DBT versus CBT

Discussion in 'Mental Health Disorders' started by unionfalls, Mar 4, 2014.

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  1. unionfalls

    unionfalls Well-Known Member

    I am looking for any advice or experiences on the difference between DBT and CBT. Advice on how DBT might be more effective as CBT has not been very helpful for me.
    I have been diagnosed with some form of depression or another for 25yrs now and am tired of not finding an effective way of managing it or at least accepting it as how I must live. Depression diagnoses have been mild, clinical, major, severe, dual(alcohol/depression), w/suicidal ideation (4 attempts over 20yrs). Doesn't really matter which diagnoses as it all comes down to living a miserable existence.
    I have gotten rid of most of the negative coping techniques over the past 6yrs or so. Such as drinking/illegal drugs, gambling, causal sex. Those negative techniques that help me feel good in the moment but make me feel worse after they are done. The problem I continue to run into is that my positive coping techniques always end up being ineffective. They always run their course and leave me searching again for a solution, if there really is one that is.
    Currently being treated weekly by a psychologist using CBT, again, and Lexapro for the suicidal ideation. As well as a vitamin D prescription and an over the counter all purpose vitamin supplement. The psychologist is the one that is recommending me to do the DBT in conjunction with the CBT. I see my GP monthly for med checks, blood checks, and any adjustments that may be necessary for the meds.
    Anyways, thank you for reading all this. Any and all advice and personal experiences are much appreciated. Thank You!:feedback:
  2. flowers

    flowers Senior Member

    Hi. I do not know for sure. But I think that DBT brings up old emotional stuff that is stored in the body. Where CBT helps people to work on and change their cognative behaviors. I think a good CBT therepist would be a good idea for me. Not so sure about DBT. But I do think it is very useful if it is time for stuff to come up to be seen dealt with and released. I could be wrong about that. not sure. I do think DBT can be pretty powerful. And useful if it is time to release some stuff. On the other hand, everything I said could be wrong. I am not expert. Mostly I hope you find the next step that is right for you !!
  3. unionfalls

    unionfalls Well-Known Member

    Thank you flowers. I really appreciate the feedback. I already have the professional/medical advice, so your advice/opinion is exactly what I am looking for. The more peoples opinions or experiences with this that i am able to hear about the better my ability will be to understand how helpful this may or may not be for me. I am going to do the DBT, as long as insurance approves, Just wanted to know what others think. Thank You!!
  4. Adam

    Adam SF Supporter

    CBT has better evidence for its efficacy than DBT. Unfortunately DBT has become a bit of a clinical cult of wonder. Even Linehan the original creator of DBT methodology is growing increasingly annoyed at how it is being applied outside her strict criteria and applied to other mental disorders that it was never designed for.

    DBT is meant to assist those with Borderline Personality Disorder. Not schizophrenia or Bipolar or even Depression. There are no clinical large scale studies as to whether this therapy is appropriate for those disorders, the few that exist did very little follow up. Yet it has exploded into popularity and is being applied to everything under the sun. Even ADHD. DBT is a subtype of CBT but has slightly different variations that some either love or hate. Like any therapy it may not be appropriate for you.

    It is often being practised with out the use of the accompanying modules that are meant to be undertaken in a group setting that last 2 and a half hours. Often the workbooks clinics purchase are not Lineham's own work but offshoots where people have added in their own take on her work and use the disclaimer 'Based' on Lineham's work. Many of those I have read I find distasteful for a variety of reasons.

    Two sentences to consider as if a therapist was saying them to you. Consider which you identify with most.

    CBT – Our thinking processes can give us a false view of reality, these are called thinking errors. I will teach you what those are and give you the tools to recognise and modify them. So they no longer rule your life and you understand your thoughts and actions better. So you can make more informed positive choices.

    DBT – We feel the way we feel and that is okay. Let us just be aware of it and accept it. I want to tell you about the reasonable mind and the emotional mind and how to be mindful. We do not need to go dredging up the past. Let us focus on your strengths and build on them.

    I can personally vouch for the raw awesome of CBT. It helps even amidst manic and depressive episodes for me. I walked out a DBT group session in abject disgust when I was an inpatient once. But those are my personal experiences.

    My advice and it is just that, non professional advice.

    Is to find a licensed CBT practitioner. CBT is designed with the depressive in mind and has solid science behind it.

    Learn Meditation, this brings down cortisol which worsens depression. There are many ways to meditate beyond 'clearing your mind.' DBT has basically ripped off meditation and renamed it mindfulness.

    Get a nutritionist, that can be expensive but diet plays such a huge role in mental health. My mind boggles that more consolidation of psychology and nutrition does not occur.

    I wish you well in your therapeutic journey. Take care.
  5. total eclipse

    total eclipse SF Friend Staff Alumni

    DBT has been very very affective in changing ones mind set it works well with borderline personality traits better the CBT
  6. Adam

    Adam SF Supporter

    The option to do both is very interesting. You should maybe try it. Another variety of CBT is called CAT, that may be something to consider if standard CBT has proven not as useful. Sometimes it comes down to getting the right therapist more than the tool of therapy used.

    I am bit off today I should have read your post more thoroughly.
    Last edited by a moderator: Mar 4, 2014
  7. flowers

    flowers Senior Member

    Perhaps I confused DBT with something else. I thought it was the eye movemement thing that brought up old stuff. Sorry I got that wrong ! good thing there were people who knew more about what it really is. I wonder what I was getting it confused with
  8. unionfalls

    unionfalls Well-Known Member

    Flowers that is all good, always like to hear your opinion. :hug1:

    Total Eclipse, thank you as well. I have never been diagnosed with BDP, but my psychologist that I currently see is thinking more and more that that is an appropriate diagnose for me as well. I have been seeing her for 2 months now. My biggest problem with CBT is that it works short term for me. I always seem to slide back after my treatments have ended. I am hoping for something that will stick with me for the long term. Thank you for the feedback.

    Adam, Awesome, you have given me a lot to digest thank you. I am really hoping that the insurance will allow me to do both treatments simultaneously. I am very interested in this as it is not something that I have tried so far, and what ever might work I am willing to give it a shot. I do not want to feel like I do and so if this is what might help, I will try it. I have had some very limited improvement over the years with a book-The Mindful Way through Depression-by Williams,Teasdale,Segal, and Kabat-Zinn. It also came with a cd. I have been unable to fully achieve its intended effects though. It is something that I have tried on my own and that usually is ineffective for me in the long term.

    Thanks again everyone!! I really really appreciate the feedback.:grouphug1:

    FYI: DBT is Dialectical Behavior Therapy and CBT is Cognitive Behavior Therapy :thank_you:
  9. NYJmpMaster

    NYJmpMaster Have a question? Message Me Staff Member Forum Owner ADMIN

    12 weeks of DBT helped my daughter (PTSD and traits of BPD) more than 16 months of CBT but she HATED DBT and only went because it was a condition set for her in a treatment plan. The issue with the DBT is it challenges her thought processes.

    Actual qualified true DBT therapist are very difficult to find in most areas. To find one we drove 80 miles each way, and they did not accept our insurance so we had to pay out of pocket- not something practical for most people. There are tons of therapist that use the DBT catch phrase but if you ask them for a credential or certification they will say some crock about "using years of clinical experience to combine the most effective of blah blah" - in other words - they have no more clue about how to do DBT and are no more trained in it than anybody else that spends a few hours on the internet downloading some work sheets.

    As mentioned above - DBT is used in a very select situations and conditions - and in those select situations it has had excellent results. But it would be like prescribing throat lozenges for a broken arm in other areas- totally non-relevant and ineffective. The surest way I had to tell when we found an actual DBT therapist is she wanted a dx sheet and supporting psychological testing for the dx before she would agree to an informal appointment to evaluate if met the criteria for DBT - whereas most therapist when I called them were all ready to sign her up for therapy based on a phone call asking for an appt.
  10. unionfalls

    unionfalls Well-Known Member

    Thank you NYJumpMaster,
    I should have thought of that as saying you can provide DBT is definitely not the same as being qualified to provide it.I will be looking into that aspect more thoroughly. I have had that experience with CBT in the past. The I am going to provide this therapy but I am not really highly qualified to do so. Which may also be why that CBT has not been as effective as it can be. Thanks for the personal informative experience. Thank you for spurring me to look more closely at what is actually being offered. Very much appreciated. Thank you!!

    Thanks all of you very much!! :grouphug1::thank_you:
  11. flowers

    flowers Senior Member

    I finally figured out what I was thinking of. It was not DBT. It was EMDR. That's why my info was so incorrect.
    NyJmpMaster, you are an awesome dad to fight for your daughters mental health as you did. You rock !!!
  12. unionfalls

    unionfalls Well-Known Member

    flowers thank you!! You are such a caring person, I appreciate it! :hug2:
  13. unionfalls

    unionfalls Well-Known Member

    Just thought I would post an update on my attempt at receiving DBT.

    Intake appointment is in 8 days and I have received a slew of paperwork that is more daunting than doing my taxes. lol. Over a 3 week wait for an intake appointment, which is not bad for a specialized treatment center such as this.
    I have been able to research the psychology center and found that DBT is their specialty. Every one at this center with a masters or PHd has had DBT training through www.behavioraltech.org. This organization is founded by Dr. Marsha Linehan, and called Behavioral Tech, LLC. In my State there is no official certification to be a DBT specialist, but that is expected to be enacted sometime this year. The certification guidelines are being worked out, I guess.

    The treatment programs offered by the center I am looking at getting into range anywhere from once a week for 2hrs to 3 times a week up to 12 hrs per week.
    They offer both individual and group therapy, as well as a mixture of these. Mostly a mixture of these. From what I have read so far I am not going to like this type of treatment. I have a hard enough time getting myself to tell my own therapist anything of substance. I am generally very closed in discussing my condition, emotions, and thinking. Oh well, hopefully if I get accepted into this program, I will be moved enough to find the strength and ability to open up.

    This is the most proactive I have ever been in seeking help for my condition and I am a bit scared. Oh well, it should hopefully be for the best. :nervous:
    I did find out that my insurance should cover this treatment which is very good as I could not afford it otherwise.

    Thank you for reading this. Thank you for your support, care, and compassion!! :hug2:
    Hoping for Better days and a kinder mind- Jeff
    Last edited by a moderator: Mar 10, 2014
  14. unionfalls

    unionfalls Well-Known Member

    So, I had my intake appointment today and I am conditionally accepted for the program. I have to meet with their psychologist and do some psychological testing with them/for them. The psychologist I meet with said I do have BPD traits and that this treatment should be helpful for me. idk. Not so sure I will complete this.:yield:
    I do want to try everything that may be helpful, but I definitely do not like the program as currently set up for me. They want me to meet in a group setting for 3hrs and one on one for an hr per week for 12 months.Homework is assigned, like school, and some other out of meeting time activities are required to be completed by me weekly. Very apprehensive about all this currently. This seems like a really really long time. Very uncomfortable talking with anyone face to face about these issues of mine in the first place, a group scares the hell out of me.:scared: I guess I am gonna have to find a way to get over that for this to be effective.
    idk, hopefully I can follow through with this, not exactly a strong trait of mine though, I already want to run from it. :uncomfortableness::frown:
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