The Difference Between Dialectical Behavior Therapy and Cognitive-Behavioral Therapy

in Addiction
Morgan Metzger
Published Dec 31, 2020
The Difference Between Dialectical Behavior Therapy and Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) are two popular behavioral therapy models used to treat mental health disorders. DBT is a modified form of CBT that has a distinct approach to treatment. While both effectively treat various mental health disorders, several important factors may influence which model a therapist uses to treat a client. Because different mental health disorders affect cognition and behavior differently, the type of treatment that’s most effective also varies.

Cognitive-Behavioral Therapy (CBT)

CBT is one of the most common and best-studied forms of psychotherapy. It is the combination of two therapeutic approaches–cognitive therapy and behavior therapy.

What an individual thinks about an experience predicts how they feel and behave. By understanding their thinking patterns, the individual can begin to change the stories they tell themselves that lead to unhelpful behaviors and reduce painful manufactured emotions. Harmful thoughts and behaviors can make people feel bad about themselves.

For example, an individual may see somebody they know and say hello, but the person doesn’t say hello back. They may think, “They ignored me; therefore, they don’t like me anymore.” This thought may lead to sadness and rejection, leading the individual to avoid this person in the future, although this assumption may be completely false. Through CBT, the goal is to frame thinking as something along the line of, “They didn’t notice me. Maybe they don’t feel well. I should give them a call and see how they are doing.” By changing the frame of thinking, negative feelings about self are avoided, and positive behaviors, such as calling a friend, are reinforced.

CBT is a problem-oriented therapy that focuses on current problems and how to solve them. CBT aims to get an individual to a point where they have the skills to cope with life without therapy. It often uses relaxation exercises, stress and pain relief methods, and specific problem-solving strategies to treat depression, anxiety, obsessive-compulsive disorder (OCD), and substance use disorder (SUD).

There are also several different types of CBT, including Dialectical Behavior Therapy (DBT), Acceptance and Commitment Therapy (ACT), Cognitive Processing Therapy (CPT), Rational Emotive Behavior Therapy (REBT), and Mindfulness-based CBT.

Compared to psychoanalysis approaches, CBT is a short-term treatment. However, there is no standard length of time for CBT to be completed. One person may feel better after a few sessions, while another may need treatment for several months.

How Does CBT Work?

The most important aspect of starting CBT is to find the right therapist. Sometimes, it can take a while to find a therapist that is the perfect fit.

In the first session of CBT, the rationale for therapy is provided. It is essential that clients understand how CBT works first. CBT requires commitment and initiative. Therapy can only be successful if individuals actively participate in treatment and work on making changes between sessions. While CBT can be a brief therapy, there is “homework” involved between each session to “teach the client how to be their own therapist.” Medication is often used in severe depression or anxiety cases to help relieve symptoms so that therapy can be achievable.

Dialectical Behavior Therapy (DBT)

DBT was initially created to treat borderline personality disorder. However, DBT is now used to treat other illnesses, such as depression, bulimia, binge-eating, bipolar disorder, post-traumatic stress disorder (PTSD), and SUD. The goal of DBT is to improve an individual’s ability to regulate emotions, tolerate distress, be mindful and present at the moment, and communicate effectively with others.

The “D” in DBT stands for dialectics. Dialectics, as it applies in DBT, involves the therapist’s stance in helping the patient bring together seemingly opposite reactions throughout therapy, reconciling some of the conflicts that happen within the individual. A dialectic is a tension between two contradictory and conflicting viewpoints in response to a situation. For example, an individual may feel both relief and deep sadness simultaneously after losing a loved one that has been ill and in pain.

Acceptance and change are essential to DBT. An individual will learn how to accept and tolerate life circumstances, emotions, and themselves. DBT will also teach skills to help make positive changes in behaviors and interactions with others. During DBT, someone may also analyze destructive behavior patterns and replace them with healthier ones. The focus of DBT is to change thoughts, beliefs, behaviors, and actions that are not helpful to the individual.

How Does DBT Work?

DBT teaches four main strategies to change behavior: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.

Mindfulness helps an individual focus on the present, and it helps to pay attention to thoughts, feelings, sensations, and impulses. Mindfulness also uses the senses, such as sight, hearing, smell, and touch, to help the individual tune in to what is happening around them. The goal of mindfulness is for the individual to slow down and focus on healthy coping strategies when dealing with difficult emotions. It can help to avoid engaging in impulsive or destructive behaviors.

Distress tolerance helps an individual to accept themselves and their current situation. In the middle of a crisis, someone will learn to use distraction, improvement of the moment, self-soothing, and thinking of the pros and cons of not tolerating distress. These techniques help you prepare for intense emotions and help you cope with them.

Interpersonal effectiveness helps to become more assertive in a relationship while keeping it positive and healthy. Assertiveness may include learning to set boundaries and how to say “no.” By learning interpersonal effectiveness, an individual will learn how to communicate effectively, deal with challenging people, and respect themselves and others.

Emotional regulation is used to cope with intense negative feelings. The skills learned in DBT will help an individual name, identify, and change their emotions.

Using CBT and DBT in Addiction Treatment

Many people struggling with substance use disorder (SUD) may reach a point of continual negative thinking. Through CBT and its various forms, including DBT, patients are guided through therapeutic exploration to change thinking patterns and behaviors. By doing so, an individual can change their thinking patterns that may have led to the development of SUD. Participation in these types of therapies can also help reduce the risk of relapse; by changing thought patterns, the individual may not be tempted to use drugs or alcohol when encountering challenging situations.

Cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) are two of the most popular forms of therapy. DBT is a form of CBT, and both are used to treat various mental health disorders. Finding the form of CBT right for you may depend on the severity of substance use and any co-occurring mental health disorders. At Gallus Medical Detox Centers, we provide you with a bio-psycho-social evaluation with our expert staff to identify your next steps and resources to achieve long-term recovery. Our team can also help you decide if CBT and its various forms, including DBT, are right for you. Quitting substances may cause frightening, uncomfortable, and even life-threatening withdrawal symptoms. We use proprietary, evidence-based medical protocols that prioritize our patients’ comfort and safety to guide them through the detox process. Our personalized treatment is delivered in a safe and peaceful environment. If you or a loved one struggles with substance use disorder, call Gallus Medical Detox Centers at (866) 296-5242 to take the first step in achieving recovery.