Cognitive behavioural therapy (CBT) is an effective form of psychotherapy used to treat mental health issues, and dialectical behavioural therapy (DBT) is a part of it. CBT and DBT are effective therapeutic modalities that sound similar but differ significantly. For example, while CBT focuses on the link between your thoughts, behaviours, and feelings and replaces the negative with positive, DBT is a type of CBT which help you learn how to regulate emotions, deal with crisis, stay in the present moment, and be effective in your relationship. In other words, CBT and DBT differ in what you learn and how the treatment is delivered.
This article will discuss the legitimate differences between cognitive and dialectical behavioural therapy and help you decide which is better for addiction recovery.
What is Cognitive Behavioural Therapy (CBT)?
A type of psychotherapy or talk therapy, cognitive behavioural therapy is widely used in addiction recovery programs. Generally, people seek CBT to treat their anxiety, depression, mental health disorders, or mental distress. CBT helps people identify their negative or unhelpful thinking patterns, feelings, and behaviours that contribute to these mental health conditions and reconstruct them towards building a positive approach and a healthy lifestyle.
The idea behind the development of cognitive behavioural therapy is that it connects everything from how you think and feel to acting under the influence of addiction. Therefore, CBT addresses the negative and unrealistic thoughts that contribute to feelings of distress and negatively impact lives. When people become aware of their negative interpretations and behavioural patterns, CBT helps them develop alternate or positive ways of thinking, reducing psychological discomfort.
Techniques Used in CBT:
- Identifying Negative Behaviours: This step involves learning how an individual’s thoughts and feelings are responsible for maladaptive behaviours.
- Practising New Skills: Individuals learn healthy coping skills and apply them in real-life situations.
- The Setting of Goals: One of the most critical steps of addiction recovery, individuals are taught how to identify the goals, distinguish between short and long-term goals, and focus on the process.
- Problem-Solving Skills: CBT helps people deal with stressful situations with a problem-solving attitude and reduce the negative impact of psychological and physical illness.
- Self-monitoring: In this process, patients are asked to write down their thoughts, symptoms, and experiences over time and identify how far they have come.
What is Dialectical Behavioural Therapy (DBT)?
Dialectical Behavioural Therapy, or DBT, is a modified type of CBT, originally developed to treat borderline personality disorder (BPD) but has since been adapted to treat other conditions. Widely used in addiction recovery programs, DBT helps people regulate their emotions and manage self-destructive behaviours, such as eating disorders, substance use disorders, and self-harm. Unlike CBT, DBT does not change a person’s entire thinking pattern or behaviour but helps them achieve a more balanced worldview. During DBT sessions, therapists also assist patients with behavioural skills and use them for interaction in group sessions.
Developed in the 1980s, DBT was used to treat core symptoms of BPD, such as intense emotions, complex relationships, impulsive actions, and black-and-white thinking. In addition, DBT stresses the practice of mindfulness, strengthening emotions, growing relationships, and increasing distress tolerance.
Techniques Used in DBT:
- Mindfulness: Mindfulness is a practice where a person is taught to be present at the moment and feel grounded, and DBT ensures that. Mindfulness is helpful for people struggling with unstable self-images and facing difficulties staying focused on the present. The idea of this practice is that negative thoughts go automatically.
- Emotional Regulation: Most people with addiction problems face intense emotions and lose control of the situation; DBT helps people manage these emotions to stay stable in unfavourable or triggering conditions. In DBT sessions, people learn how to react to negative emotions and avoid situations where their addiction can be activated.
- Distress Tolerance: DBT teaches people how to manage their behaviour and emotions to avoid impulsive acts and think healthy things at that time.
- Interpersonal Effectiveness: Interpersonal effectiveness is vital for addiction recovery, and DBT aims to teach assertiveness to people and how to put it within healthy boundaries. People will also learn communication skills to interact with people in healthy and respectable ways. Also, listening skills, conflict resolution skills, and trust building are taught in dialectical behavioural therapy.
The Differences Between CBT and DBT
Though CBT and DBT have a similar process of aiming to alter negative thoughts and use coping skills in triggering situations, there are distinctive differences described below:
Emphasis or Goals
Cognitive-behavioural therapy (CBT) is typically more goal-oriented than dialectical behavioural therapy (DBT). While CBT helps people identify negative behaviours and provide tools to adjust to these problems, DBT focuses on assisting patients in finding a way to accept themselves, regulate destructive behaviours, and manage emotions. Also, DBT focuses on emotional and social aspects, while CBT is an approach that studies patients’ behaviours.
Compared to DBT, CBT completes in a short time. It is because the goals are set, and therapists work in a single direction to address specific patient problems during CBT, which is about 6 to 20 weeks. On the contrary, DBT involves sessions that run over a more extended period of time so that the therapists understand the whole picture and help clients work through several issues. It usually lasts for at least six months to complete all modules but may run for years in some instances.
CBT is a one-on-one approach that usually occurs between a therapist and a patient. The therapists talk to the clients during the session to understand them and give them homework to take home. The assignment includes talking to the family members, practising coping skills, and maintaining a positive approach to everyday life.
However, DBT features individual and group weekly sessions where patients learn skills like interpersonal communication from one of the four modules and practice them in a safe and supportive environment.
Each therapy is suitable for certain medical conditions and depends on an individual’s needs. For example, CBT better suits patients struggling with depression, anxiety, post-traumatic stress disorder (PTSD), phobias, and obsessive-compulsive disorder (OCD). On the other hand, DBT helps people with borderline personality disorder (BPD), self-harming behaviours, and chronic suicidal ideation.
The difference in approach is what makes CBT and DBT diverse. DBT focuses on the person’s social interaction and uses mindfulness philosophies to help people accept themselves and their environment. In contrast, CBT is more logic-focused and encourages patients to develop healthier thinking patterns and behaviours.
CBT or DBT, which is better?
Addiction recovery programs have different sides. While some people want help with anxiety, depression, and PTSD, others need help with issues like bipolar personality disorder. Therefore, cognitive behavioural therapy and dialectical behavioural therapy are effectively used in rehab centres for patients with mental health issues. Though the process of CBT and DBT are similar, specific differences can help you decide which one is better. Also, no evidence-based factors can determine any one therapy’s effectiveness, and it solely depends on the needs of individuals. If it is confusing to decide which treatment to choose, go to your therapist for an honest review.