What is the Difference Between CBT and DBT?

woman in behavioral therapy for addiction

Many people who struggle with a substance or alcohol use disorder also suffer from a co-occurring mental health issue. In fact, the Substance Abuse and Mental Health Services Association reports that approximately one in four individuals with a Serious Mental Issue (SMI) also struggle with drugs or alcohol. As a result, it makes sense that a significant component of most substance and alcohol programs involves mental health therapy. But if you've never entered a treatment program or seen a therapist before, getting help for a mental health issue can be disorienting and, at times, overwhelming. There are many different therapy options available. How do you know what is right for you?

Your healthcare professionals will help you decide a course of action for your SUD (substance use disorder) or AUD (alcohol use disorder). Two of the most commonly used therapies to help people recover from these disorders are Cognitive Behavior Therapy (CBT) and Dialectic Behavior Therapy (DBT). What is the difference between CBT and DBT, and how can these evidence-based therapies help someone recover?

What is CBT?

In the late 1960s, American psychiatrist Aaron Beck formally created cognitive behavioral therapy, or CBT. Beck researched depression and suicide and discovered that many of the patients he saw complained about specific difficulties. He interviewed hundreds of depressed persons and uncovered similar negative thought processes (called "cognitive distortions") that he suspected were causing their depression symptoms.

Beck developed CBT because he believed that our cognition (how we think) and emotion (how we feel) are inextricably intertwined. Dr. Beck proposed that the way we think influences our feelings and, as a result, our conduct. CBT attempts to modify thought patterns and unreasonable beliefs by identifying the cognitive distortions that create stress.

Cognitive behavior therapy can describe any psychotherapy that focuses on modifying thoughts and actions to increase mood and reduce stress. This type of therapy helps people identify, challenge, and remove their negative and unhelpful thought patterns. CBT techniques have evolved over the last 60 years from previous treatments, including Cognitive Therapy and Rational Emotive Behavioral Therapy. CBT has modalities that can assist with everything from quitting smoking to dealing with chronic pain.

What is DBT?

Dialectical Behavior Therapy (DBT) is a kind of cognitive-behavioral therapy (CBT) created to treat Borderline Personality Disorder (BPD) in the 1990s. Marsha Linehan, a psychologist and author, coupled CBT approaches with components of Zen Buddhism to assist persons suffering from BPD or other mental health issues in finding meaning and purpose in their lives. DBT emphasizes interpersonal effectiveness, mindfulness, emotion control, and stress tolerance skills. Dialectic is a philosophical term that refers to finding a balance. The balance in DBT is between acceptance and change.

Dialectic Behavior Therapy can also help patients suffering from eating disorders, substance abuse, or suicidal ideation. It has also been used to help elderly patients suffering from depression, parents of children with ADHD, and restless students in schools.

The Difference Between CBT and DBT

While DBT is a form of CBT, the two therapies are not interchangeable. As part of your recovery program, your medical team will help to determine what forms of therapy will be most beneficial to your recovery.

The therapeutic emphasis is perhaps the most significant distinction between cognitive behavioral therapy and dialectic behavior therapy. While CBT focuses on redirecting negative thought patterns, DBT focuses on finding a balance between acceptance and change. Other differences include:

Length: One big difference between cognitive behavioral therapy and dialectical behavior therapy is the length of treatment. CBT generally requires a specific treatment time frame, whereas DBT is designed as an open-ended solution. CBT is a short-term process that lasts anywhere between 5 to 20 sessions and over a few weeks or months. DBT, on the other hand, has no set end time and may last several years.

Goals: CBT typically has a defined goal that the patient and therapist agree upon. Undergoing CBT includes learning new coping skills, practicing them, and preparing how to use them when future challenges arise. DBT is primarily concerned with emotional and social factors, and it helps people cope with strong emotions or destructive behavior such as addiction.

Orientation: While CBT focuses on the patient's problems today, DBT may examine how previous events have contributed to existing challenges.

Areas of Treatment: CBT is most typically used to treat anxiety, depression, and other mental health conditions that include negative thought patterns. DBT is often used to treat those who struggle with impulse control and self-destructive behaviors.

How CBT and DBT Can Help Those in Recovery

If you're struggling with getting sober, cognitive behavioral therapy may be able to help. Cognitive-behavioral therapy can assist those struggling with substance dependence and lower their risk of relapse. CBT is a popular drug and alcohol addiction treatment strategy because it is proven to work. CBT has been demonstrated in trials to be more successful than medication in treating depression, anxiety, and other psychological illnesses. CBT supports individuals suffering from addiction disorders in identifying negative thinking patterns and behaviors that contribute to their compulsive drug or alcohol use and developing skills to modify these patterns and behaviors. As a result, there is less reliance on alcohol or drugs as a coping technique and more personal control over substance use.

People who struggle with substance use usually engage in addictive behaviors due to feelings of anger, fear, or sadness. This can lead to impulsive behavior, like drinking or taking drugs. This is where DBT comes into play. DBT encourages the person in recovery to practice mindfulness by recognizing negative emotions in the moment. By being mindful, the DBT patient can be more conscious of how they respond to their emotions and choose to make a better decision. DBT can help people who struggle with addiction be more independent, become more stable in their routines, and learn to cope with stress without turning to drugs or alcohol.

Because so many individuals suffering from SUD or AUD have mental health difficulties, behavioral therapy should be part of any drug or alcohol rehabilitation program. Many therapists utilize a hybrid approach to treatment, combining CBT and DBT. This is known as multimodal therapy or combination therapy. Addiction, mental health concerns, and co-occurring disorders can benefit from combining CBT and DBT. Both treatment methods aim to assist patients in identifying patterns in their behavior and thinking associated with addiction, which can aid them in establishing a new ability to deal with difficult situations.

How to Get Started With CBT and DBT

While finding treatment for addiction and mental health can be overwhelming, the good news is that many healthcare professionals have training in Cognitive Behavioral Therapy. At Lake Ave Recovery, CBT is just one of the therapeutic areas we specialize in. When you come to our center for treatment, you'll be evaluated individually and personally. No plan of treatment is the same. Your treatment will begin with psychological and cognitive tests so that we can better understand your addiction history. We'll also consider any co-occurring illnesses and mental health disorders that might influence your care.

Recovery from drug and alcohol addiction is difficult, but it's not out of reach. With the help of trained healthcare professionals, you can learn to manage your mental health. Although they're similar, CBT and DBT are different therapies. You need a skilled mental healthcare professional to know which treatment plan is best. To learn more about the available therapy options at Lake Avenue Recovery, call (855) 921-5280, and you'll get connected to one of our friendly intake counselors.

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