What is Cognitive Behavioral Therapy (CBT)?
CBT is a type of therapy that focuses on the way our thoughts, feelings, and behaviors are connected. It helps people recognize negative thinking patterns and replace them with more helpful and realistic thoughts.
How Does CBT Work?
CBT follows a structured approach where a therapist helps a person:
- Identify Negative Thoughts – People struggling with depression or anxiety often have automatic negative thoughts (e.g., “I’m a failure,” “Nothing will ever get better”). These thoughts can make them feel worse.
- Challenge These Thoughts – A therapist helps examine whether these thoughts are based on facts or assumptions.
- Replace Negative Thoughts with Healthier Ones – Once a person understands that their thoughts aren’t always accurate, they can learn to change them. Instead of thinking, “I’m a failure,” they might reframe it to, “I made a mistake, but that doesn’t mean I’m a failure.”
- Change Behavior to Improve Mood – Depression often makes people withdraw from activities they once enjoyed. CBT encourages small, achievable actions that can help improve mood over time.
What is CBT Used For?
CBT is one of the most widely used and researched types of therapy. It is highly effective for treating:
- Depression – Helps people break out of negative thinking loops and take small steps to improve their mood.
- Anxiety Disorders – Teaches people how to manage worry, panic attacks, and social anxiety by shifting unhelpful thinking patterns.
- Obsessive-Compulsive Disorder (OCD) – Helps individuals face fears and resist compulsive behaviors.
- Post-Traumatic Stress Disorder (PTSD) – Guides people in processing traumatic memories in a way that reduces emotional distress.
- Phobias – Uses gradual exposure techniques to help people overcome irrational fears.
- Eating Disorders – Helps people challenge negative beliefs about food, body image, and self-worth.
Key Benefits of CBT
- Structured and Goal-Oriented – CBT follows a plan with clear steps to help people improve their mental health.
- Short-Term – Unlike traditional therapy, which can last for years, CBT often lasts for 12–20 sessions.
- Evidence-Based – Decades of research have proven its effectiveness for a wide range of mental health issues.
- Homework and Practice – CBT involves practicing skills outside of therapy sessions to make lasting changes.
What is Dialectical Behavior Therapy (DBT)?
DBT is a specialized form of CBT designed to help people who struggle with intense emotions and self-destructive behaviors. It was originally developed to treat people with Borderline Personality Disorder (BPD), but it has since been adapted for other conditions.
How Does DBT Work?
DBT helps people balance two important ideas:
- Acceptance – Learning to accept emotions and experiences without judgment.
- Change – Learning skills to regulate emotions, improve relationships, and reduce harmful behaviors.
Key Skills Taught in DBT
DBT teaches four main skills that help people manage their emotions and behaviors:
1. Mindfulness (Staying Present in the Moment)
Many mental health struggles involve dwelling on the past or worrying about the future. Mindfulness teaches people to focus on the present, accept their thoughts and feelings without judgment, and respond calmly instead of reacting impulsively.
2. Distress Tolerance (Coping with Intense Emotions Without Making Things Worse)
This skill helps people deal with emotional pain in healthy ways. Instead of turning to self-harm, drugs, or reckless behavior, DBT teaches techniques like deep breathing, distraction, and self-soothing activities (e.g., listening to music, taking a warm bath).
3. Emotion Regulation (Managing Strong Feelings)
People with intense emotions may feel like their mood swings are uncontrollable. DBT teaches how to:
- Identify and label emotions
- Reduce emotional sensitivity
- Use coping strategies to prevent emotions from overwhelming them
4. Interpersonal Effectiveness (Improving Communication and Relationships)
DBT helps people build healthier relationships by teaching them how to:
- Ask for what they need in a respectful way
- Set boundaries without feeling guilty
- Handle conflicts without escalating them
What is DBT Used For?
DBT is especially helpful for people who experience extreme emotions and difficulty controlling them. It is commonly used to treat:
- Borderline Personality Disorder (BPD) – Helps with emotional instability, self-harm, and difficulty maintaining relationships.
- Chronic Suicidal Thoughts & Self-Harm – Teaches coping strategies to prevent self-destructive behaviors.
- Substance Use Disorders – Helps people manage cravings and emotional triggers that lead to addiction.
- Eating Disorders – Supports emotional regulation and healthier coping mechanisms for people struggling with binge eating or restriction.
- Severe Mood Disorders – Can be helpful for depression and anxiety, especially when emotional regulation is a challenge.
Key Benefits of DBT
- Comprehensive Approach – DBT combines individual therapy, group skills training, and phone coaching to support individuals outside of sessions.
- Focuses on Emotional Stability – Teaches practical skills to manage overwhelming emotions.
- Balances Acceptance and Change – Helps people accept themselves while also working toward personal growth.
- Long-Term Benefits – The coping skills learned in DBT can be applied throughout life.
CBT vs. DBT: What’s the Difference?
| Feature | CBT (Cognitive Behavioral Therapy) | DBT (Dialectical Behavior Therapy) |
| Main Focus | Changing negative thoughts to improve emotions and behaviors. | Managing intense emotions and improving relationships. |
| Best For | Depression, anxiety, OCD, PTSD, phobias, eating disorders. | BPD, self-harm, extreme mood swings, substance use, eating disorders. |
| Treatment Structure | Short-term, structured, goal-oriented. | Long-term, includes individual therapy, group skills training, and phone coaching. |
| Skills Taught | Cognitive restructuring (changing thoughts), problem-solving. | Mindfulness, distress tolerance, emotional regulation, interpersonal effectiveness. |
| Approach to Emotions | Identifies and challenges negative thoughts that cause distress. | Accepts emotions while teaching skills to manage them. |
How Do CBT and DBT Help with Depression?
CBT for Depression
CBT is one of the most effective treatments for depression because it directly targets negative thinking patterns that keep people feeling stuck. Depression often makes people:
- Feel hopeless about the future.
- Withdraw from activities and isolate themselves.
- Blame themselves for things that aren’t their fault.
- Struggle to find motivation to do anything.
CBT helps by:
✔ Teaching people to recognize and challenge negative thoughts.
✔ Encouraging small, manageable actions to increase motivation and positive feelings.
✔ Helping break the cycle of avoidance and inactivity.
DBT for Depression
DBT is particularly useful for people whose depression is linked to emotional instability or intense mood swings. If someone:
- Feels emotions very strongly and has trouble controlling them.
- Gets overwhelmed by feelings of anger, sadness, or frustration.
- Has self-harming thoughts or suicidal feelings.
- Struggles with relationships due to mood instability.
DBT helps by:
✔ Teaching skills to regulate emotions and avoid extreme reactions.
✔ Providing tools to cope with distress without self-harm.
✔ Helping improve relationships and communication.
Which Therapy Should You Choose?
- If you struggle with negative thinking, depression, or anxiety, CBT is usually the best choice.
- If you experience intense emotions, self-harm, or difficulty controlling reactions, DBT may be more effective.
- Many therapists use a combination of both approaches depending on an individual’s needs.
- You can learn both!
If you’re unsure, a mental health professional can help guide you to the best approach for your situation.
Here are sources that provide information on Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT), their differences, benefits, and applications in treating depression:
- Here to Help – Explains the key differences between CBT and DBT, focusing on validation and relationships in DBT. It highlights how DBT emphasizes acceptance of experiences and the importance of the therapeutic relationship.
https://www.heretohelp.bc.ca/q-and-a/whats-the-difference-between-cbt-and-dbt - SBTreatment.com – Discusses how CBT helps change problematic thinking, making it effective for conditions like depression and anxiety, while DBT focuses on emotional regulation and is beneficial for disorders such as Borderline Personality Disorder (BPD) and eating disorders.
https://sbtreatment.com/dialectical-behavioral-therapy/dbt-vs-cbt/ - Verywell Health – Provides an overview of both therapies, noting that CBT is more established while DBT is newer and being studied for its effectiveness in various applications.
https://www.verywellhealth.com/dialectical-behavior-therapy-vs-cognitive-behavioral-therapy-uses-benefits-side-effects-and-more-5323767 - Palo Alto University – Highlights CBT’s effectiveness in treating depression, anxiety, PTSD, OCD, phobias, and panic disorder. It also notes that DBT, originally developed for BPD, is useful for eating disorders, substance-use disorders, and self-harm behaviors.
https://concept.paloaltou.edu/resources/business-of-practice-blog/cbt-dbt - Psych Central – Compares CBT and DBT by explaining that CBT focuses on changing thought patterns and behavior, whereas DBT emphasizes how individuals interact with the world, themselves, and others.
https://psychcentral.com/lib/whats-the-difference-between-cbt-and-dbt - Choosing Therapy – Discusses philosophical differences, stating that CBT is focused on the present, while DBT processes past trauma to facilitate healing. It also notes that DBT encourages acceptance, whereas CBT primarily seeks to change maladaptive thinking patterns.
https://www.choosingtherapy.com/dbt-vs-cbt/ - Simply Psychology – Provides an overview of the key differences between CBT and DBT, including their target populations, philosophical foundations, and treatment approaches.
https://www.simplypsychology.org/whats-the-difference-between-cbt-and-dbt.html - Hillside Atlanta – Explains how CBT helps clients identify and change problematic ways of thinking and behaving, while DBT helps clients regulate extreme emotions to improve relationships through validation and behavior change.
https://hside.org/dbt-vs-cbt/ - First Session – Provides success rates for CBT and DBT, noting that both therapies have an overall success rate of 50-60% in treating various mental health conditions.
https://www.firstsession.com/resources/cbt-vs-dbt-understanding-the-differences-and-benefits - Health.com – Discusses how DBT focuses on emotional regulation, acceptance, and coping strategies, while CBT primarily aims to identify and change negative thought patterns.
https://www.health.com/dbt-vs-cbt-8694023