Research has proven that the most effective way to treat the disease of addiction is through a combination of therapy and medication. In nearly all levels of addiction treatment, ranging from residential treatment to outpatient treatment, behavioral therapies serve as a crux of recovery. Of the most renowned behavioral therapies for the treatment of addiction are cognitive behavioral therapy and dialectical behavioral therapy. Both therapies have been used to treat countless conditions for decades, but have shown exceptional benefits for those in recovery from addiction. And while CBT and DBT might seem like the same thing at first glance, the two therapies are different in many ways. To gain a better understanding of their differences, it is important to be aware of what each therapy is capable of doing.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy, which is frequently referred to as CBT, is a type of psychotherapy that focuses on the principle that the way people think, act, and feel all interact with each other to influence behaviors. The guiding features of CBT states the following:
- A cognitive approach believes that mental illness is derived from false thoughts about oneself, others, and the things around them
- False thinking patterns and cognitions create distortions in how a person views themselves
- A person functions in the world based on their idea of what the world is, meaning that if a person thinks the world is negative, they will behave negatively
By challenging negative cognitions and perceptions, cognitive behavioral therapy can help to restructure a person’s way of thinking, feeling, and behaving.
Dialectical Behavioral Therapy (DBT)
Dialectical behavioral therapy, or DBT, is a type of cognitive behavioral therapy, but it focuses more on emotional regulation and intelligence as opposed to how thoughts, actions and feelings dictate behaviors. The components of DBT include the following:
- Helps people identify their strengths in an effort to build on them, thus improving one’s self-confidence
- Aids in identifying patterns of thinking, behaving, or feeling that negatively influence their wellbeing
- Gives people the opportunity to collaborate with professionals and others receiving DBT therapy through role playing, homework assignments, etc. in an effort to teach and develop a healthy skill set
Within DBT therapy sessions, clients focus on the four modules of DBT, which are mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.
CBT vs. DBT
As mentioned before, it can be easy to think there is no difference between CBT and DBT, especially since they are both behavioral therapies. However, each of these therapies shine in their own way and have different elements to offer those looking to recover from addiction and/or mental illness.
CBT and DBT have different end goals
Another difference between CBT and DBT is that they are more effective in treating their own specific conditions. CBT has been studied and researched enough to prove that it is one of the leading therapeutic treatments for substance use disorders, depression, anxiety disorders (especially obsessive-compulsive disorder, phobias, panic disorder, and posttraumatic stress disorder), and sleeping problems like insomnia. Conversely, DBT excels at treating symptoms related to self-harm and chronic suicidal ideations, plus the effects of sexual trauma. In fact, DBT was originally developed to treat borderline personality disorder.
CBT utilizes rationale while DBT utilizes spiritual techniques
CBT is heavily rooted in using rationale to help treat clients, while DBT relies more on spiritual techniques. CBT encourages clients to recognize what is true and what is false in an effort to change their behaviors, while DBT helps clients cope with the behaviors that they experience. A client participating in CBT will spend a great deal of their time talking one-on-one with a therapist who can help in the identification of the problematic thinking, feeling, or believing so that it can be modified. A client participating in DBT, however, does not spend time challenging the origin of their feelings or thoughts, rather they focus on how to cope with them when they occur. This is why DBT is more effective for people with more severe mental health conditions, as changing the thoughts and feelings they have is not the goal, rather learning how to cope with them is. The coping skills taught in DBT are spiritual-based and include mindfulness and distress tolerance techniques that are derived from Buddhist culture and zen practices.
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