CBT Versus DBT for Treating Borderline Personality Disorder

How CBT and DBT are Related

group therapy session
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If you have borderline personality disorder, you have probably heard of both cognitive-behavioral therapy and dialectical behavior therapy. Are theses modes of treatment different or simply variations of each other? Let's take a closer look at these types of behavioral therapies, and how they are related.

What is Cognitive Behavioral Therapy?

Cognitive-behavioral therapy, or CBT, is a form of therapy that aims to restructure and change the way a person thinks and behaves.

Whether or not this therapy is beneficial depends strongly on the relationship between the patient and her therapist, and the patient's willingness to make a change.

Examples of techniques used by a cognitive-behavioral therapist include cognitive restructuring and behavioral changes, like reducing self-defeating behaviors and learning how to respond to problems in a healthy, adaptive manner. In cognitive restructuring, a patient is taught to identify negative reactive thoughts and modify them. 

What is Dialectical Behavior Therapy?

Dialectical behavioral therapy, or DBT, is a modified type of CBT that was uniquely developed to to treat borderline personality disorder. It focuses on skills like mindfulness, or living in the present, regulating emotions, tolerating distress, and effectively managing relationships with others. DBT is composed of 4 elements provided over a year or more:

  • Individual DBT therapy — uses techniques like cognitive restructure and exposure  to change behavior and improve quality of life
  • Group therapy — uses skills training to teach patients how to respond well to difficult problems or situations
  • Phone calls — applying learned skills to life outside therapy
  • Weekly consultation meetings among the DBT therapists — a means of support for the therapists and to ensure they are following the DBT treatment model

    How is DBT Distinguished from CBT?

    DBT is simply a modified form of CBT that uses traditional cognitive-behavioral techniques, but also implements other skills like mindfulness, acceptance, and tolerating distress. The good news is that DBT has been found to be considerably effective in treating people with borderline personality disorder. 

    It's interesting to note that some cognitive-behavioral therapists incorporate certain elements of the DBT model into their treatments sessions. Also, other forms of CBT have developed that use the elements of DBT. For instance, mindfulness-based cognitive therapy utilizes traditional cognitive-behavioral techniques with mindfulness to treat depression. 

    What Does This Mean for Me if I Have BPD?

    If you have BPD, there are great therapies out there for you. Please speak with your doctor about finding the right therapist and treatment model for you, so you can feel better and improve your quality of life. 


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    Linehan, MM. Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford, 1993.

    Matusiewicz AK, Hopwood CJ, Banducci AN & Lejuez CW. The effectiveness of cognitive behavioral therapy for personality disorders. Psychiatr Clin North Am. 2010 Sep;33(3):657-685. 

    Segal, SV, Williams, JMG, & Teasdale, JD. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford, 2001.

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