CBT vs. DBT: Is One Better Than the Other?


Sober Recovery Expert Author

Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are two of the most widespread therapeutical methods in existence today. In treatment, these methods are used as a guideline for the activities or topics included in an individual or group therapy session. CBT is the more practiced and methodical approach, while DBT takes a more creative and emotional one. Both have many benefits and consequential drawbacks, and so the debate still goes on as to which one is the best method.

Personal Experience

I experienced both CBT and DBT treatment methods when I was hospitalized for an eating disorder for the first time. The first day at the hospital was what I thought would be the scariest day of my life. I sat through multiple groups labeled CBT or DBT, but my mind was too lost in fear and sadness that I did not really understand what the group was actually about. It was not until two weeks later that I really began to fully understand the subjects. CBT always managed to bore my interests as the subjects could be highly repetitive and simply not engaging. I tended to like DBT groups as the activities were usually more creative. DBT groups also tended to contain happier subjects whereas CBT could be very neutral. In my case, DBT was more of a match for me. Here's a quick look at each of them.

These two most prevalent types of treatment have differences that could affect which one could better benefit a patient.

Cognitive Behavioral Therapy

According to psychiatrist Ben Martin, CBT is a “short-term, goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behavior that are behind people’s difficulties, and so change the way they feel.” CBT also has homework assignments for patients to complete outside of the established group times. These assignments provide additional reinforcement of the positive thoughts that eventually develop in the patient’s mind. The goal is to change the thought process of the individual, so that the person will choose to react differently instead of relying on negative alternatives.

The drawback to this approach is that it is only effective for individuals with one specific disorder. Martin continues, “People who describe having particular problems are often the most suitable for CBT, because it works through having a specific focus and goal. It may be less suitable for someone who feels vaguely unhappy or unfulfilled, but who doesn’t have troubling symptoms or a particular aspect of their life they want to work on.”

Sometimes, feelings are nameless. They do not have to relate to a specific category. Someone can feel depressed but not know exactly why he or she feels that way. In this type of situation, other forms of treatment may better serve the person.

Dialectical Behavioral Therapy

DBT teaches the classic “I” phrases and derives benefits from meditation and mindfulness. According to the Linehan Institute, DBT is most effective on patients with three different types of particular behaviors. Each of the three represents the severity or differences of each diagnosis. These behaviors are categorized as the following.

(a) Life Threatening Behaviors: Life threatening behaviors are those most related to suicidal tendencies where the patient is at immediate risk of dying. These can include self-harm and eating disorders as those can be potentially life threatening.

(b) Therapy Interfering Behaviors: These are behaviors that “interfere with the client receiving effective treatment,” which includes “coming late to sessions, cancelling appointments, and being non-collaborative in working towards treatment goals.”

(c) Quality of Life Behaviors: These behaviors include “mental disorders, relationship problems, and financial or housing crises.”

Like CBT, DBT requires homework. However, only DBT requires daily homework. The repetition of recording thoughts and repeating positive phrases is to establish a type of brain muscle memory, so that in a moment of crisis, the patient turns to the DBT phrases instead of the negative thoughts that tend to induce addictive or harmful behaviors in patients. MD Junction writes that, “Each day, patients fill out diary forms, and most patients spend many hours each week in therapeutic activities. To benefit from the therapy, patients must be highly motivated.” Like in all things, practice makes perfect, so if the patient does not have the will to practice DBT methods daily, then he or she will not fully benefit from the treatment.

Ready for Change

Whether the patient undergoes CBT or DBT, treating an illness requires that person is actually willing to engage in treatment. Patients who do not recognize their illnesses will not see a difference in their lives by simply attending the groups. Practicing the ideals in the phrases and homework on a studious and meaningful level is the only way to see positive results from CBT or DBT. Given enough time, a general lift will become present in the patient’s life if there is a sincere passion to achieve recovery.

If you or someone you know is seeking help from addiction, please visit our directory of treatment centers or call 800-772-8219 to speak to a treatment specialist.

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