CBT vs. DBT: What’s the Difference Between Cognitive and Dialectical Behaviour Therapy?
If you're exploring therapy options, you’ve likely come across two terms that sound similar but serve different purposes: Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT).
Both are evidence-based, structured, and goal-oriented approaches that help people manage emotional distress. But they’re not the same and understanding the difference can help you choose the path that’s right for you.
In this post, we’ll explain what CBT and DBT are, how they work, and who can benefit from each.
What Is Cognitive Behavioural Therapy (CBT)?
Cognitive Behavioural Therapy is one of the most well-known and widely used forms of psychotherapy. It’s based on a simple but powerful idea:
Our thoughts, feelings, and behaviours are all connected.
CBT helps you identify and change unhelpful thought patterns that lead to distressing emotions or behaviours. For example, if you often think “I’m a failure,” that belief can lead to feelings of hopelessness and withdrawal from activities. CBT helps you recognize that thought, challenge its accuracy, and replace it with something more balanced like “I made a mistake, but that doesn’t mean I’m a failure.”
CBT is:
Structured: Sessions follow a plan with clear goals.
Time-limited: Often 6–20 sessions.
Practical: You learn tools and coping strategies to manage your thoughts and emotions.
Evidence-based: Effective for anxiety, depression, phobias, OCD, PTSD, and more.
Common CBT Techniques:
Thought records and reframing
Behavioural experiments
Exposure therapy
Goal-setting and problem-solving
Relaxation and mindfulness skills
CBT is a great option if you’re looking for a skills-based, results-focused approach to managing mental health challenges.
What Is Dialectical Behaviour Therapy (DBT)?
Dialectical Behaviour Therapy (DBT) is a specialized type of CBT designed for people who experience intense emotions, impulsivity, or unstable relationships. Originally developed for borderline personality disorder (BPD), it has since been adapted to help with:
Emotion dysregulation
Self-harm or suicidal thoughts
Eating disorders
PTSD
Substance use, and more
DBT blends traditional CBT with mindfulness, emotional acceptance, and interpersonal skills. The word dialectical means holding two seemingly opposite ideas at once — for example:
“I am doing the best I can” and “I can learn to do better.”
This balance of acceptance and change is the heart of DBT.
DBT typically includes:
Weekly individual therapy sessions
Skills training groups (learning coping skills in a class-like setting)
The Four Core DBT Skills
DBT teaches clients four essential life skills:
Mindfulness – Staying present and aware without judgment
Distress Tolerance – Surviving emotional crises without making things worse
Emotion Regulation – Understanding and managing strong emotions
Interpersonal Effectiveness – Communicating needs and setting boundaries clearly and respectfully
These skills are incredibly valuable for anyone who feels overwhelmed by emotions, struggles with impulsive behaviour, or finds relationships difficult to navigate.
Which One Is Right for Me?
Both CBT and DBT are effective, evidence-based therapies, but which is right for you depends on what you’re struggling with.
CBT may be a good fit if you:
Struggle with anxiety, depression, or negative thinking
Want practical skills to manage everyday challenges
Prefer a short-term, structured approach
Are looking to challenge and change your thought patterns
DBT may be a better fit if you:
Have intense, overwhelming emotions
Struggle with emotional outbursts, impulsivity, or self-harm
Find relationships unstable or chaotic
Need help tolerating distress and staying present
A therapist can help assess which approach would be most helpful for you and in some cases, a blend of both therapies may be used.
What to Expect in a Session
CBT Sessions typically include check-ins, setting an agenda, reviewing homework, learning a new tool, and setting goals for the week.
DBT Sessions focus on applying skills, reviewing emotional challenges, and using both validation and coaching to navigate situations.
In both therapies, you’ll be supported in a non-judgmental space where you’re encouraged to be honest, curious, and self-compassionate.
Whether you’re looking to reframe negative thoughts or learn to navigate intense emotions, CBT and DBT offer powerful tools for healing and growth. You don’t have to keep struggling on your own. Therapy can offer both understanding and practical support — tailored to where you are, and where you want to go.
If you’re not sure which therapy is right for you, that’s okay. A qualified therapist can help guide you through that decision and build a treatment plan that feels safe, effective, and aligned with your goals.
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