

Dialectical Behavioral Therapy vs Cognitive Behavioral Therapy
Dialectical behavioral and cognitive-behavioral treatments offer two different approaches to treating depression and addiction. Let’s take a look at both.
Cognitive Behavioral Therapy (CBT)
Cognitive-behavioral therapy was first embraced in the 1960s by therapists as a more effective psycho-social treatment than the Freudian focus on unconscious influences and impact from childhood experiences. Behavioral therapy focuses on a patient’s current distorted thoughts, beliefs, and attitudes.
Far in advance of modern psychotherapy, Alcoholics Anonymous was founded in 1935 implementing the 12-step program of therapy. At each AA meeting, the members recite the following serenity prayer:
“God grant me the Serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.
That in a nutshell is mindful behavioral therapy. Addiction therapists like to characterize their work as eradicating “stink’n think’n”. Today, behavioral therapies are often combined with a 12-step program.
Behavioral therapy is essentially mind control. It was originally used to treat depression. But it has become popular for treating many mental health conditions including post-traumatic stress disorder, marital problems, eating disorders, and addiction.
Dialectical Behavioral Treatment
Dialectical behavioral treatment (DBT) is a branch of behavioral therapy. It was developed in the 1980s to deal with suicidal thoughts. But it came to be used for treating substance addiction and borderline personality disorder. The term dialectical expresses a philosophy that seemingly opposite beliefs or behaviors can coexist.
What’s the Difference?
In CBT, patients identify their personal goals and also their perceived obstacles. They are then taught the mindful skills to overcome those obstacles. Mainly, those skills identify and eliminate the “stink’n think’n”.
The same is true for DBT. But DBT employs a much more structured therapy and mind training. Among the principal teaching modules are:
- Core mindfulness skills. Eastern meditation skills serve as the model for patients to be more objectively cognizant of and recognize their thinking of the moment.
- Distress tolerance. This looks a lot like the AA serenity prayer. It teaches that some things are beyond our control and we learn to live with them in peace and without self-blame.
- Interpersonal effectiveness. Patients are taught methods for establishing healthy relationships to deal with conflict.
- Emotion regulation. Patients are taught how to handle emotions and obstacles in order to manage their emotions. They are also taught to avoid situations that trigger harmful emotions.
Efficacy of Behavioral Therapy
Numerous studies have shown that behavioral therapy works. Among them is a manuscript published in July 2012 in PubMed Central (PMC), an archive maintained by the National Institute of Health.
The study, “The Efficacy of Behavioral Therapy: A Review of Meta-analyses” identified 269 meta-analytic studies and reviewed a representative sample of 106 meta-analyses examining behavioral therapy. The consensus conclusion was that CBT showed more efficacy than other compared treatments for many mental health issues including substance addiction, depression, and several other disorders.
Sands Treatment Center
At The Sands Treatment Center, we have many years of experience treating substance addiction as well as other disorders. We employ 12-step programs in combination with behavioral therapies. Contact us to find out more.
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