Is CBT (Cognitive Behavioral Therapy) better or more effective than DBT (Dialectical Behavioral Therapy)?

Great question.  The truth is that there are similarities between DBT vs CBT.  And, at the same time, there are some unique differences.  A lot of this depends upon the client.  Both approaches are very focused upon the client.  DBT has often been found to be more effective with folks who:

  • Have a history of experiencing emotions deeply
  • Have a history of relational instability
  • Have a history of self-harm of one kind or another
  • Have a history of suicidal ideation or suicidal thoughts
  • Have a history of feeling emptiness
  • Have a history of issues connected with food such as anorexia, bulimia, or overeating

When contrasting DBT to CBT, CBT has been found to be effective with folks who experience:

  • Anxiety
  • Depression
  • Panic Disorder
  • Panic Attacks
  • Obsessive compulsive disorder (OCD)
  • Anger issues
  • Eating issues such as anorexia, bulimia, or overeating
  • (ADHD) Attention Deficit Hyperactivity Disorder

When comparing DBT and CBT is one more effective?

There are small differences between the 2 approaches. Given these differences, the client may experience different outcomes. There are not huge differences in outcomes. However, depending upon the client and depending upon the issues being treated, one may be a better choice. The clinician is likely to have a feel for which one may be best for a particular person.

What about for Anxiety? Should I go with DBT vs. CBT?

CBT boasts of many techniques. Some of these techniques teach clients to “talk back to the brain.” Cognitive reframing is one such technique. CBT teaches one to get rid of cognitive distortions, and it teaches one to restructure their language. These cognitive distortions are then replaced with positive and accurate thoughts. CBT also teaches various relaxation techniques, allowing one to slow the heart rate and think more rationally.

DBT also uses techniques to help clients to decrease anxiety. One of the things which a DBT therapist will do is encourage the client to do is to engage in radical acceptance of the one’s reality and to increase one’s distress tolerance. The client is taught to engage in self-distraction and is taught to self-sooth and shift one’s focus. Mindfulness is another huge component of DBT. DBT therapists use a concept called “meaning making” while encouraging the client to skillfully engage in relaxation, imagery, prayer, and focusing upon the here and now.

For ADHD, CBT vs. DBT?

CBT has been very utilized over time for the treatment of many conditions, one of which is ADHD. Folks who struggle with ADHD struggle with various aspects of life which include, prioritizing tasks, setting goals, and general issues surrounding one’s ability to organize schedules. But with DBT clients can learn skills such as mindfulness. This helps one to regulate the impulses such as impulsiveness in speech and impulsiveness in behavior.

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Which is best for Eating Disorders?

For issues surrounding disruption of eating, DBT would be the choice; for one reason, it assists the client with skills to increase emotional regulation.  This is often done by assisting the client to identify emotions, develop insight into one’s emotions, and then to express the emotions in an effective and safe way.

With CBT, the client is often taught how to identify unpleasant situations or events, identify one’s beliefs associated with the event, and then to identify the consequences of those thoughts such as resulting feelings or resulting behaviors.

Can You Do DBT and CBT at the Same Time?

Routinely, therapists practice CBT and DBT conjointly with a goal of helping the client to meet their goals. Another way that we practice is to have a client doing individual CBT and at the same time to have the client doing DBT group. This can be a very powerful way of injecting change into the clients life, and we’re all very interested in change.

What about ACT vs CBT vs. DBT: What Are the Similarities and Differences?

(ACT) Acceptance and commitment therapy encourages one to view life through a lens that incorporates one’s values, and it also encourages one to truly accept situations as they are. In addition to accepting the situations as they are, ACT encourages the client to no longer deny one’s feelings or see the feelings as an inappropriate response to certain circumstances. These events may or may not need processing. Maybe they could also be processed in a DBT group.

One of the things shared by ACT, DBT, and CBT is the need to accept one’s emotions.
The techniques used by the 3 may be different. For instance:

  • DBT likely will encourage the client to be more focused upon emotion. DBT will likely work better for folks dealing with issues of harming themselves, for those dealing with borderline personality disorder, or disordered eating.
  • CBT will likely focus on thoughts, focus upon how the thoughts are connected to behavior, and focus upon teaching the client to erase negative thoughts.
  • ACT will likely focus more upon mindfulness and there will be less teaching. It, however, does help the client to notice negative thoughts and it does help the client to change the way they talk to themselves.

CBT vs. DBT vs. EMDR: How Are They Different?

(EMDR) Eye-movement desensitization and reprocessing has achieved a lot of notoriety.
It has a base in CBT, but it deals with a more specific focus of issues. EMDR uses lateral movements that are often rapid. A therapist will often move a finger back and forth in front of the client. Or the therapist will ask the client to hold pulsers, or the therapist may ask the client to watch a light moving back and forth across a light bar with a goal of assisting the client to lower the emotional responses that are trauma connected.

By engaging in these techniques, it allows the client to remember events of the past with more clarity and begin to process them. EMDR is most often done for trauma processing, such as folks diagnosed with PTSD.

While DBT and CBT are also used to help clients who have been through trauma, EMDR is meant to enable the client to remember the traumatic event, process the event or events, and engage in reduction of the impact of the event upon the client’s life in the here and now. Individual therapy, using EMDR, can also be easily combined with a DBT group.

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