Cognitive Behavioral Therapy vs. Dialectical Behavior Therapy
A central component of our therapeutic approach here at CBT Denver is Cognitive Behavioral Therapy (CBT). CBT is a practical, goal-oriented, and evidence-based method of therapy. It focuses on the relationship between thoughts, emotions, and behaviors, and how changing unhelpful thoughts and/or behaviors can decrease mood symptoms and improve daily functioning. CBT is a broad therapeutic technique that includes various interventions and therapies including Dialectical Behavior Therapy (DBT). In other words, DBT is a specific form of CBT. Clients will often ask if a certain therapeutic approach will be more effective for them than another. For example, is CBT more effective than DBT or vice versa? The answer depends on what a client’s primary concerns are.
DBT provides skills for managing intense emotions and effectively navigating relationships. DBT is based on CBT principles and also incorporates mindfulness practice. DBT typically focuses on helping clients change their behavior patterns. DBT is particularly helpful for those who experience intense emotional reactions and/or impulsive behaviors in response to a sense of overwhelming feelings such as emotional pain or rejection.
While both CBT and DBT focus on how thoughts, feelings, and behaviors influence each other, DBT emphasizes regulating emotions, being mindful, and learning to accept unpleasant emotional experiences. The “dialectic” in DBT is a recognition that human experience is complex and opposing thoughts, feelings, or situations can occur simultaneously. It is about adopting an “and, both” mentality vs. an “either, or” mentality. For example, if you accepted a job promotion that requires you to work in a new location, you may concurrently feel excited by the opportunity and sad to leave your current officemates.
DBT also encourages change within the context of accepting the present moment as it is. Fighting against the reality of the moment hinders change as you are using energy to resist what is vs. focusing on taking helpful action.
DBT skills focus on four main areas:
Mindfulness skills facilitate the ability to tune into and accept, the present moment by practicing observing internal experiences and the temporary nature of feelings. Mindfulness can decrease the power of emotions to dictate unhelpful behaviors.
Emotion regulation skills aid in managing or changing emotions' intensity, which can enable more helpful behaviors and relationships.
Distress tolerance skills help to tolerate unpleasant emotions/internal experiences without needing to escape them or behave in ways that worsen the situation.
Interpersonal effectiveness skills involve practicing communicating with others in a direct, effective, and respectful manner. These skills help create and maintain beneficial relationships.
This article reviews four key DBT skills that can be used in daily life. While these skills are helpful when coping with intense emotions, they can also be useful when navigating more routine stressors. For example, the skill of opposite action is where you choose to do the opposite of what your emotions are telling you to do, your emotional urge, particularly when your emotions want to lead you to engage in unhelpful behavior.
Let’s say you are feeling down and have the urge to stay in bed all day. In this instance, staying in bed all day may worsen your mood and a helpful opposite action would be to choose to get up and do something, even if you don’t feel like it. Or, perhaps you are feeling anxious about attending a celebration for a friend you admire, and due to your anxiety, you don’t want to go. However, if it is important to you to practice not letting anxiety control what you do and/or you value your relationships, a helpful opposite action is to attend the celebration.
It is common to use evidence-based techniques from different approaches in therapy. So, your therapist may use techniques from CBT and DBT. In general, a helpful way to figure out what therapy approach is best for you is to talk to your therapist. Based on your concerns, treatment history, and goals, your therapist can offer suggestions and you can make a collaborative decision together.
If you are interested in learning more about CBT and/or DBT, please contact us at CBTDenver.