What Is the Difference between CBT and DBT?
There are all sorts of different tools experts could use to help clients with mental illnesses. They could offer medications to soothe chemical imbalances within the brain. They could provide supervision, so people have no opportunity to make poor decisions. They could use tools like yoga or meditation to ease mental distress. All of these tools work, but there is one that works just a little better: That tool is talk therapy.
In a therapy session, a person with a difficult problem, such as addiction or mental illness, has an opportunity to discuss that issue in detail with a trained professional in a safe and completely private environment. During those conversations, people may learn more about how the issue began, but they might also learn more about how to keep the issue under control in the future.
There are all sorts of different forms therapy conversations can take, and each one might be better or worse for certain people in need. This article will discuss two main types of therapy: Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT).
Who Would Benefit from This Therapy
CBT is one of the most commonly used forms of therapy. Mayo Clinic reports that it is often used in the treatment of depression, post-traumatic stress disorder, and eating disorders. It has also been used to help people move through a stressful situation, regardless of whether or not that situation is complicated by mental illness.
CBT is also widely used in the treatment of addiction, mainly because it has been proven effective in helping people to both understand why they use and help them to come up with replacement tasks they could complete when the urge to use begins to grow. CBT has even been proven effective in the treatment of Internet addictions. In one study of its use within that group of addicted people, published in the Australian and New Zealand Journal of Psychiatry, researchers examined 56 people. Some got CBT, and some did not. Those who did had better time management skills, along with better emotional, cognitive, and behavioral symptoms.
Studies like this demonstrate the power of CBT, and they demonstrate why clinicians might choose to provide this therapy to people in need. It does seem to work.
Unlike CBT, which could be used for almost anyone, DBT is a very targeted form of therapy that was designed to assist one specific type of person. This therapy was developed for people who have borderline personality disorder. These people may have a host of habits they need to change, but pushing these people to change could cause them to grow angry or close down. They need a close alliance with a therapist in order to see the need for change. DBT can bring that about.
DBT has been proven remarkably effective. In one study of its efficacy, published in JAMA Psychiatry, researchers found that people who got DBT were about 50 percent less likely to attempt suicide, and they were less likely to drop out of treatment too. That means this form of care helps to ease symptoms, and it could make life easier for this specific type of person.
The National Alliance on Mental Illness (NAMI) reports that CBT is designed to eliminate negative modes of thinking. These are the types of thought patterns that erode a person’s confidence and strength. These are the thoughts that can lock poor decisions and bad behaviors in place. With CBT, those thoughts and opinions can shift, and that could help people to make better decisions in the future.
Before CBT, a person might live with an inner voice that consistently focuses on a person’s failings, including:
- Financial distress
- Relationship failures
After CBT, a person might no longer hear this voice at all. And if it appears, the person might know just what to do to make that voice grow silent once more.
Practitioners who use DBT also try to shift thought patterns and help people to see the world in a new light, but the therapy also has a secondary goal. Practitioners also want to help their clients to feel supported and nourished. Many people who get DBT have a long history of destructive relationships with others. They do not expect a healthy relationship. They might get one, for the first time, with a DBT practitioner. That healthy relationship could be the foundation for other healthy relationships, and that could ease a great deal of distress about life in general.
According to NAMI, DBT aims to help people learn to live with discomfort and distress without reacting to it. Where people with mental illnesses and addictions might be accustomed to trying to fix or amend every negative thing that happens, after DBT, they may be able to simply see something negative and move away from it without reacting to it. That could help to eliminate some of the more egregious problems that personality disorders can cause.
How Does It Work?
CBT is meant to move quickly. In each session, the provider asks the person to outline a major challenge from the week prior, and the therapist and the person discuss that challenge in detail and the thoughts it sparked. Then, they come up with a list of tactics the person could use to deal with that issue differently in the future. The therapist might take a pushy role, trying to entice the person to change. There is a great deal of homework to complete after each session.
In a DBT session, the therapist does not take on a challenging role. Instead, the therapist works to support the decisions the person made, and the therapist attempts to help that person understand how to make better decisions. Individual sessions can help, but Psych Central reports that DBT also includes group skill-building sessions, in which the person has the chance to dive deep into lessons that are all about changing behavior.
Making the Most of Any Therapy Session
Both of these therapy types rely on a sense of openness. People who get these therapies need to feel able to confide in a therapist, and they need to be honest about what they are thinking and feeling. That honesty helps the therapist do effective work, and it is vital in recovery. The more honest you can be in your therapy sessions, the better your therapist will be able to help you.