Content reviewed by Karen Rubenstein, LMFT

Successful recovery from mental health disorders, substance use disorders (SUDs) and co-occurring disorders require effective, evidence-based treatment. Evidence-based practices (EBPs) are therapies that have been thoroughly researched and identified as clinically successful. Among typical psychotherapy treatments, two popular evidence-based interventions include cognitive-behavioral therapy (CBT) and dialectal behavior therapy (DBT).

While these treatment approaches share many similarities, they also differ. It is important to understand what makes each concept unique so that if you find yourself or your loved one needing treatment, you can make an educated decision on what treatment to pursue.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is one of the most popular forms of psychotherapy. It combines two therapeutic approaches — cognitive therapy and behavioral therapy — by identifying the links between thoughts, emotions and behaviors.

Self-Recognition and Reevaluation

The first main goal of cognitive behavioral therapy is to help patients create clearer thoughts, attitudes and expectations. Mental health disorders and SUDs cloud an individual’s sense of self. These disorders can impair an individual’s ability to think clearly and make rational decisions. CBT helps patients recognize false beliefs and negative attitudes that they may hold regarding their life situation or themselves. Then, therapists will actively work with the patient to change these false beliefs.

The second main goal of cognitive-behavioral therapy sheds light on how an individual’s thoughts and emotions affect their behavior. As a therapist works with a patient to change distressing thoughts and feelings, they will also evaluate how specific behavioral patterns intensify the patient’s problems.

For example, depressive thoughts can cause individuals to isolate themselves and withdraw from activities they once enjoyed. However, isolating and withdrawing from activities will perpetuate feelings of depression. In this scenario, a patient recognizes how their behavior may perpetuate their thoughts and emotions and vice versa.

Dialectal Behavior Therapy

Dialectal behavior therapy is another comprehensive psychotherapy treatment. It is considered a modified version of CBT for several reasons. While its main goals include addressing the relationship between negative thinking patterns and behaviors, it works to transform thought and behavior patterns through acceptance rather than change.

Mindfulness Skills

The foundation of DBT lies in mindfulness. Mindfulness is awareness of the present moment. Mindfulness helps an individual tune into what is happening inside (thoughts, feelings and emotions) and what is happening around them (environment and stimuli). Mindfulness emphasizes the importance of objectivity, acceptance and nonjudgement. In DBT sessions, patients are taught to accept challenging emotions and experiences as they surface, rather than trying to change them.

Interpersonal Effectiveness

In DBT, interpersonal effectiveness helps patients recognize and cater to their own needs within a relationship. Patients will learn to effectively listen, communicate and navigate complex interpersonal conflicts while prioritizing self-respect and personal boundaries.

Emotional Regulation

Emotional regulation is the ability to manage and control emotions effectively. While individuals have no control over what happens to them in life, they can learn how to control their responses appropriately. Patients will learn how to take charge of their emotions during sessions instead of letting their emotions rule over them.

Distress Tolerance

Distress tolerance recognizes an individual’s ability to persevere beyond life’s circumstances. DBT teaches patients how to handle, respond to and overcome crises. Some techniques that may be introduced for distress tolerance include distraction and utilizing healthy coping mechanisms.

The Differences Between CBT and DBT

Despite their similarities, many factors set CBT and DBT apart. Some of these differences include:

  • Central focus: The main focus of CBT is the evaluation of thought patterns. While DBT addresses thinking distortions, its main focus is the validation of personal emotions through mindfulness. DBT encourages patients to recognize that distressing emotions are not just a result of ill thinking but rather a result of attempting to fight and change unpleasant emotions.
  • Interpersonal relationship focus: DBT intentionally emphasizes the role of interpersonal relationships in mental health and well-being. This approach helps patients learn how to overcome urges for heightened emotional responses during conflict. On the contrary, CBT does not concentrate on interpersonal relationships as heavily.
  • Skills taught: CBT uses various techniques to equip patients with skills to recognize how their thoughts, feelings and behaviors interconnect. Therapists can tweak program content and lessons to fit the patient’s individualized needs. On the other hand, DBT involves a set curriculum for every patient.
  • Application: Another difference between these approaches is when they are typically used. DBT was initially developed and recognized as an effective treatment for borderline personality disorder (BPD). Individuals who have difficulties with emotional regulation or participate in self-destructive behaviors (including SUDs) may benefit from DBT. CBT can also treat a range of conditions, although it is primarily used to change underlying thought patterns and associated behavior.

At Authentic Recovery Center, we offer CBT and DBT as treatment options. We offer treatment for substance use disorders as well as co-occurring conditions. We are empowered by your decision to seek treatment and recovery and are devoted to guiding you through your unique healing journey. To learn more about our treatment programs, please give us a call today at (866) 786-1376.


This blog is for informational purposes only and should not be a substitute for medical advice. We understand that everyone’s situation is unique, and this content is to provide an overall understanding of substance use disorders. These disorders are very complex, and this post does not take into account the unique circumstances for every individual. For specific questions about your health needs or that of a loved one, seek the help of a healthcare professional.