Psychologists and therapists often use a variety of therapies to help their clients based on their specific needs. The three most popular and effective approaches to therapy are Cognitive Behaviour Therapy (CBT), Rational Emotive Behaviour Therapy (REBT) and Dialectical Behaviour Therapy (DBT). While all of these cognitive therapies focus on our thoughts, feelings and behaviours, their application has key differences. Let’s understand these differences in depth.
Cognitive Behaviour Therapy (CBT)
CBT is an effective form of talk therapy developed by Aaron Beck in the 1960s. It is based on the assumption that our thoughts, feelings and behaviours influence each other. Thus, CBT believes that changing one’s thoughts and actions or behaviours can also lead to change in one’s feelings. So, a CBT therapist often helps clients challenge unhelpful thought patterns and replace them with more helpful or realistic ones.
CBT aims to empower clients with practical tools to change their thinking and behaviours through cognitive restructuring, behavioural activation, gradual exposure and skills training. CBT’s focus on practical skills and thought restructuring makes it an evidence-based, effective approach for treating various conditions such as anxiety, OCD, phobias and depression.
Rational Emotive Behaviour Therapy (REBT)
Albert Ellis developed REBT in the 1950s. Much like CBT, REBT is also based on the principle that unwanted behaviours or feelings are often a result of unhelpful or flawed patterns of thinking. However, unlike CBT, which focuses on modifying thoughts, REBT goes deeper and explores irrational beliefs-
Irrational beliefs are unrealistic, rigid thinking patterns not based on facts or logic. Thus, REBT aims to help people identify these irrational beliefs and re-evaluate them to form more rational thinking patterns. Rational beliefs are generally based on reality and are likely to change over time as well.
REBT uses a technique called disputation to help clients challenge and modify their irrational beliefs. What makes REBT different from CBT is that it encourages unconditional Self-Acceptance. which helps clients to accept themselves as human beings with flaws and mistakes without harsh self-judgment. This self-acceptance is seen as crucial for developing healthy emotional responses and behaviours.
Dialectical Behaviour Therapy (DBT)
DBT was developed by Marsha Linnehan, an American psychiatrist. Initially, it was designed to treat Borderline Personality Disorder (BPD) but now it is used to treat various other conditions such as anxiety and depression as well. Unlike CBT which focuses on changing one’s thoughts, DBT is much more focused on dealing with one’s emotions. Thus, DBT empowers clients by focusing on self-awareness and also teaches them emotional regulation skills to deal with difficult emotions. Some key concepts of DBT are:
- Mindfulness: Encourages clients to be in the moment and observe their thoughts without judgement
- Distress Tolerance: Involves building resilience to handle crises and cope with intense emotions in positive ways, such as through distraction, self-soothing, etc.
- Interpersonal Effectiveness: Encourages clients to build healthy communication skills to enhance interpersonal relationships
- Emotional Regulation: Teaches clients skills to manage intense emotions through grounding and other activities
Due to these skills, DBT is beneficial for people with borderline personality disorders. Self-harm behaviours and people who experience emotional dysregulation.
How Do They Differ?
Let’s look at the differences between the three theories through the table below
| Aspect | CBT | DBT | REBT |
| Focus | Focuses on changing negative thought patterns | Focuses on dealing with intense emotions | Focuses on dealing with irrational beliefs |
| Techniques | Cognitive Restructuring, exposure | Mindfulness, emotion regulation, distress tolerance | Disputation, Unconditional Self-Acceptance |
| Whom does it help? | People with anxiety, phobias, depression | People struggling with intense emotions | People struggling with unhelpful beliefs |
Conclusion:
CBT, REBT, and DBT are all effective therapeutic approaches with unique strengths. The best approach depends on a person’s needs and therapeutic goals. In some cases, therapists might adapt elements from all three therapies to make a comprehensive and holistic treatment plan. Ultimately, all three therapies provide effective relief and help to individuals.
References:
- DBT Vs. CBT: Understanding the Differences. (n.d.). ChoosingTherapy.Com. Retrieved January 15, 2025, from https://www.choosingtherapy.com/dbt-vs-cbt/
- How Dialectical Behavior Therapy (DBT) Works. (n.d.). Verywell Mind. Retrieved January 15, 2025, from https://www.verywellmind.com/dialectical-behavior-therapy-1067402
- REBT Vs. CBT: Understanding the Differences. (n.d.). ChoosingTherapy.Com. Retrieved January 15, 2025, from https://www.choosingtherapy.com/rebt-vs-cbt/
- What Is Rational Emotive Behavior Therapy (REBT)? (n.d.). Verywell Mind. Retrieved January 15, 2025, from https://www.verywellmind.com/rational-emotive-behavior-therapy-2796000
