You may have heard of cognitive behavioral therapy and dialectical behavior therapy for anxiety, depression, and other mental health challenges, but which one is right for you? At Santé Center in Northern Texas, our experienced clinicians provide personalized care using evidence-based approaches to support your mental wellness journey, including these two therapy modalities.

Introduction to CBT and DBT

Cognitive behavioral therapy (CBT) grew from cognitive therapy and behaviorism in clinical psychology. It is a structured, goal-oriented talk therapy that looks at the link between thoughts, feelings, and actions. CBT focuses on identifying negative thought patterns, testing those thoughts, and building healthy behaviors that support mental wellness.

Dialectical behavior therapy (DBT) evolved from CBT to better support people who experience intense emotions and emotional dysregulation. The term “dialectical” reflects the balance between acceptance and change. DBT focuses on validating a person’s experience while teaching skills to reduce problematic behaviors and improve relationships. Standard dialectical behavior therapy includes individual therapy, group skills training, coaching between sessions in some models, and a therapist consultation team. You can learn more general background on psychotherapy options from the National Institute of Mental Health’s overview of psychotherapies, which describes how evidence-based talk therapies help with common mental health issues.

What is Cognitive Behavioral Therapy (CBT)?

CBT is a short-term, skills-based approach that helps you notice and change negative thoughts and maladaptive behaviors. CBT focuses on the present, uses worksheets and other homework outside of therapy sessions, and measures progress. Typical techniques include:

• Thought records to track situations, emotions, and automatic thoughts
• Cognitive restructuring to challenge negative thoughts and replace them with balanced thinking
• Behavioral experiments to test predictions and learn from results
• Exposure strategies for anxiety disorders, including panic disorder
• Problem-solving and activity scheduling to rebuild healthy routines

How CBT helps with anxiety and depression

• CBT for anxiety targets avoidance, catastrophic thinking, and safety behaviors. You practice approaching feared cues in small steps, then update beliefs based on what you learn.
• CBT for depression addresses negative thoughts about the self, world, and future, and increases rewarding activities to improve mood.

CBT can be provided in individual therapy or group therapy, and many programs use both CBT and medication when needed. At Santé Center, our clinicians use cognitive behavioral therapy within integrated treatment plans. We invite you to learn more about how cognitive behavioral therapy at Santé Center can benefit you.

What is Dialectical Behavior Therapy (DBT)?

DBT is a specialized form of CBT designed to support people with intense emotions and patterns like self harm and other harmful behaviors. DBT focuses on both acceptance and change, helping you validate your experience while building new skills. Core skills, often called DBT skills, are taught in specific skills training modules. These include:

• Mindfulness skills to anchor attention in the present
• Emotion regulation to understand, label, and shift feelings
• Distress tolerance to cope with crises without making things worse
• Interpersonal effectiveness skills to ask for what you need and set limits

Dialectical behavioral therapy is especially known for its effectiveness with borderline personality disorder. It also shows benefits for eating disorders, substance use disorders, post-traumatic stress disorder (PTSD), and mood disorders. The Mayo Clinic explains how DBT is delivered, including weekly sessions and skills modules that help with emotional regulation and interpersonal effectiveness.

Santé Center offers a dialectical behavior therapy program near Dallas where you can learn these skills in a supportive setting.

CBT vs DBT: Key differences

Use this side-by-side comparison to clearly understand the key differences between CBT and DBT. This overview will help you grasp how each therapy targets specific mental health challenges, their unique approaches, and which might be best suited for your personal needs and goals.

Treatment focus

• CBT focuses on identifying negative thoughts, testing beliefs, and building healthy behaviors.
• DBT focuses on acceptance and change, with emphasis on emotional regulation and interpersonal effectiveness.

Primary goals

• CBT aims to change negative thought patterns and reduce maladaptive behaviors that maintain symptoms.
• DBT aims to reduce life threatening behaviors, reduce therapy interfering behaviors, and increase quality of life skills.

Structure and intensity

• CBT is often 5 to 20 sessions, once weekly, with homework.
• DBT is often more intensive, commonly including weekly individual therapy, weekly group sessions for skills training, and between-session coaching in some programs.

Best suited for

• CBT is widely used for anxiety disorders, obsessive compulsive disorder, depression, and many other mental health conditions.
• DBT is a first line approach to treat borderline personality disorder (BPD), and it also helps when intense emotions lead to problematic behaviors, self-harming behaviors, or conflict with others.

Techniques

• CBT uses thought records, behavioral experiments, and exposure.
• DBT uses distress tolerance, emotion regulation, mindfulness techniques, and interpersonal effectiveness skills.

When to prefer one approach

Consider CBT if your main concern is persistent negative thoughts and avoidance. For example, panic disorder or social anxiety where exposure is key.

Consider DBT if you struggle with intense emotions, frequent crises, chronic suicidal ideation, or patterns tied to borderline personality disorder. DBT treats emotional response patterns by teaching you to notice, name, and ride out urges without acting on them.

If your presentation is complex, a blended plan using both CBT and DBT elements can also work well. A mental health professional can help you choose a path tailored to your history and goals. Learn more about how the Santé Center helps you find your path through individual therapy.

Applications of CBT and DBT for anxiety and depression

Anxiety disorders

• CBT for anxiety often starts with education on the fight or flight response, then builds a fear ladder for gradual exposure. You learn coping skills like balanced breathing, but the core change comes from facing feared situations and updating beliefs. Evidence from NIH shows CBT can produce significant improvements in symptoms and functioning for children with anxiety disorders, and similar gains are seen in adults.
• DBT for anxiety helps when anxiety occurs with intense emotions, urges to engage in harmful behaviors, or volatile relationships. DBT focuses on distress tolerance and emotion regulation so you can ride out emotional distress without avoidance or escalation.

Depression

• CBT for depression targets low activity and negative thoughts that drive withdrawal. You track negative thoughts, test them, and schedule activities that provide mastery and pleasure.
• DBT for depression is useful when low mood is linked to emotional dysregulation, self harm, or conflict. Skills like opposite action, interpersonal effectiveness, and mindfulness can reduce suffering and rebuild connection.

Session structure and pace

• CBT is usually individual therapy, sometimes with adjunct group therapy, and may include 8 to 16 weeks of structured modules.
• Standard DBT includes weekly individual therapy and weekly group sessions focused on skills training. Some programs include coaching during business hours to help you apply skills in the moment. At Santé Center, DBT sessions are designed to help you practice skills between visits through worksheets and coaching in session.

If you want to see how therapy options fit together in a program, review our types of treatment overview.

Conclusion: Choosing between CBT vs DBT

CBT and DBT are proven therapeutic modalities that help people build healthy behaviors, reduce symptoms, and reconnect with values. CBT focuses on changing negative thoughts and behaviors that keep problems going. DBT focuses on validation, mindfulness, and skills that stabilize intense emotions, improve interpersonal relationships, and prevent harmful behaviors. Many care plans use both CBT and DBT at different stages of recovery.

If you are ready to compare options for anxiety, depression, or other mental health issues, reach out to the Santé Center in Argyle, Texas, today.