CBT vs. DBT Treatment

Instructor: David White
Among the many types of mental health treatment, CBT and DBT can be very effective at changing thought patterns and behaviors. Through this lesson, you'll learn how each operates and why they are used to treat different diagnoses.

Using Different Treatments

What would you think if you had a broken leg and the doctor simply put a bandage on it? Or if you had the flu and he prescribed radiation therapy? This would probably seem ridiculous because you know that neither is the right treatment for your physical illness. Well, the same is true for mental illness; different therapies are used to most effectively treat different diagnoses.

In the fields of psychology and behavioral health, these treatments are often referred to as modalities, which is just a technical way of describing a particular treatment method like medication management or group therapy. There are many different types of therapies and they are often used in conjunction with one another. In this lesson we're going to look at two of the more common modalities: CBT and DBT.

Cognitive Behavioral Therapy

Among the many types of mental health treatment, cognitive behavioral therapy (CBT) is the one that you are probably most familiar with, even though you might not have known it by this name. CBT is usually what a person is referring to when they say 'therapy' or 'psychotherapy.' In CBT, an individual works with a trained therapist to explore how their feelings, emotions, and thought patterns affect their behavior. CBT is generally used to treat common emotional problems like anxiety or generalized depression, which are related to a person's way of thinking.

The CBT model shows an inseparable relationship between thoughts, emotions, and behaviors.

Imagine that Jane sets up an appointment to see a new therapist for CBT. When she arrives, she explains that for months she's been experiencing depression and feeling bad about herself because she can't find a job. Through their discussions, Jane and her therapist begin to discover that she has a long pattern of thinking negatively about herself and her abilities, which she learned at a very young age and has affected her self-esteem ever since. As a result, when she goes to interview for jobs, Jane lacks confidence and expresses a generally negative outlook, which is likely the reason why she's having a hard time finding work.

The primary objective of CBT is to identify the negative thinking and its origins, and then change that pattern by incorporating new thinking and behaviors. In Jane's case, she has for years engaged in negative thinking, which has caused depression and poor self-esteem. Working together, Jane and her therapist devise a plan in which every time she begins to have negative thoughts, she'll stop and consider whether those thoughts are rational or whether there is any truth to them. Because there is likely no truth to her thought pattern, she will actively replace those thoughts with new, more positive thinking.

Dialectical Behavior Therapy

Although it looks very similar to cognitive behavioral therapy, dialectical behavioral therapy (DBT) walks a fine line between accepting things as they are and encouraging change. This modality was established in the late 1970s to treat patients with personality disorder who did not respond well to CBT.

A personality disorder is a very negative way of thinking and behaving that develops over the course of a person's life and can make forming and maintaining relationships very difficult. Among the various symptoms, many people with a personality disorder feel as though others are persecuting them or are highly critical of their behavior, to which they often respond with outbursts of anger.

People with personality disorders often respond impulsively with angry outbursts.

Given that CBT is built on the practice of identifying negative behaviors and thought patterns, it proved entirely ineffective for treating personality disorders because patients felt they were being criticized, something to which they respond very poorly. Instead, practitioners using DBT will make efforts to accept the person as they are and focus on certain areas of their lives that are most affected by the disorder.

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