Cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) are two therapies proven to be effective for mental health conditions. Here at Eagle View Behavioral Health, we use these two therapies prevalently in our individual and group work with clients.
Before we get into the details of each therapy, we’ll begin with a look at their foundation: automatic thoughts.
The “Cognitive” Aspect of CBT and DBT
As humans, we have brains. Our brains generate thoughts. A lot of them. According to some estimates, our brains process about 70,000 thoughts per day. Others offer a more modest estimate of 6,000 thoughts per day, but either way…a lot of thoughts. How many of these thoughts are negative, repetitive, or intrusive has also been estimated, with some estimates as high as 80%. (But really, how do you measure such a thing? Also, don’t trust everything you read.)
Even so, most sources agree that a large portion of our thoughts are automatic and that many of those automatic thoughts tend toward the negative–especially if a mental health disorder is at play.
The foundation of CBT and DBT is the theory that our thoughts directly influence our emotions and behavior. Therefore, these therapies try to teach clients to “catch” their automatic thoughts as they drift by and assess their accuracy. Doing so will, with practice, help clients modify their feelings and actions.
So…what is Cognitive Behavioral Therapy?
CBT was developed in the 1960s and has grown to become one of the most frequently used therapies for people with a wide range of mental health disorders, including depression, anxiety, substance use disorder, and more.
As stated earlier, it is based on the premise that our thoughts and emotions influence our behaviors. By becoming aware of how our thoughts and emotions work, we can learn how to shift them toward the positive. The change in thoughts and emotions will result in positive behavior change. As such, CBT is a very practical and goal-oriented therapy style, focusing on modifying the behaviors the client finds most problematic.
As the therapist helps the client learn to monitor their thoughts, they typically assign homework that encourages the client to practice the techniques between sessions. In most cases, CBT works quickly compared to more traditional forms of therapy, within a matter of weeks or months as opposed to years.
What is Dialectical Behavior Therapy?
DBT is an offshoot of CBT, developed for people who experience emotions very intensely. Therefore, it’s commonly used for people with borderline personality disorder, although it’s effective for other issues as well, such as post-traumatic stress disorder, self-harm behavior, suicidal behavior, substance use disorders, and more.
Dialectical behavior therapy, developed in the 1970s, focuses on helping clients find a balance between accepting themselves as they are and embracing the benefits of change. As such, DBT gently encourages clients to appreciate their unique gifts while also helping them see that modifying their thoughts and behaviors can make life a little easier for them. Ultimately, clients learn to regulate their emotions so they aren’t derailed by them.
Just as with CBT, homework may be part of the treatment plan. Clients are often asked to track their emotions and actions in a journal so they can begin to see patterns. In addition, clients are taught four core skills:
- Mindfulness – developing awareness of thoughts and being present with them without judgment
- Emotion regulation – shifting unproductive emotions to more positive emotions
- Distress tolerance – learning how to cope with difficult and painful situations
- Interpersonal effectiveness – learning how to set boundaries, ask for what you need, and handle confrontation
How CBT and DBT Can Work Together
Both CBT and DBT rely on a strong relationship between the therapist and the client, and the work is accomplished through talk. Often, therapists will combine elements of CBT and DBT based on the individual client’s needs. For example, a client in therapy for anxiety disorder may need to focus mostly on shifting anxious thoughts in order to gain more freedom and ease in their day-to-day behaviors. However, maybe some of their anxiety is connected to a fear of emotions or of expressing themselves. In this case, some DBT tactics of distress tolerance or learning how to say “no” will be particularly helpful.
Therapy at Eagle View
Our facility in Bettendorf, Iowa, uses CBT, DBT, and more to help adolescents and adults who are struggling with anxiety, depression, bipolar, schizophrenia, or any other mental health disorder. We know our program works because we’ve seen our clients leave with new hope and a path for healing. To learn more, contact our admissions counselors today.
