DBT vs CBT: What's the Difference and Which Is Right for You?
from a Psychotherapist’s Lens
Choosing a therapy approach can feel overwhelming—especially when you’re already carrying emotional stress, anxiety, or uncertainty about where to start. Two of the most well-known, evidence-based therapies are CBT and DBT. They’re both effective, both structured, and both widely used, but they’re meant to support very different kinds of struggles.
As a psychotherapist, I often explain them to clients this way:
CBT helps you challenge unhelpful thoughts. DBT helps you navigate overwhelming emotions.
Let’s break that down in a simple, human way.
What Is CBT—and What Is It Useful For?
Cognitive Behavioural Therapy (CBT) is a structured, present-focused therapy that teaches you how your thoughts, feelings, and behaviours influence one another. The foundation of CBT is simple:
When you change how you think, you change how you feel and act.
Who CBT Helps Most
CBT is effective for people experiencing:
OCD
PTSD
Perfectionism
Phobias
Persistent negative thinking patterns
If you’re someone who gets stuck in spirals like “What if…?”, assumes the worst, or tends to criticize yourself, CBT offers very practical tools.
How CBT Works (In Real Life)
CBT sessions often include:
Identifying thought patterns
Challenging and reframing unhelpful beliefs
Gradually facing avoided situations
Practicing new behaviours outside the session
This can look like keeping a thought journal, doing exposure exercises, or planning activities that help boost motivation and mood. CBT is typically short-term, collaborative, and goal-oriented.
What Is DBT—and What Is It Useful For?
Dialectical Behaviour Therapy (DBT) was created for people who feel emotions intensely or struggle to regulate them.
If you’ve ever felt like your emotions go from 0 to 100 quickly, or that you react before you can think, DBT may be the support you didn’t know you needed.
Who DBT Helps Most
DBT is especially helpful for individuals with:
Borderline Personality Disorder (BPD)
Chronic emotion dysregulation
Impulsive or self-harming behaviours
Suicidal thoughts
Trauma-related emotional instability
Interpersonal conflict
Eating disorders
Substance use concerns
It’s also incredibly supportive for people who feel misunderstood, invalidated, or overwhelmed by intense emotional experiences.
How DBT Works (In Real Life)
DBT teaches four main skill areas:
Mindfulness – staying present and aware of your emotions without reacting impulsively.
Distress Tolerance – surviving emotional crises safely and without harmful coping.
Emotion Regulation – understanding and stabilizing strong emotional reactions.
Interpersonal Effectiveness – communicating needs clearly and maintaining healthy boundaries.
Unlike CBT, DBT is usually delivered through:
Weekly individual sessions
Weekly group skills training
Between-session coaching (brief, skill-based support)
It’s more structured and intensive, but deeply transformational for those who need consistent emotional support.
So… Which One Do You Need?
Here’s a simple way to understand the difference:
CBT may be right for you if you struggle with:
Excessive worry
Negative thinking
Self-criticism
Avoidance patterns
Anxiety or depression symptoms
Fear-based behaviours or phobias
You might identify with thoughts such as:
“I know my thoughts aren’t realistic, but I can’t stop them.”
DBT may be right for you if you struggle with:
Intense or unpredictable emotions
Impulsivity
Self-harm urges
Anger outbursts
Relationship instability
Feeling misunderstood or invalidated
Shifting self-image or identity confusion
You might relate more to:
“My emotions feel too big. I react before I even understand what I’m feeling.”
A Therapist’s Perspective
You don’t need to decide this alone. Many people find relief in a combination of CBT and DBT approaches. What matters most isn’t choosing the “perfect” therapy—it's choosing the one that helps you feel seen, supported, and equipped with tools that actually work.
As therapists, our role is to understand your emotional patterns, symptoms, history, and goals, then recommend the approach most suited to your unique needs.
Not Sure Where to Start? I Can Help.
Therapy is a personal journey, and your needs deserve a tailored approach. If you’re unsure whether CBT or DBT fits your situation, we can explore it together in a safe, supportive space.
Book a consultation to discover which therapy approach aligns best with your healing journey.
Whenever you’re ready, I’m here.