What is the difference between CBT and DBT? Are CBT and DBT helpful for anxiety and depression?

If you're curious about CBT and DBT therapy and how it can help with anxiety and depression, this post is for you. Find out what it is and how it can improve your mental health.

Cognitive Behavioral Therapy (CBT) is a type of talk therapy that focuses on changing negative thought patterns and behaviors, while Dialectical Behavioral Therapy (DBT) focuses on teaching skills to manage emotions, improve relationships, and increase overall quality of life. Learn more about CBT and DBT therapy and how it can benefit you.

What is CBT?

Cognitive-behavioral therapy (CBT) was developed by Dr. Aaron Beck through his work with clients with depression. Dr. Beck discovered that most of his clients exhibited automatic thoughts, which were often negative and in turn impacted his clients’ behavior. His clients also often exhibited negative core beliefs about themselves (“I am not good enough”), those around them (“no one likes me”) and the world (“nothing ever works out well for me”). Thus, he developed CBT, which is based on the idea that our thoughts, feelings and behaviors are interconnected and if we change one, we can influence the others too.

How does CBT work for anxiety and depression?

CBT works for anxiety and depression by helping you identify negative automatic thoughts (NATs), which in turn are driven by core beliefs such as “I am not good enough…I am unlovable...etc”. We will work on challenging some of those core beliefs as well as learn strategies to notice, but not engage with NATs. CBT also involves exposure therapy, where you gradually confront your fears and anxieties in a safe and controlled environment. This would help you to learn that you can tolerate and manage your symptoms, which can lead to a reduction in anxiety and depression over time.

How does DBT therapy help with anxiety and depression?

Dialectical Behavioral Therapy (DBT) was developed by Dr. Marsha Linehan several decades ago originally for clients with Borderline Personality Disorder (BPD). Over time, clinical studies have shown that DBT skills can also be helpful in reducing anxiety and depression symptoms and overall help clients improve their quality of life.

The four modules of DBT

DBT consists of four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Each module focuses on a specific set of skills that you can use to manage your emotions and improve your relationships. Mindfulness skills help you become more aware of your thoughts and feelings, while distress tolerance skills teach you how to cope with difficult situations without resorting to harmful behaviors. Emotion regulation skills help you identify and change negative thought patterns that contribute to anxiety and depression, and interpersonal effectiveness skills help you improve your communication and relationships with others. By learning and practicing these skills, you can improve your overall mental health and well-being.

What is the difference between CBT and DBT?

While both types of therapy are based on the cognitive behavioral model that thoughts, feelings and behaviors are interconnected and influence each other, the skills you would learn within each type of therapy are quite different. Under the CBT umbrella of therapeutic interventions, you would focus on identifying and challenging your negative thoughts, while in DBT the focus is much more on noticing your thoughts and letting them pass through vs engaging with them.

If I am seeking therapy for anxiety and depression, would every session be just focused on learning CBT or DBT skills?

While I and many other therapists incorporate CBT and DBT strategies in our work, it is important to note that the relationship and trust between the client and therapist has been shown to be one of the major factors for success in therapy. Thus, my number one priority is to ensure we build a strong rapport and that our styles are a good match while also providing you with practical skills you can use between sessions to manage your anxiety and depression symptoms. Often times, relationship patterns that you engage in with your family, friends and coworkers, will play out in therapy sessions and allows me to provide you with objective feedback regarding potential blind spots you may not be aware of and that may be contributing to relational difficulties which in turn may be contributing to worsened anxiety and depression symptoms.

Veselina Hristova Jones, LICSW, is a Boston-area therapist based in Wellesley, MA, who specializes in anxiety, depression, and relationship issues. She provides compassionate, evidence-based therapy to adults across Massachusetts through secure online sessions, as well as in-person therapy for clients in Wellesley, Newton, Weston, Needham, Natick, and Framingham.