What’s the difference between CBT vs DBT? (Pros & Cons)

Are you looking to understand the difference between CBT vs DBT and the Pros & Cons of each? You came to the right place.

CBT or Cognitive Behavioral Therapy and DBT or Dialectical Behavior Therapy are widely used in the field of mental health, therefore, understanding the differences can help you make an informed decision whether you are an individual looking for the best therapist for you or a healthcare provider looking for the best mental health service to integrate into your programme. 

At RESET instead of using one therapeutic approach, CBT or DBT, we integrated a range of approaches (CBT, DBT, Systemic Therapy, Motivational Interviewing etc) as we believe in treating patients holistically. We believe that an integrative approach to treatment leads to long-lasting change. Given that many individuals that seek therapy present with multiple concerns and complex issues, by incorporating a range of approaches, we are better able to address multiple dimensions of a person’s well-being and can tackle complexity and comorbidity. 

Despite our multi-method approach, we promise to be as objective as possible in this list as we care about helping you to find the most appropriate therapeutic approach tailored to your organisation and clients’ needs. 

We understand that choosing the right therapy can be a complex and challenging task due to serving a diverse population, limited resources, availability of empirical support, staff training and expertise and client preferences. Given these complexities, mental health organisations must carefully evaluate the benefits, limitations and feasibility of different therapies. You have done the right thing by coming to this blog and, luckily we specialise in helping organisations find the best healthcare solutions in mental health available.

At RESET, we understand the importance of choosing the right therapeutic approach. With over 20 years of experience providing psychological services within the NHS and the private sector, we will share everything we can about the pros, cons and considerations of implementing CBT vs. DBT within your service. 

By the end of this blog, you will gain clarity on which therapy aligns best with your organisation’s goals, resources, and the needs of your target population. 

CBT vs DBT: what is the difference?

CBT and DBT are both forms of psychotherapy that are widely used in the field of mental health, but the main difference lies in their treatment focus and the populations they were originally developed for. 

CBT primarily focuses on identifying, challenging and changing negative thoughts and behaviours that contribute to distressing emotions and mental health symptoms to bring about change. While mindfulness techniques can be incorporated into CBT, it is not a core component.

DBT, on the other hand, focuses on developing skills to manage intense emotions, tolerate distress, improve relationships, and promote mindfulness. It emphasizes accepting the current situation while also fostering motivation for change. DBT places significant emphasis on mindfulness as a fundamental aspect of treatment. Mindfulness exercises aim to develop awareness, acceptance, and a non-judgmental stance towards patients’ thoughts, emotions, and experiences. 

CBT was developed as a general approach targeting a wide range of mental health conditions, whereas DBT was initially developed for borderline personality disorder (BPD) but has been adapted for other conditions as well. 

CBT ProsCBT Cons
Wide Applicability: CBT is effective in treating a wide range of mental health conditions. This means you can offer a versatile and evidence-based treatment approach that can benefit a large number of patients across different diagnostic categories.Limited suitability for complex cases: CBT may not be the most suitable for patients with complex mental health conditions or those who struggle with significant emotional dysregulation.
Structured and Time-Limited: CBT consists of a fixed number of sessions focused on specific goals. This structure helps to optimise resource allocation and allows therapists to treat more patients within a given time frame.Lack of individualised treatment: CBT often follows a structured and manualised approach. This standardized nature may not fully accommodate the unique needs, preferences, and cultural backgrounds of patients. This may limit how applicable CBT is within your organisation.
Cost-effective: The structured and time-limited nature of CBT makes it cost-effective. By offering shorter treatment durations, CBT can lead to reduction in overall treatment costs compared to longer-term therapies.Less comprehensive approach: CBT focuses more on the cognitive and behavioural aspects of therapy, with less emphasis on mindfulness, emotional regulation skills training and interpersonal skills found in DBT. 
Availability of therapists: CBT is one of the most widely practised forms of therapy, and many therapists are trained in this technique. This makes it easier to find and train therapists – improving access to therapy for patients.  
Strong Evidence Base: CBT has a robust evidence base supporting its acceptance and effectiveness, providing confidence to healthcare providers, and policymakers.  
DBT ProsDBT Cons
More suitable for more complex cases: DBT was specifically designed to treat individuals with BPD, a complex and challenging condition. It has also been adapted and found to be effective for other conditions such as substance use, eating disorders, and self-harm behaviours. CBT may not be the most suitable option for those struggling with emotional dysregulation. Availability of trained professionals: There are fewer DBT-trained professionals than CBT. DBT is a more specialised therapy, therefore, implementing DBT may require additional training and resources
Mindfulness integration: DBT emphasizes mindfulness. This approach can enhance individuals’ ability to cope with distress and improve their overall well-being. Longer treatment duration: DBT is typically longer-term therapy compared to CBT. This longer duration may pose challenges in terms of capacity and access to care, especially if there is a high demand for mental health services. You should consider the implications of longer treatment times on waitlists. 
Comprehensive Approach: DBT uses a comprehensive and systematic approach to address the specific needs of patients with complex mental health. DBT includes skills training, individual therapy, and phone coaching and places particular emphasis on acceptance and validation of individuals’ experiences and emotions.Resource-intensive nature: DBT involves multiple components, including individual therapy, skills training groups, phone coaching, and therapist consultation teams. These additional components require more time, staffing, and infrastructure to implement effectively.  
Self-management and relapse prevention: DBT equips patients with practical skills and tools that can be applied beyond therapy sessions. It focuses on empowering individuals to actively manage their symptoms, prevent relapse, and lead more fulfilling lives. This emphasis on self-management can enhance long-term outcomes and reduce the need for ongoing intensive therapy.  
Suicidality and self-harm management: DBT has specific modules and strategies dedicated to managing suicidal ideation and self-harming behaviours. DBT’s focus on safety and crisis management can be critical in reducing self-destructive behaviours and promoting overall well-being.  

Who is CBT right for?

Based on the pros and cons, implementing CBT would be suitable for organisations that are: 

  • Seeking a versatile and evidence-based treatment approach: CBT’s broad applicability and effectiveness in treating a range of mental health conditions makes it a suitable choice for organisations aiming to offer a versatile approach. CBT can benefit a large number of patients across different diagnostic categories.
  • With resource limitations or a need for cost-effective interventions: CBT’s structured and time-limited nature makes it a cost-effective option. If you have resource limitations or need to optimise resource allocation, you can benefit from CBT’s shorter treatment durations.
  • Wanting to improve access to therapy: CBT’s availability of therapists is a significant advantage. It is one of the most widely practised forms of therapy, making it easier to find and train therapists, ultimately improving access to therapy for patients.
  • With a preference for evidence-based interventions: CBT has a strong evidence base supporting its effectiveness. This evidence base can provide confidence to health providers, policymakers and service users.
  • Serving individuals with complex mental health needs: DBT is specifically designed to address the needs of individuals with complex conditions such as BPD, substance use, eating disorders etc.
  • With a focus on mindfulness and acceptance: DBT integrates mindfulness practices, which can be beneficial for individuals who can benefit from developing skills for distress tolerance and emotion regulation. Organisations that prioritise mindfulness and acceptance-based interventions may find DBT aligns well with their treatment philosophy.
  • Aiming for comprehensive and systematic care: DBT’s comprehensive approach, which includes skills training, individual therapy, and phone coaching, allows for more systematic delivery of care. This can be advantageous for those seeking to provide a well-rounded and integrated treatment approach.
  • Addressing suicidality and self-harm: DBT has specific modules for managing self-harming behaviours. If an organisation works with populations at high risk for self-destructive behaviours, implementing DBT can effectively manage this.

Your next steps for choosing between CBT vs. DBT

In this article, we delved into the distinctions between CBT and DBT, discussing their advantages and disadvantages, as well as determining the organizations for which each approach is suitable.

CBT offers wide applicability, cost-effectiveness, and a strong evidence base, making it suitable for organizations seeking a versatile and evidence-based treatment approach. 

On the other hand, DBT is more comprehensive, and particularly beneficial for complex cases and individuals with conditions like borderline personality disorder, self-harm behaviours, and substance use. It emphasizes mindfulness, self-management, and relapse prevention. However, implementing DBT may require additional resources and trained professionals.

Should I choose CBT or DBT?

Truthfully, both are evidence-based effective interventions – it just depends on your organisation’s individual needs. 

If you prioritize versatility, evidence-based approaches, and cost-effectiveness, CBT may be the right choice for you. Conversely, if you work with individuals with complex mental health needs, emphasize comprehensive care, and require specific modules for self-harm management, DBT might be a better fit.

To take the next step, we recommend assessing your organization’s resources, consulting with experts, and considering the preferences and needs of your target population.

For example, if you recognise that your client population is complex, short-term/brief interventions are not producing long-term outcomes, and you have the resources to train and hire psychologists, perhaps DBT is for you.

By carefully evaluating these factors, you can make a well-informed decision that aligns with your organization’s mission and ultimately provides the most effective and beneficial therapy for your clients. 

If you want to learn How to Improve Patient Treatment Adherence, check out this blog. Also, check out this blog about the 5 Best Methods to Increase Patient Engagement in Mental Health.

Msc Saiyuri Naidu is a Senior Assistant Psychologist at the RESET Health Group and an MSc Clinical Psychology Graduate with a special interest in trauma and how this can affect an individual’s mind and body. 

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