Anxiety is a common mental health condition involving constant worry and other physical symptoms such as shortness of breath, raised heart rate, etc. Mental health professionals use various modalities or therapies in the treatment of anxiety. Two of the most prominent approaches used in anxiety treatment are Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT). Although both approaches focus on reducing anxiety symptoms, they have key differences. Understanding these differences can help people choose the approach that suits them best.

Exploring Cognitive Behavior Therapy (CBT)

American psychiatrist Aaron Beck is the founder of CBT. CBT assumes that our thoughts, emotions and actions are interlinked and also believes that changes in one of these areas would also help change the other two domains. Thus, CBT focuses on helping people interrupt and change problematic or unhelpful thoughts and behaviours that might be causing or contributing to the issues at hand. 

CBT And Anxiety

CBT is one of the most popular and evidence-based approaches to dealing with anxiety. What sets CBT apart from other approaches is its comprehensive focus on changing both thoughts and behaviours that might be causing anxiety. Some CBT techniques to deal with anxiety are:

  • Identifying Patterns

The initial part of CBT treatment focuses on helping people identify thoughts or behaviours that might be contributing to their anxiety. This is done through worksheets

  • Thought Stopping

This technique involves teaching people the skills required to interrupt negative thought patterns

  • Cognitive Restructuring

This involves replacing or reframing negative or unhelpful anxiety-provoking thoughts and replacing them with more helpful ones

  • Exposure Therapy

Exposure therapy involves confronting anxiety-provoking situations while practising relaxation techniques and coping skills so that anxiety reduces over time

Understanding Dialectical Behaviour Therapy (DBT)

DBT was originally developed by Marsha Linnehan, an American psychiatrist, for the treatment of Borderline Personality Disorder. However, due to its focus and efficiency in addressing a wide range of emotional dysregulation issues, it is being used in the treatment of various disorders, such as anxiety and depression. In simple terms, dialectic means bringing together opposite ideas. Thus, DBT focuses on helping people integrate opposite ideas by encouraging self-acceptance and empowerment by teaching them emotional regulation skills.

DBT And Anxiety

Although there has been limited research on the effectiveness of DBT in anxiety treatment, it is effective in reducing anxiety symptoms. A few techniques used in DBT for anxiety are:

  • Mindfulness

Mindfulness involves being in the present moment, accepting and observing one’s thoughts, emotions, and bodily sensations without judgment. Mindfulness can help stop ruminating and worrying about the future, which are common in anxiety.

  • Distress Tolerance

DBT focuses on teaching people to manage difficult emotions and situations effectively without engaging in unproductive or unhelpful behaviours, These skills can help manage anxiety-provoking situations effectively

  • Emotional Regulation

This skill involves teaching people to cope with intense emotions through healthier responses. This can help stop excessive suffering that comes from intense emotional experiences

  • Interpersonal Effectiveness

This involves learning effective communication skills, such as boundary setting, and conflict resolution strategies, which can help improve relationships and reduce social anxiety.


CBT And DBT For Anxiety- Which is Better?

Various studies report that CBT is one of the most effective treatments for anxiety.  A literature review from 2019 revealed that people who underwent CBT reported reduced anxiety symptoms even 12 months post-treatment. Another study in 2021 found that CBT can significantly reduce moderate and even severe anxiety symptoms.

There is also evidence to support the effectiveness of Dialectical Behavior Therapy (DBT) in reducing anxiety symptoms. A study involving 173 participants in 2016 found that DBT skills training led to a decrease in anxiety symptoms, among patients in a psychiatric hospital.

Thus, research suggests that both CBT and DBT can help with anxiety reduction. However, there is more evidence to suggest that CBT is effective for anxiety treatment as compared to DBT 


In summary, there is evidence to suggest that both CBT and DBT can help with anxiety, however, the body of research supporting CBT is much larger as compared to DBT. Ultimately, the choice of approach depends on the needs and preferences of individual clients. Many therapists might use a combination of both of these approaches, which can be tailored according to the clients.


  1. CBT for Anxiety: How It Works & Examples. (n.d.). Choosing Therapy. Retrieved March 14, 2024, from
  2. CBT vs. DBT: What’s The Difference? (2016, May 17). Psych Central.
  3. DBT for Anxiety: 4 DBT Techniques to Cope With Anxiety. (n.d.). Choosing Therapy. Retrieved March 14, 2024, from
Dhruva Koranne

Dhruva Koranne has completed his Masters in Applied Psychology from Tata Institute of Social Sciences, BALM. He has been practicing as a counsellor since 2020 and works to create a safe space for clients where they can open up. In addition to this, Dhruva loves researching and studying about upcoming theories in the field of Psychology. Connect with him on Linkedin