Happy family


Dialectical Behavior Therapy (DBT) vs. Cognitive Behavioral Therapy (CBT): What’s the Difference?

dialectical behavior therapy vs cbt

Mental health disorders—such as anxiety, depression, and substance addiction—are complex conditions that can stir a range of symptoms in individuals. Everyone has a different experience with mental illness, including the severity of their disorder and how much it affects their day-to-day life. Some individuals struggle with multiple, co-occurring mental health problems. Therefore, no treatment plan can be the same. Mental health disorders require a comprehensive and personalized approach to treatment, often combining multiple modalities and forms of therapy. Two evidence-based approaches—which have garnered widespread recognition for their effectiveness in treating mental illness—are Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT)

Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) sound similar in nature, and that’s because they are. DBT is actually derived from the CBT therapy model. However, there are key distinctions between the philosophies, techniques, and applications of DBT and CBT. 

If you are researching treatment options – for yourself or a loved one – it’s essential to understand the types of evidence-based therapy available. Below we explore the core elements of CBT vs. DBT, highlighting their unique features, therapeutic goals, and practical applications to provide a comprehensive comparison for those navigating the path to mental well-being.

What is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that is widely used to treat mental health and substance use disorders. At its core, CBT focuses on helping people identify and rectify negative thought patterns, which underlie many emotional and behavioral issues.

For example, people struggling with depression might experience intense, persistent feelings of worthlessness. In this case, Cognitive Behavioral Therapy would work to help these individuals identify when these destructive feelings arise, challenge them, and take positive action to shift their ways of thinking. CBT would spin thoughts of “I am useless” into a mindset of “I am capable. Although I have made mistakes, I also have many strengths and things to offer.”  

For individuals battling a substance use disorder, CBT works similarly. Drug addiction is triggered by compulsive cravings and, very often, struggles with one’s mental health. For example, many people self-medicate mental illness with drugs and alcohol. In these instances, CBT would work to help identify when negative emotions arise and make active changes before one reaches for a drink or a drug. When someone with anxiety feels, “I need to take this pill to calm my nerves,” working through the skills taught in CBT might allow them to instead say, “These worries are temporary. I am strong and can work through them by calling a friend, going for a run, or writing in my journal.”

To summarize, there are a few, key components of Cognitive Behavioral Therapy that allow it to work so well. These include:

  • Identifying destructive or intrusive thought patterns and beliefs
  • Challenging and questioning those negative thoughts
  • Considering alternative, more balanced perspectives
  • Restructuring negative thoughts into positive ones
  • Implementing positive behaviors and lifestyle changes, to support one’s mental health (e.g. finding activities that offer joy and meaning for an individual)
  • Developing coping skills to overcome negative feelings as they arise
  • Building an improved sense of self-worth and confidence in one’s abilities

What is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is another type of evidence-based psychotherapy used to treat mental illness and substance use disorders. DBT was originally built upon the principles of CBT but customized to meet the specific needs of people with borderline personality disorder (BPD). While DBT is still widely used to treat personality disorders, it is now applied to a variety of mental health conditions including depression and anxiety. 

At its core, DBT is focused on emotional regulation. It takes a dialectical approach to this, however, by promoting acceptance and change. Individuals participating in DBT therapy are encouraged to accept and validate their negative feelings, experiences, and—ultimately—themselves. At the same time of this acceptance, individuals are also encouraged to make positive changes to manage the intense emotions associated with their condition.

Individuals participating in Dialectical Behavior Therapy will recognize negative thoughts as they arise, validate them in that moment, and take steps to change them. For example, someone struggling with social anxiety might be scared to attend an event. DBT would help this individual validate their fears in the moment, saying “I am having the thought that everyone will judge me. It’s okay to feel this way, but I must remember all the positive interactions I’ve had with people lately. It’s possible that some people will judge me, but it’s also likely that people will be kind or indifferent. I am capable of handling any reactions and having a good time.”

Ultimately, DBT works to help people work through intense, destructive emotions and feel understood at the same time. It operates through the following tactics:

  • Encouraging mindfulness, or being aware and present in the moment
  • Regulating emotions, offering clients the tools they need to manage them effectively
  • Increasing a person’s tolerance of negative emotions, rather than allowing them to escape from them 
  • Developing positive skills and habits to change negative feelings and emotions 
  • Improving motivation and increasing one’s capabilities, while reducing negative behaviors

Key Differences Between CBT vs. DBT

As you can see, Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) share many similarities. Both are evidence-based therapies that are effective in treating a variety of mental health disorders. Both are based on the principle that a person’s thoughts and feelings can significantly influence their behavioral responses—and, as a result, both CBT and DBT focus on giving people the skills they need to change their negative thoughts.

However, there are also some core differences between CBT and DBT approaches:

Philosophy and Focus

CBT primarily focuses on the present, addressing current problems and the negative thought patterns that can contribute to them. It is a structured therapy that aims to change unhelpful thinking in the moment, leading to more positive reactions and behaviors. The philosophy of CBT is often summarized by the idea that if you change your thinking, you can change your life.

DBT, on the other hand, places a strong emphasis on acceptance and validation of one’s emotions first. DBT aims to find balance between accepting negative thoughts and feelings, and implementing strategies to change them (drawn from CBT). DBT is fundamentally rooted in the idea that effective treatment occurs by holding two seemingly opposite perspectives at once: clients are taught to accept themselves as they are, while also working on changing their behavior. 


CBT is generally practiced as individual therapy, while DBT often includes both individual therapy sessions and skills training groups. CBT is recognized as the gold-standard for treating mental health disorders like depression and anxiety, as well as stress-related disorders. DBT is often applied to cases where clients have not responded to traditional CBT therapies, such as those with severe suicidal ideation or emotional dysregulation. Examples of their applications are as follows.

Cognitive Behavioral Therapy (CBT) is often applied to the treatment of:

  • Depression
  • Anxiety disorder
  • Post-traumatic stress disorder
  • Panic disorder
  • Obsessive-compulsive disorder
  • Eating disorders
  • Substance use disorders

Dialectical Behavior Therapy (DBT) is often applied to the treatment of:

  • Borderline personality disorder
  • Intense emotional disorders
  • Self-harm and suicidal ideation
  • Substance use disorders

It’s important to note that an individual’s treatment plan can be comprised of both CBT and DBT—you do not need to pick-and-choose one type of therapeutic model. In fact, it’s likely that providers will recommend an integrated and comprehensive approach based on your individual needs.

CBT and DBT at Turnbridge 

Turnbridge is a mental health treatment provider that operates on evidence-based therapeutic models, including Cognitive Behavioral Therapy and Dialectical Behavior Therapy. 

Every client at Turnbridge receives a personalized treatment plan, based on their individual needs, experiences, and health conditions. Here, treatment is not one-size-fits-all but rather customized to meet clients where they are and offer them a positive pathway to change. With that in mind, the treatment provided typically involves a combination of evidence-based therapy methods, including psychotherapies (like CBT and DBT), as well as medication management, educational support, group therapy, 12-step programming, family therapy, and more.

If you would like to learn more about how CBT and DBT are applied at Turnbridge, please visit:

You may also call us at any time to speak with a mental health professional. We are here for you. Call 877-581-1793 today.