DBT vs CBT

DBT vs CBT: Understanding the Differences and Finding the Right Treatment for You

If you’re exploring therapy options for emotional struggles, you’ve likely encountered the terms DBT and CBT. While these acronyms may sound similar, understanding the differences between Dialectical Behavior Therapy (DBT) and Cognitive Behavioral Therapy (CBT) can help you find the most effective treatment for your specific needs.

What is CBT?

Cognitive Behavioral Therapy (CBT) is a widely-used, evidence-based form of psychotherapy that focuses on identifying and changing unhelpful thought patterns and behaviors. CBT operates on the principle that our thoughts, feelings, and behaviors are interconnected, and that changing negative thought patterns can lead to changes in feelings and behaviors.

CBT is effective for treating a range of mental health conditions, including:

• Depression
• Anxiety disorders
• Phobias
• PTSD
• Obsessive-compulsive disorder
• Sleep disorders

In CBT, therapists help clients recognize distorted thinking patterns, develop problem-solving skills, and use behavioral techniques to change unwanted patterns. Treatment typically involves structured sessions with homework assignments between meetings.

What is DBT?

Dialectical Behavior Therapy (DBT) was developed by psychologist Marsha Linehan specifically to treat individuals with borderline personality disorder (BPD) and chronic suicidal ideation. DBT is actually based on CBT principles but adds important components that make it particularly effective for people struggling with intense emotional dysregulation.

The word “dialectical” refers to the integration of opposites—in DBT, this means balancing acceptance and change. While CBT focuses primarily on changing thoughts and behaviors, DBT emphasizes both accepting yourself as you are and working toward positive change.

DBT includes four key skill modules:

• Mindfulness: Learning to be present in the moment without judgment
• Distress Tolerance: Developing skills to survive crises without making situations worse
• Emotion Regulation: Understanding and managing intense emotions
• Interpersonal Effectiveness: Communicating needs effectively while maintaining self-respect and relationships

DBT vs CBT: Key Differences

While both therapies are evidence-based and effective, several important distinctions set them apart:

Treatment Structure: CBT typically involves weekly individual therapy sessions alone. Comprehensive DBT, by contrast, includes multiple components: individual therapy, skills training group, phone coaching between sessions, and a therapist consultation team to ensure quality care.

Approach to Emotions: CBT focuses on changing thought patterns to influence emotions and behaviors. DBT places greater emphasis on validating intense emotions while simultaneously teaching skills to regulate them.

Skills Training: While CBT may teach coping strategies, DBT provides systematic, structured skills training in a group format, giving clients a comprehensive toolkit for managing emotional challenges.

Length of Treatment: CBT treatment length varies depending on the individual and condition being treated. Research-supported DBT programs typically last one year for adults and six months for adolescents, with a minimum commitment of three hours per week.

DBT vs CBT: When is DBT the Preferred Choice?

So, DBT vs CBT? Which one do you need? DBT has proven particularly effective for individuals experiencing:

• Borderline Personality Disorder (BPD)
• Intense emotional dysregulation
• Self-harming behaviors
• Chronic suicidal thoughts
• Difficulty maintaining relationships due to emotional reactivity
• Impulsive behaviors

Research has consistently shown that comprehensive DBT, when delivered with fidelity to the model created by Marsha Linehan, produces remarkable outcomes. Multiple randomized controlled trials have demonstrated its effectiveness in reducing self-harm, suicidal behavior, and psychiatric hospitalizations while improving overall emotional regulation and quality of life.

When Might CBT Be a Good Fit?

CBT remains an excellent choice for many individuals, particularly those dealing with:

• Depression without severe emotional dysregulation
• Specific anxiety disorders
• Phobias
• Thought pattern-related challenges
• Those seeking a shorter-term, focused intervention

Both approaches are valuable, and the most effective treatment depends on your individual needs and circumstances.

Gladstone’s Certified DBT Program

At Gladstone Psychiatry and Wellness, we’re proud to offer Maryland’s first DBT program certified by the DBT-Linehan Board of Certification (DBT-LBC). We are currently one of three certified programs in the state. This certification was awarded after a rigorous examination that included a comprehensive review of our program documents, interviews with therapists and clients, and verification that our program adheres to the evidence-based model developed by Marsha Linehan.

Our program director and several of our therapists hold individual certification through DBT-LBC, demonstrating their advanced expertise in delivering this specialized treatment. This dual distinction—both program and individual clinician certification—reflects our commitment to providing the highest quality DBT services.

Our outcomes speak for themselves. Data collected from our DBT program shows that clients experienced a 98% reduction in psychiatric hospitalizations. Additionally, clients showed substantial reduction in emotional dysregulation, with average scores on the Difficulties in Emotion Regulation Scale dropping from 111.3 (correlated with severe symptoms requiring higher levels of care) to 86.27 (correlated with mild symptoms manageable within the community).

What’s Included in Comprehensive DBT at Gladstone?

Our DBT program provides all components of comprehensive, evidence-based DBT:

• Individual Therapy: One hour per week with your DBT therapist
• Skills Training Group: Two hours per week learning and practicing DBT skills
• Phone Coaching: Between-session support to help you apply skills in real-life situations
• Therapist Consultation Team: Regular meetings among DBT therapists to ensure you receive the highest quality care

We offer flexible options for individual sessions, with both in-person appointments available at our Hunt Valley, Bethesda, Columbia, Baltimore, and Frederick locations, as well as virtual sessions via HIPAA-compliant telehealth. Adult skills training groups are currently offered virtually, while Multifamily Skills groups for adolescents and their families are available both virtually and in-person at our Hunt Valley location.

Insurance and Payment Options

We’re in-network with most local (Maryland) CareFirst/BCBS commercial plans. We can also accept Aetna, United/Optum, Cigna/Evernorth, and certain non-local CareFirst plans with an additional monthly fee of $1,500 (billed in bimonthly installments of $750). Self-pay options are also available at $2,200 monthly (billed in bimonthly installments of $1,100).

Our specialized contract with CareFirst of Maryland allows us to bill for the entire comprehensive DBT program, including components that most insurance companies don’t typically cover, such as skills training groups, phone coaching, and therapist consultation team services.

How to Apply to Gladstone’s DBT Program

Getting started with DBT at Gladstone is straightforward:

1. Complete the application: Visit our website to access the DBT program application
2. Submit your application: Send your completed application to [email protected]
3. Join the waitlist: Your application will be added to our waitlist and matched with a therapist based on your scheduling availability and preferences
4. Consultation call: When a therapist has an opening that matches your needs, they’ll contact you for a brief 15-minute phone consultation
5. Schedule intake: During the consultation, you may schedule your intake appointment
6. Begin Pretreatment: Your first session begins the Pretreatment phase (approximately four sessions), during which you’ll learn more about DBT and prepare to start the full program

You don’t need to be a current Gladstone client to apply, and no referral is necessary unless specified by your insurance plan. While you don’t need to be a Maryland resident, you do need to be physically present in Maryland during your virtual sessions, as our therapists are licensed to practice in Maryland.

DBT vs CBT: Making the Right Choice for Your Mental Health

Both DBT and CBT offer valuable paths to improved mental health and wellbeing. The choice between them depends on your specific challenges and treatment goals. If you’re struggling with intense emotions, relationship difficulties, self-harm, or have been diagnosed with borderline personality disorder, DBT may offer the comprehensive skills and support you need to create lasting change.

At Gladstone Psychiatry and Wellness, our certified DBT program provides evidence-based treatment delivered by highly trained clinicians committed to helping you build a life worth living. We welcome your questions about whether DBT is right for you.

To learn more about our DBT program or to begin the application process, visit our website or contact us at [email protected]. We’re here to support you on your journey toward emotional wellbeing.