Cognitive vs Dialectical Behavior Therapy

Cognitive vs Dialectical Behavior Therapy (DBT)

What is Dialectical vs Cognitive Behavior Therapy?

One of the most common types of therapy is called Cognitive Behavioral Therapy (CBT). Also called talk therapy, CBT focuses on talking about your problems to help you frame your thoughts differently. If you feel like negative thoughts are always in control – CBT can help you use logic and reason to flip the script and be in control of your thoughts instead of allowing your thoughts to control you. CBT is based on the idea that our thoughts and behaviors influence our feelings, so changing the way we think about and react to situations will help us feel better.

However, standard CBT isn’t effective in treating all mental illnesses. Another common type of therapy is called Dialectical Behavior Therapy (DBT). DBT is a form of evidence-based, talk therapy based on cognitive behavioral therapy (CBT), that tries to identify and change negative thinking patterns and pushes for positive behavioral changes. DBT is specially adapted for people who experience emotions very intensely.

Read on to learn about the differences between CBT vs DBT and how to figure out which one will best help you.

Cognitive Behavioral Therapy is a More General Therapy

CBT is a catch-all phrase for therapies that share common characteristics. DBT is a type of CBT, along with several other types. Therapists who practice CBT generally practice talk therapy that relies on several guiding features. Those features include:

  • Treats Emotional Response: based on the idea that our thoughts influence our feelings, so changing the way we think about and react to situations will help us feel better.
  • Limited to a Specific Period of Time: most patients will seek treatment for a a period of time and then start to apply CBT strategies on their own without significant support from a mental health professional. If mood or behavior problems persist, clients may then progress to a different type of therapy to address a specific trauma or other issue that continues to cause pain or be a barrier to healthy living.
  • Having a Good Therapist-Patient Relationship: CBT works best when the patient feels like they can trust their therapist. Because of the personal nature of therapy, patients should seek out someone they respect and feel comfortable with.
  • Relies on Cognition and Rationale: CBT encourages patients to apply logic and reason to help direct how they respond to situations instead of letting emotions do all the driving.
  • Uses Structure to Guide Treatment: therapists have a specific reason for the techniques and methods they bring up in each session. They use the client’s goals to figure out which CBT concepts will be most beneficial to them and tailor each one accordingly.


While DBT is a type of CBT, it is tailored towards helping people acknowledge the pain and discomfort they feel, yet still feel safe and empowered to choose healthy behaviors instead of impulsive or harmful behaviors. While some emphasis is put on dealing with thoughts, patients are taught to identify triggers outside of themselves and match those triggers with a healthy coping mechanism or response.

Cognitive vs Dialectical Behavior Therapy for Treating Specific Disorders

Not all mental disorders respond to treatment in the same way. Because each illness responds differently to treatment techniques, you will want to go with the method that has been shown most effective for treating your diagnosis and symptoms. If you have not yet received a diagnosis from a psychiatrist or psychologist, consider setting an appointment for psychiatric diagnosis and psychological testing. This will help you identify the best treatment options, as well as strengths and existing skills you can leverage in your recovery process. Depression and anxiety sufferers have found a lot of success with CBT, while people with borderline personality disorder and chronic thoughts of suicide find DBT more helpful. Keep in mind that many people have more than one diagnosis, and sometime people use elements from both DBT and CBT to manage their symptoms.


What Does Cognitive Behavior Therapy Treat?

CBT has been shown to be incredibly effective when treating depression, and is more likely to make depression go into remission than other types of therapy. This method of therapy has also been proven beneficial in treating anxiety, as it gives patients control over their recovery. CBT has also been shown to help with obsessive compulsive disorder (OCD), phobias, panic disorder, post-traumatic stress disorder, and sleeping issues.


What Does Dialectic Behavior Therapy Treat?

DBT was created to help those diagnosed with borderline personality disorder. DBT focuses on helping people change their behavior patterns, as opposed to trying to think or talk through the issues they are struggling with. This type of CBT helps those who have developed patterns of intense emotional reactions and impulsive behaviors in response to what patients describe as overwhelming feelings of pain and rejection – the feeling of walking through a world filled with knives. DBT often is the most effective therapy for those who struggle with self-harm behaviors like cutting and chronic suicidal ideation. Sexual trauma survivors also respond well to DBT techniques.

Cognitive vs Dialectical Behavior Therapy Philosophies

A big difference in DBT vs CBT is how they approach the patient. DBT is mostly focused on how a person interacts with others and themselves. It tends to use mindfulness philosophies to help patients accept themselves and their environment. Meanwhile, CBT tends to be more logic-focused. Therapists encourage patients to use critical thinking to develop healthier ways of thinking and behaving.


CBT and the Socratic Method

CBT focuses on reasoning and rationale, as most commonly found in stoic philosophy and the Socratic Method. The Socratic Method uses critical thinking to question assumptions in place. This works well for those who suffer with anxiety and depression, as it helps them to see their problems from a more logical point of view. For example, clients who struggle with feelings of failure and inadequacy are asked to look at the facts. When have they in fact been successful at accomplishing a goal? Are there other people – friends, family or co-workers – who could give evidence of the client’s success in different situations? Who or what are they using as a measuring stick for success? Is that a realistic comparison?


DBT and Mindfulness

DBT relies heavily on mindfulness skills used in Buddhism and Zen practices. DBT teaches patients to use specific mindfulness techniques to learn to live with pain in the world and accept how things are instead of suffering by trying to change them.

CBT vs DBT and The Difference in Treatment Methods

CBT Talk Therapy

CBT focuses on how your thoughts, feelings and behavior influence each other. While DBT does work on these things, emphasis is given more towards regulating emotions, being mindful, and learning to accept pain. CBT seeks to give patients the ability to recognize when their thoughts might become troublesome, and gives them techniques to redirect those thoughts. DBT helps patients find ways to accept themselves, feel safe, and manage their emotions to help regulate potentially destructive or harmful behaviors.

DBT Talk Therapy

Clients who engage in DBT therapy participate in DBT skills training sessions that are typically taught in a group setting in four modules. Most patients also meet weekly with a DBT therapist or DBT coach and receive DBT phone coaching as needed when they need help the most. Sometimes, once patients are able to use DBT skills to regulate their emotions, practice mindfulness, and improve relationships with others, they are able to transition to more standard CBT groups to address specific negative thought patterns or recurring harmful behaviors.

The Goals of CBT vs DBT

Typically, CBT is more goal-oriented. It aims to help patients identify negative thoughts or behaviors and then it gives patients tools to adjust these problems. DBT does have goals, but they are not as firm and direct. Its main purpose is to help patients find a way to accept themselves, manage emotions, and regulate destructive behavior. DBT focuses more on emotional and social aspects, while CBT is more about the patient’s behaviors.

Types of Sessions for CBT vs DBT

CBT sessions are usually shorter sessions than DBT overall. CBT may just last a few weeks, while DBT is often a months-long process. An important difference is that DBT typically involves a group therapy component. Though CBT can sometimes have group sessions, talking to your peers is not as essential. For patients doing DBT, being able to do group sessions is an important part of the process. It gives people a chance to practice skills like interpersonal communication in a supportive and safe environment.

How to Get Started With Dialectical Behavior Therapy

The best way to figure out which type of therapy treatment is best for you is to talk with a mental health professional. Your provider, current therapist, or another trusted mental health professional can to refer you to a colleague who specializes in DBT. You may also find online therapists who offer DBT therapy. A professional who is trained in the method  will evaluate your symptoms, treatment history, and therapy goals to see if DBT might be a good fit.

Dialectical behavior therapy (DBT) is an effective treatment to help people who experience very intense, negative emotions. Although it may be difficult and time-consuming to find the right DBT therapist for you, it’s important to keep trying. The sooner you can start therapy — and stay committed to it — the sooner you’ll have an improved quality of life.

Dialectical Behavior Therapy with Healing Minds

Healing Minds is adding a second location in Reno, which will operate solely as a center for dialectical behavioral therapy, or DBT. The new Healing Minds will be located on Reno Corporate Drive across from the new Sierra Medical Center. The second location will operate solely as a center for dialectical behavioral therapy, or DBT.

This new center is just one of the ways Healing Minds continues to lead the way for mental health in Northern Nevada. We employ a dedicated team of counselors and therapists in Reno, NV, who share a deep commitment for helping individuals and families rebuild and improve their lives. Our team offers a range of services to treat mental health issues, including individual therapy, group therapy, DBT, family counseling, and Telehealth therapy. At Healing Minds, we believe that everyone can benefit from therapy and our mission is to become a resource for mental health and stability in our community.

Schedule an Appointment

With so many treatment options out there, it can be confusing to know what techniques will best help you. CBT and DBT are some of the more common therapy practices, and have been shown to help individuals suffering from a number of mental illnesses. Healing Minds offers both CBT and DBT to our clients.

At Healing Minds, we have therapists that can help you deal with difficult times and mental health issues using DBT. Working with a therapist can make the difference you need to step towards a full, whole life once again.

Please reach out to schedule a therapy appointment with a trained practitioner.  We offer in person or Telehealth therapy from the comfort of your own home.