CBT vs. DBT: Understanding the Differences & Finding What Would Fit for You

Meet Alex: Looking for Therapy that will help them

Alex has been struggling for a while. Their thoughts spiral into worst-case scenarios, emotions feel overwhelming, and no matter how hard they try, they keep reacting in ways they later regret.

They know they need support and start researching therapy.

CBT – Cognitive Behavior Therapy is a widely practiced approach that helps people recognize and shift unhelpful thought patterns, leading to changes in emotions and behaviors.”

However, as Alex kept reading, they also encountered Dialectical Behavior Therapy (DBT).

“What’s the difference?”

“Which one would help me more?”

Both CBT and DBT are evidence-based therapies that help people manage emotions, change behaviors, and improve their lives. While DBT is built on CBT, it also introduces unique elements that better fit particular challenges.

Let’s explore what makes them similar—and where they differ—so you can see what might be the best fit for you.

1. How CBT Works: Understanding & Changing Thought Patterns

The idea that CBT has is that our thoughts, feelings, and behaviors are interconnected. When we change how we think, we can change how we feel and act.

🔹 Focuses on the present – Addresses current thoughts and behaviors rather than deeply exploring past experiences.

🔹 Identifies cognitive distortions – Helps recognize and challenge unhelpful thinking patterns (like catastrophizing, all-or-nothing thinking, or negative self-talk).

🔹 Uses behavioral strategies – Helps modify behaviors that contribute to distress.

🔹 Collaborative approach – A DBT therapist and the client work together to develop coping strategies.

Example: How CBT Helps Alex

Alex often feels anxious in social situations, convinced everyone silently judges them.

At a work meeting, Alex thinks:

“I sound stupid. Everyone is going to think I don’t belong here.”

As a result, they feel anxious and self-conscious, leading them to avoid speaking up.

A CBT therapist would help Alex challenge that thought:

❌ Is there actual proof that people think you sound stupid?

❌ Have there been times when people responded positively to you?

❌ Could this be your Anxiety talking rather than reality?

By shifting the thought, Alex’s emotions and behaviors change.

✅ “Maybe I don’t sound as bad as I think.”

✅ Alex feels a little more confident.

✅ They contribute to the discussion instead of staying silent.

CBT is beneficial for:

✔️ Anxiety and depression – Shifts negative thought patterns that drive distress.

✔️ OCD and phobias – Reduces fear-based behaviors by changing thinking patterns.

✔️ Perfectionism and self-doubt – Encourages more balanced thinking.

✔️ PTSD – Challenges trauma-related negative beliefs.

CBT provides powerful tools for managing unhelpful thoughts and behaviors.

2. How DBT Therapy Works: Balancing Change with Acceptance

DBT is similar to CBT in that it analyzes thoughts, behaviors, and emotions, and each influences the other.

However, the “D” in DBT stands for dialectics, which means two opposing things can be true at the same time.

• You are doing the best you can, AND you can do better.
• Your emotions are valid, AND they don’t always reflect reality.
• You can accept yourself as you are AND still work toward change.

This balance between acceptance and change is a core DBT principle that sets it apart from traditional CBT.

DBT’s Key Components

DBT incorporates six core components to help people regulate emotions and behaviors:

Mindfulness – Increasing awareness of the present moment and slowing down impulsive reactions.

Dialectics – Recognizing that two opposing things can both be true and learning how to find the middle path between them.

Validation – Acknowledging that emotions and experiences are real and understandable—even when they don’t seem logical.

Behavior Strategies (Including Behavior Chain Analysis) – Understanding what leads to a behavior by breaking it down into pieces to identify what keeps a behavior pattern going.

Cognitive Strategies – Using tools to check the facts, reframe negative thoughts, and recognize when emotions cloud perception.

DBT Therapy Skills (Four Main Areas):

🔹 Mindfulness – is about tuning into the present moment on purpose, without judging whatever comes up.

🔹 Distress Tolerance – Developing coping techniques to sit with difficult emotions without acting on them.

🔹 Emotion Regulation – Understanding emotions and building strategies to manage intense feelings.

🔹 Interpersonal Effectiveness – Strengthening communication and relationships and effectively getting what you want. 

 

Example: How DBT Helps Alex

Let’s go back to Alex’s work meeting.

Instead of just challenging their thoughts, a DBT therapist would first help Alex look at what’s happening emotionally and behaviorally.

💬 Step 1: Identify what’s happening in the moment.

“I feel a tightness in my chest. My heart is racing. My body feels frozen.”

💬 Step 2: Validate the experience.

“It makes sense that I feel this way. I’ve had experiences where I’ve felt judged before.”

💬 Step 3: Use DBT skills to manage the intensity.

• Use mindful breathing to calm the nervous system.
• Use a grounding technique to stay present.
• Notice the urge to stay silent—but remind themselves that they can choose a different action.

💬 Step 4: THEN challenge the thought.

“Now that my Anxiety has lessened, let’s check the facts. Did anyone react negatively when I spoke? Maybe I’m assuming judgment when there isn’t any.”

By first regulating emotions, DBT makes cognitive restructuring more effective.

3. What DBT Helps With

DBT can be helpful for many different struggles, especially when emotions feel intense and hard to manage. If emotional dysregulation makes it difficult to stay in control of your feelings, DBT helps by providing ways to understand and regulate them.

It’s also helpful for depression and Anxiety, offering tools to work through overwhelming thoughts and emotions.

For those dealing with PTSD or trauma, DBT supports healing by reducing distress and helping to build a sense of stability. It can also be a valuable approach for substance use, teaching skills to identify triggers and find healthier ways to cope.

People with ADHD often find DBT helpful for improving impulse control and emotional regulation, while those experiencing suicidal thoughts or self-harm can benefit from learning strategies to reduce distress and build coping skills that create safety.

DBT is also effective in relationships, especially for those who fear rejection, abandonment, or communication challenges. By strengthening interpersonal skills, DBT helps people build and maintain healthier, more balanced relationships.

4. Final Thoughts: Finding the Therapy for me

CBT teaches us how to challenge unhelpful thoughts.

DBT teaches us how to manage emotions before changing thoughts.

It’s not about choosing one but finding what works best for you.

Ready to explore therapy? Let’s talk about how DBT (and CBT) can help you create the life you want to live.

Begin Your Journey with DBT Therapy in Las Vegas

You don’t have to stay stuck in overwhelming emotions or patterns that no longer serve you. DBT therapy in Las Vegas can help you build the skills to manage emotions, navigate relationships, and move forward with more confidence. To start your therapy journey with the DBT Center of the South Bay:

• Contact Us using our contact form to schedule an appointment and explore if DBT therapy in Las Vegas, NV, is right for you.
• Meet with a compassionate and experienced DBT therapist who will support and guide you through the healing process.
• Start making real changes by building emotional resilience and developing healthier coping strategies.

Additional Services at DBT Center of South Bay

At the DBT Center of South Bay, we are committed to helping individuals discover the motivation to lead fuller, more connected lives. In addition to our EMDR therapy for trauma, anxiety, and depression, we offer a range of treatment options. Our services include DBT Therapy for adults, aimed at managing anger, reducing social isolation, and overcoming loneliness. We also specialize in supporting individuals experiencing suicidal thoughts and self-harmbehaviors, providing targeted therapy for Borderline Personality Disorder (BPD) to help manage its challenging symptoms. With locations in Las Vegas, NV, and Torrance, CA, our services are accessible throughout California and Nevada via online therapy. This flexibility ensures that you can receive the support you need, no matter where you are. Reach out to us today and begin your journey towards emotional well-being and a more connected life.