a short-term, structured therapy. It’s through practice that you’ll begin to see long-term results with your cognitive behavioral therapy program. In essence, CBT depends on a positive change in either a thought or behavior during a single experience. Your CBT therapy will continually add to an overall improvement of intense emotions, thinking, and actions in your life.

DBT, on the other hand, puts more emphasis on your social and emotional responses to external stimuli. Situations and relationships that were previously difficult for you can become easier. You’ll begin to accept what’s happening at the moment⁠. DBT is often the therapy of choice if you have overwhelming feelings of rejection or other emotional pain. The goal of dialectical behavioral therapy is to reduce the intensity of emotions and limit impulsive responses.

Similarities in CBT and DBT

Nonetheless, in these types of individual therapy, you’re guided and supported through intensive conversations with a mental health professional. A therapy session can take place in either a group or individual setting. Both therapy models are similar in that you’re taught how your thoughts, feelings, and behaviors intertwine. Finally, both therapies have similar goals:

• To increase self-awareness in real-life scenarios
• To reevaluate self-destructive thoughts and behaviors
• To form healthier response patterns and behaviors

What is CBT?

Cognitive behavioral therapy is a psychotherapy technique that reframes or restructures negative thought patterns, and reinforces healthy behaviors for stress management. A CBT therapist’s goal when using CBT techniques is to help you identify specific problems in your daily life and relationships. Sometimes, these will be secondary symptoms of a mental health condition like:

• Depression
• Bipolar disorder
• Schizophrenia
• PTSD
• Anxiety disorder

CBT teaches you to take the thoughts and behaviors you’ve identified and apply new thinking patterns. This is done within the context of examining your everyday experiences. In the beginning, you’ll be tasked with becoming aware of negative thoughts, when they happen, in real-life situations, and in real-time. 

Next, specific types of CBT are used to intercept those negative thoughts. You’ll begin to learn how to reshape your thinking so you can arrive at a more positive (and healthier) interpretation of an event and the thoughts surrounding it. Eventually, this will effectively lead to new, healthier thought patterns and behaviors in general.

One study shows just how effective CBT in online-based therapy sessions can be. When treating seasonal affective disorder (SAD), an acute, but recurring type of depression, CBT was found to be highly effective with 50 – 75% of people responding positively.

Another study shows randomized clinical trials demonstrating that CBT is effective in treating different types of depression in multiple types of delivery systems, including group therapy, telephone consultation, or through guided, online treatment formats.

What is DBT?

DBT therapy offers a slightly different approach. There are four main skill building modules that DBT addresses:

• Mindfulness
• Emotion regulation
• Interpersonal effectiveness
• Distress tolerance

The goal of DBT treatment is to teach you first to become mindful of your harmful thoughts and intense emotions. Then you’ll learn to apply two opposing approaches⁠— acceptance and change. The full acceptance of any experience that’s happening in a given moment offers you the chance to respond in a more constructive manner (which ultimately represents a change of behavior).

DBT is effective for individuals dealing with borderline personality disorder (BPD), which causes acute emotional distress followed by irrational behaviors. The techniques are also used to treat:

• Generalized anxiety disorder (GAD) and other anxiety disorders
• Bipolar disorder (BD)
• Addiction treatment for drugs or alcohol
• Major depressive disorder (MDD) and other depressive disorders
• Post-traumatic stress disorder (PTSD)
• Attention-deficit hyperactivity disorder (ADHD)
• Eating disorders such as anorexia nervosa, binge-eating disorder, and bulimia nervosa

When considering DBT therapy vs CBT, remember that dialectical behavioral therapy principles are built on the foundational theories of cognitive behavior. Almost all human actions begin as a thought, which is a cognitive function of the brain. If you’re struggling with mental health challenges, thoughts can be distorted and emotional regulation can become extremely difficult. Both of these can lead to destructive behavior patterns, and DBT might be a successful therapy technique for you. 

“Both CBT AND DBT can help us challenge our perceptions and patterns so that we are not stuck in repetitive dysfunctional behaviors.”

Talkspace therapist Dr. Karmen Smith LCSW DD

How to Know Which Type of Therapy is Right for You