The Difference Between Dialectical and Cognitive-Behavioral Therapy

Written by: Lynn Finnell, LFMT, LAADC | Reviewed by: Christian Small, MD

The Difference Between Dialectical and Cognitive-Behavioral Therapy


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    Talk therapy is a common form of counseling. But what are the differences between the dialectical and cognitive modes of this therapy? How are they the same? This article will explain what each type does and what it’s commonly used to treat.

    Psychotherapy and Talk Therapy

    If a person is hoping to work through problems in their life or develop coping skills for a mental health disorder, they might seek therapy. There are many different kinds of treatment, but talk therapy is one of the most common types. Talk therapy involves taking part in weekly sessions with a licensed mental healthcare professional where you and your therapist talk one-on-one about various aspects of your life.

    Therapists might have different approaches depending on their expertise and what you’re hoping to receive from your sessions. There are various reasons why a person might see a therapist. Some may seek healing from past trauma or want to learn enhanced coping skills for symptoms and develop a plan to get through an obstacle keeping them from achieving their goals.

    Understanding Cognitive-Behavioral Therapy

    Cognitive-behavioral therapy, or CBT, is a combination of both cognitive therapy and behavioral therapy. The basic theory of this type of therapy is that our thoughts and feelings influence our behavior. You might talk to your therapist about your thoughts on a particular situation during a session. For example, maybe you asked your child to take out the trash before playing outside. When you came home, the garbage was untouched. Your thought might be, “he didn’t take out the trash because he is lazy or doesn’t care.” The therapist then will ask you to reflect on how that made you feel, which most likely made you feel frustrated and disrespected, and as a response, you might have yelled at your child.

    While it might be true that your child was acting lazy or careless, a therapist might ask you to consider other reasons your child didn’t take out the trash. Perhaps they forgot because they were distracted by a difficult upcoming test. Viewing this new information, your feelings on the subject might change, and your reaction may differ.

    Dialectical Behavioral Therapy Explained

    Dialectical behavioral therapy (DBT) is a type of therapy that focuses mainly on emotions and the environmental conditions that lead to them. It is similar to CBT but includes learning life skills such as emotional regulation, navigating interpersonal relationships, mindfulness, and learning stress resiliency. It also focuses on the balance between accepting emotions and past behaviors and changing those emotional responses and behaviors in the future.

    What Are Their Similarities?

    Both of these therapy models are forms of talk therapy. In both models, there is an emphasis on taking what you learned in each session and applying the skills to real life. They both expect the patient to stay committed to treatment outside of the session and take the initiative to make behavioral changes.

    Dialectical behavioral therapy originates from cognitive-behavioral therapy and uses some CBT approaches such as implementing problem-solving and looking at things from a different perspective.

    What Are Their Differences?

    Cognitive-behavioral therapy focuses solely on the current problems at hand. It doesn’t deal with the past but looks at the thought processes, emotions, and behaviors occurring in the present moment. The goal is to change current distressing thoughts, feelings, and behaviors for the better. CBT also usually involves only one on one therapy sessions.

    DBT is more complicated than CBT. Often, DBT sessions require a team of therapists and the patient to attend group and individual therapy and in-between session check-ins. DBT also focuses more on the balance between acceptance and change, noting that both can’t exist independently. A patient might be resistant to change because they don’t feel accepted. Accepting behavior without expecting change can set them up for repeated problematic behaviors. In DBT, the therapist helps the patient accept their behaviors without judgment but still expects the inappropriate behaviors to change for the better.

    Which Is the Best Option?

    Cognitive-behavioral therapy is often recommended for depression, anxiety, OCD, and addiction. Those with mood disorders might have distressing thoughts that might not be the most accurate perspective due to their condition. By challenging their initial thoughts, they can influence their emotions and behaviors that could cause more pain.

    Most evidence supports dialectical behavioral therapy as the most effective approach to borderline personality disorder (BPD), but it’s shown positive results for BPD and substance use disorder as well. Dialectical behavioral therapy is still new, but its effects on other conditions are being researched. There are hypotheses that DBT could also be used to help emotional dysregulation in people with attention-deficit hyperactivity disorder (ADHD).

    Therapy can be an excellent tool for recovery. Talking about your problems with a trained medical professional can help you build the skills you need for a more fulfilling life. There are plenty of reasons to try talk therapy, but you might not know which option works the best for you. Both CBT and DBT are excellent options, and many therapists can even do hybrid sessions of both, depending on your individual needs. DBT is a new form of talk therapy. Still, based on how it’s helped many people so far, it can be a fantastic way to look deeper into your emotions and find alternative ways to handle them.

    If you would like to learn more about these two forms of talk therapy, call Villa Oasis San Diego today at (323) 739-8673. You are just one call away from changing your life for the better.

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