What is the Difference between DBT and CBT?

Many clients and family members want to know how DBT differs from CBT.

Cognitive-behavioural therapy (or CBT) has been the mainstay of modern therapy for several decades. CBT is the front-line treatment in tackling depression, anxiety and substance use (and is usually very effective). However, clients who have more complex difficulties (such as self-harm or suicidality) or who have a number of different issues (such as problems with substance use combined with depression or anxiety as well as family or relationship difficulties) will tend to benefit more from DBT.

Dialectical Behaviour Therapy (or DBT) grew out of a need to help suicidal clients to lead lives worth living where more mainstream therapies had failed. The developer of DBT, Marsha Linehan, drew on her deep knowledge of cognitive and behavioural therapies and combined this with applied mindfulness techniques as well as with the theory of dialectics (dialectics helps patients to get unstuck from black-and-white thinking). The combination of CBT, mindfulness and dialectics was formulated into a manualised treatment consisting of four modules, which teach clients the skills that they need to meet life on life’s terms.

Many clients who succeed in DBT have previously undertaken CBT and found it be either of limited use, or worse, downright invalidating! DBT takes the most useful aspects of CBT and reconfigures them into bite-size skills that most everyone can learn and use in their everyday life.

The message in all of this is, don’t be disheartened if CBT hasn’t worked for you. If you are dealing with multiple or complex life issues and CBT has failed to produce results, you are more than likely a good candidate for DBT.

Lyndon Barei