%20(1).png?width=200&height=80&name=Trillium%20Counselling%20Logo%20(999%20x%20398%20px)%20(1).png "Trillium Counselling Logo (999 x 398 px) (1)")
CBT vs DBT: What's the Difference?
CBT focuses on changing unhelpful thoughts and behaviours, while DBT pairs change with acceptance and teaches skills for managing intense emotions. DBT is based on CBT and was developed by Marsha Linehan for people with borderline personality disorder. It teaches four skill sets (mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness), and a standard program runs for about a year, although the practical skills from DBT can be used by anyone and learned in a few sessions. CBT is usually shorter, often 6 to 20 sessions.
Last updated: October 2026
What is the difference between CBT and DBT?
Both are talk therapies where you work with a therapist and learn skills to cope. The main difference is focus. CBT mainly teaches you to change unhelpful thoughts and behaviours, while DBT teaches you to accept your thoughts, feelings, and behaviours as well as ways to change them, with extra attention to relationships (CAMH).
DBT grew out of CBT, but it puts more weight on the emotional and social side of life, because it was created to help people manage intense emotions (CAMH). At Trillium, our therapists offer CBT therapy and DBT-based support in person in Waterloo and online across Ontario.
| Compare | CBT | DBT |
|---|---|---|
| Main focus | Changing unhelpful thoughts and behaviours | Balancing acceptance and change, especially with intense emotions |
| Core idea | Your thoughts, feelings, and actions affect one another | Your experience makes sense, and you can still change what isn't working |
| Skills you learn | Thought records, activity planning, behavioural experiments, and facing fears step by step | Mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness |
| How it's delivered | Usually weekly one-on-one sessions | Standard DBT combines individual therapy, a weekly skills group, and coaching between sessions |
| Typical length | Often 6 to 20 sessions | About a year for a standard program; shorter DBT-informed options exist |
| Often used for | Anxiety, depression, phobias, OCD, and many other concerns | Intense emotions, self-harm, suicidal behaviour, and borderline personality disorder |
What does CBT focus on compared with DBT?
CBT works on the link between what you think, how you feel, and what you do. You learn to notice automatic thoughts, check them against the evidence, and try new behaviours, such as planning activities or facing a fear in small steps. It's structured, goal-focused, and time-limited, usually 6 to 20 sessions (CAMH).
Where CBT asks "Is this thought accurate, and what can I do differently?", DBT also asks "How can I accept this moment while I work on changing it?" If you'd like the fuller picture of the method, read how CBT works.
What does DBT add to CBT?
DBT was developed by Marsha Linehan, and it combines behaviour therapy, CBT, and mindfulness (APA Dictionary of Psychology). Its name points to its core idea.
"Dialectical" means holding two things that seem opposite at the same time. In DBT, those two things are acceptance, the idea that your experiences and behaviours make sense, and change, the idea that you'll need to make changes to manage emotions and move forward (CAMH).
The four DBT skill sets
- Mindfulness: staying in the present and noticing thoughts, feelings, and behaviours as they happen, without trying to control them.
- Distress tolerance: getting through a crisis without making it worse, and accepting a situation as it is when you can't change it right now.
- Emotion regulation: managing emotions so they don't take over your thoughts and actions.
- Interpersonal effectiveness: asking for what you need and saying no when you need to, while keeping your self-respect and your relationships.
How a standard DBT program is set up
A standard DBT program has several parts that work together: a weekly skills group that runs much like a class, weekly individual therapy of 60 to 90 minutes, in-the-moment coaching such as by phone, and a consultation team that supports the therapists. The full skills curriculum takes 24 weeks and is often repeated to make a one-year program. Shorter 'DBT-informed' programs use some of these methods and can be very helpful for certain people (CAMH).
At Trillium, we offer DBT-informed individual therapy. Your therapist teaches you DBT skills and concepts one-on-one and helps you use them in daily life. We don't offer skills groups or between-session phone coaching. You can read more on our DBT therapy page.
Not sure whether CBT or DBT would suit you better? You don't need to have it figured out before you reach out. A free 20-minute consultation with our intake team is a simple way to talk through what you're looking for and get matched with a therapist who fits.
Book a free matching consultWhat is each therapy used for?
CBT is widely used for anxiety and depression, and it has been tailored to many other concerns, including specific phobias, panic, obsessive-compulsive disorder, and eating disorders (CAMH).
DBT was developed for people with borderline personality disorder, but it can also help with suicidal behaviour, self-harm, substance use, PTSD, depression, and eating disorders (CAMH). For borderline personality disorder, a large review found that DBT may ease symptoms, reduce self-harm, and improve day-to-day functioning compared with usual care, though more research may be needed to be sure (Cochrane review, 2020).
A diagnosis such as borderline personality disorder can only come from a physician, psychiatrist, psychologist, or nurse practitioner. You don't need a diagnosis to work on intense emotions with a therapist, and our therapists work with these patterns whether or not you ever pursue one.
How do you choose between CBT and DBT?
CBT may fit if you have a specific problem you want to work on, such as worry, low mood, or a fear, and you'd like a structured, shorter-term approach.
DBT may fit if your emotions often feel overwhelming, if they shift quickly and strain your relationships, or if you've tried CBT and found that changing your thoughts wasn't enough on its own. It's also designed for people dealing with self-harm or frequent crises.
You don't always have to pick one. Some therapists blend the two, using CBT tools alongside DBT skills such as distress tolerance. If you're having thoughts of suicide or self-harm right now, please reach out for support today; the crisis lines at the end of this article are available 24/7.
Who would help me with CBT or DBT at Trillium?
At Trillium Counselling, therapy is provided by Registered Social Workers (RSWs) and Registered Psychotherapists (RPs), including therapists trained in CBT and DBT. After a free consultation, our intake team matches you with a therapist whose experience and approach fit what you're looking for. You can meet in person at our Waterloo office or online by video from anywhere in Ontario. Your therapist will talk with you about which approach, or blend, suits your goals. Fees, insurance, and the current team are on our CBT therapy page.
If you're weighing CBT against DBT, you don't have to decide alone. A free 20-minute consultation with our intake team is a low-pressure way to share what you're looking for and get matched with a therapist whose approach fits you.
Book a Free ConsultationLearn more about CBT therapy at Trillium
Frequently asked questions
+Is DBT a type of CBT?
Is DBT a type of CBT?
Yes. DBT combines behaviour therapy, CBT, and mindfulness practices (APA Dictionary of Psychology). What sets it apart is its focus on accepting your experience while you work to change it, and its extra emphasis on emotions and relationships (CAMH).
+Can you do CBT and DBT at the same time?
Can you do CBT and DBT at the same time?
Yes. Many people use skills from both, and a therapist may use CBT tools, such as thought records, alongside DBT skills, such as distress tolerance, in the same sessions. If you're already in a full DBT program, talk with your DBT team before adding another therapy so your care stays coordinated.
+Is DBT more intensive than CBT?
Is DBT more intensive than CBT?
A standard DBT program usually is. It can ask for a one-year commitment, with a weekly skills group as well as individual therapy (CAMH), while CBT often runs 6 to 20 sessions (CAMH). At Trillium, we offer DBT-informed individual therapy instead of a full program. You'll learn and practice DBT skills one-on-one with your therapist, without a group or a one-year commitment. That makes the time commitment closer to regular individual therapy, and you and your therapist decide together how many sessions you need.
+Which is better for anxiety, CBT or DBT?
Which is better for anxiety, CBT or DBT?
For most anxiety concerns, CBT is the more established choice, and it is particularly effective for anxiety and depression (CAMH). DBT may fit better when anxiety comes with intense emotions that are hard to manage, self-harm, or frequent crises. A therapist can help you decide which approach suits your goals.
Crisis Resources
If you or someone you know needs support right now, help is available:
- 988 Suicide Crisis Helpline (Canada-wide): call or text 9-8-8 — free, confidential, 24/7.
- Here 24/7 (Waterloo–Wellington crisis & mental health line): 1-844-437-3247.
- If someone is in immediate physical danger, call 911.
About the reviewer — Devon Jorge, MSW, RSW, Registered Social Worker, Psychotherapist — Devon is the Clinical Director at Trillium Counselling and a Registered Social Worker who provides psychotherapy to clients. She reviews Trillium's educational articles to help ensure they remain accurate and responsible. Last reviewed in October 2026.
About this article — This article is intended for general education about mental health and the therapy process. It is not a substitute for professional diagnosis, treatment, or individualized mental health advice. If you have concerns about your mental health, please speak with a qualified health professional or contact local crisis services in an emergency.
