What’s the difference between CBT and DBT?

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Author: Canadian Mental Health Association, BC Division


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CBT (cognitive-behavioural therapy) and DBT (dialectical behaviour therapy) are two forms of psychotherapy or “talk therapy.” In both, you work with a mental health professional to learn more about the challenges you experience and learn skills to help you manage challenges on your own.

Cognitive-behavioural therapy or CBT teaches you how your thoughts, feelings, and behaviours influence each other. For example, if you believe that people don’t like you (thought), you might avoid social situations (behaviour) and feel lonely (feeling). However, CBT teaches you how to use these relationships to your advantage: a positive change in one factor (changing a thought or behaviour) can lead to positive changes in all factors. CBT is an approach that has been proven by research to work for many different mental health problems, including depression, anxiety disorders, eating disorders and substance use problems.

CBT is structured, short-term, goal-oriented and focused on the present. It starts with education around the particular mental illness or challenge and how the illness or challenge affects you. Next, you’ll learn and practice skills and strategies like problem-solving or realistic thinking to help you make changes in your thoughts, feelings, and behaviours. You’ll learn how you can use your new skills to deal with problems in the future.

Dialectical behaviour therapy or DBT is based on CBT, with greater focus on emotional and social aspects. DBT was developed to help people cope with extreme or unstable emotions and harmful behaviours. DBT is an evidence-based approach to help people regulate emotions. It started as a treatment for borderline personality disorder, and current research shows it may help with many different mental illnesses or concerns, particularly self-harm.

Key differences between CBT and DBT are validation and relationships. DBT teaches you that your experiences are real, and it teaches you how to accept who you are, regardless of challenges or difficult experiences. Relationships are also very important in DBT—including the relationships between you and your DBT practitioner. You may have frequent check-ins to talk about any successes or problems. Treatment may include a mix of one-on-one sessions and group sessions. In addition to CBT skills, you’ll learn skills around managing your emotions, building relationships with others, coping well with problems or distress, acceptance, and mindfulness.

As with many talk therapies, it takes time and effort to enjoy the benefits of CBT and DBT skills. But once people master skills with support from your CBT or DBT therapist, they often find that their new skills and strategies become second nature—they are tools that last a lifetime.

Where can I learn more?
  • You can learn more about CBT is the Cognitive-Behavioural Therapy issue of Visions Journal
  • You can learn more about DBT in the Borderline Personality Disorder issue of Visions Journal
  • You can learn more about DBT skills at Emotions Vancouver, a blog from the DBT Centre of Vancouver
  • Ask Us: How can I find a doctor, psychiatrist, psychologist, or counsellor?
  • Ask Us: Where can I find free or low-cost mental health services like counselling or psychiatric medication?

    About the author

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    The Canadian Mental Health Association promotes the mental health of all and supports the resilience and recovery of people experiencing a mental illness through public education, community-based research, advocacy, and direct services. Visit www.cmha.bc.ca.