What is the Difference Between CBT and DBT?

Question: What is the Difference Between CBT and DBT?

I've heard of dialectical behavior therapy, or DBT, as a treatment for borderline personality disorder. But a friend with BPD recently told me that he is being treated with something called cognitive-behavioral therapy, or CBT. Is CBT the same as DBT, or are they different?

Answer: CBT is not necessarily different than DBT. CBT is a term that refers to any type of psychotherapy that focuses on addressing the cognitive (thoughts and beliefs) and behavioral (actions) aspects of a disorder to reduce symptoms. DBT is actually one specific type of CBT that is used to treat borderline personality disorder.

When Dr. Marsha Linehan, the psychologist who developed DBT, first began testing treatments for people with BPD, she found that traditional CBT alone was not as helpful to people with BPD because of its strong focus on change, which people sometimes found invalidating. For this reason, she designed DBT to include some elements that, in the past, were not traditionally part of CBT. For example, in DBT there is a strong emphasis on mindfulness and acceptance (both by the patient and the therapist).

What is confusing is that, since DBT was developed, more and more cognitive-behavioral therapists have started to include some of these new modifications in their practice. There are also a number of other new CBTs for a variety of disorders that include elements such as mindfulness; one example is mindfulness-based cognitive therapy, or MBCT, for depression. As a result, DBT and other new therapies that include elements such as mindfulness and acceptance are being called “third-wave” cognitive-behavioral therapies because they represent a new trend in CBTs in general.

Sources:

Hayes, SC. “Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavior Therapy.” Behavior Therapy, 35:639-665, 2004.

Linehan, MM. Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford, 1993.

Segal, SV, Williams, JMG, & Teasdale, JD. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford, 2001.