DBT vs CBT vs ACT: A Comprehensive Comparison of Psychotherapy Approaches

Written By

Dr. Azhar Qureshi


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Dbt Vs Cbt Vs Act

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In this article, we will delve into the key aspects of each therapy and compare them to help you understand which approach might be most suitable for your needs.

In the world of psychotherapy, there are numerous approaches designed to help individuals overcome mental health challenges and improve their overall well-being.

Three of the most prominent and widely practiced therapies are Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Acceptance and Commitment Therapy (ACT).

While these therapies share some similarities, they also have distinct differences in their underlying philosophies, techniques, and areas of focus.

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What is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment developed by Dr. Marsha Linehan in the late 1980s.

Initially designed to treat individuals with Borderline Personality Disorder (BPD), DBT has since been adapted to address a wide range of mental health issues, including substance abuse, eating disorders, and depression [1].

DBT is based on the principle of dialectics, which emphasizes the integration of opposites. It teaches individuals to accept their thoughts, feelings, and circumstances while simultaneously working to change them.

The therapy focuses on four key skill sets:

  1. Mindfulness
  2. Interpersonal effectiveness
  3. Emotion regulation
  4. Distress tolerance
Skill SetDescription
MindfulnessThe practice of being fully present and aware of one’s thoughts, feelings, and surroundings without judgment.
Interpersonal EffectivenessThe ability to communicate assertively, maintain healthy relationships, and set boundaries.
Emotion RegulationStrategies to identify, understand, and manage intense emotions in a healthy manner.
Distress ToleranceTechniques to cope with and survive crises without resorting to harmful behaviors.

DBT typically involves individual therapy sessions, group skills training, and phone coaching to help clients apply the skills they learn in real-life situations.

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What is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT) is a short-term, goal-oriented psychotherapy that focuses on the relationship between thoughts, feelings, and behaviors.

Developed by Dr. Aaron T. Beck in the 1960s, CBT is based on the idea that our thoughts influence our emotions and actions, and by modifying dysfunctional thinking patterns, we can improve our mental health [2].

CBT helps individuals identify and challenge negative or distorted thoughts, replacing them with more balanced and realistic ones.

The therapy also emphasizes the importance of behavioral changes, encouraging clients to engage in activities that promote positive emotions and reduce stress.

Some of the key techniques used in CBT include:

  • Cognitive restructuring
  • Exposure therapy
  • Behavioral activation
  • Problem-solving
  • Relaxation techniques

CBT has been extensively researched and has proven effective in treating a wide range of mental health conditions, including anxiety disorders, depression, phobias, and post-traumatic stress disorder (PTSD) [3].

Difference Between Cbt Dbt And Act

What is Acceptance and Commitment Therapy (ACT)?

Acceptance and Commitment Therapy (ACT) is a form of cognitive-behavioral therapy that emphasizes the importance of accepting one’s thoughts and feelings while committing to values-based actions.

Developed by Dr. Steven C. Hayes in the 1980s, ACT is based on the concept of psychological flexibility, which refers to the ability to be present, open, and adaptable to life’s challenges [4].

ACT teaches individuals to observe their thoughts and emotions without judgment, recognizing that they are temporary experiences rather than permanent realities. The therapy encourages clients to clarify their values and take committed action towards their goals, even in the presence of difficult thoughts and feelings.

Six core processes of ACT are:

  1. Acceptance
  2. Cognitive defusion
  3. Being present
  4. Self as context
  5. Values
  6. Committed action
AcceptanceEmbracing one’s thoughts and feelings without attempting to change or avoid them.
Cognitive DefusionLearning to observe thoughts objectively, without getting caught up in their literal meaning.
Being PresentFocusing on the here and now, rather than dwelling on the past or worrying about the future.
Self as ContextRecognizing that one’s sense of self is separate from thoughts, feelings, and experiences.
ValuesClarifying what is truly important and meaningful in life.
Committed ActionTaking consistent action towards one’s values, even in the face of obstacles.

ACT has been found to be effective in treating a variety of mental health issues, including anxiety, depression, chronic pain, and substance abuse [5].

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Comparing DBT, CBT, and ACT

While DBT, CBT, and ACT share some common elements, such as a focus on the relationship between thoughts, emotions, and behaviors, they also have distinct differences in their approaches and areas of emphasis.


  • All three therapies are evidence-based and have been extensively researched.
  • They all aim to help individuals improve their mental health and overall well-being.
  • Each therapy emphasizes the importance of developing coping skills and strategies.


  • DBT places a strong emphasis on acceptance and validation, while CBT focuses more on challenging and modifying dysfunctional thoughts.
  • ACT prioritizes values clarification and committed action, whereas CBT and DBT do not explicitly focus on these aspects.
  • DBT was originally developed for individuals with Borderline Personality Disorder, while CBT and ACT have a broader range of applications.

Ultimately, the choice between DBT, CBT, and ACT depends on an individual’s specific needs, preferences, and the nature of their mental health concerns.

It is essential to consult with a qualified mental health professional who can assess your situation and recommend the most appropriate therapy for you.

Reflection: As someone who has personally experienced the benefits of therapy, I can attest to the transformative power of these approaches. While it may take time and effort to find the right therapy and therapist for you, the journey toward improved mental health and well-being is well worth it.

How Does Cbt Dbt And Act Therapy Work

Impact of DBT, CBT, and ACT on Modern Psychotherapy

Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), and Acceptance and Commitment Therapy (ACT) have had profound impacts on the field of psychotherapy.

These evidence-based approaches have revolutionized the way mental health professionals conceptualize and treat a wide range of psychological disorders, offering individuals struggling with mental health issues more effective and targeted interventions.

DBT, CBT, and ACT share a common foundation in the principles of cognitive and behavioral psychology, emphasizing the crucial role that thoughts, emotions, and behaviors play in shaping an individual’s mental well-being.

By providing clients with the tools and strategies to identify and modify maladaptive thought patterns, regulate emotions, and engage in values-driven behaviors, these therapies empower individuals to take an active role in their own recovery process. 
The structured nature of these approaches, coupled with their strong empirical support, has made them invaluable assets in the treatment of conditions such as depression, anxiety disorders, borderline personality disorder, and substance abuse. 

As a result, the integration of DBT, CBT, and ACT into mainstream psychotherapy has not only improved treatment outcomes but has also contributed to the destigmatization of mental health treatment, counseling, and making it more accessible and acceptable to those in need.


In conclusion, Dialectical Behavior Therapy, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy are all valuable approaches to psychotherapy, each with its own unique strengths and areas of focus.

By understanding the key differences and similarities between these therapies, individuals can make more informed decisions about which approach might best suit their needs.

Which of these three therapies resonates with you the most, and why? Share your thoughts in the comments below, and let’s start a conversation about the power of psychotherapy in transforming lives.


  1. Dialectical Behavior Therapy
  2. Cognitive Behavioral Therapy
  3. The Efficacy of Cognitive Behavioral Therapy
  4. Acceptance and Commitment Therapy
  5. The Effectiveness of Acceptance and Commitment Therapy
  6. A Comparison of Cognitive Behavioral Therapy and Dialectical Behavior Therapy
  7. Comparison between dialectical behavior therapy, mode deactivation therapy, cognitive behavioral therapy, and acceptance and commitment therapy in the treatment. C Bass, J van Nevel, J Swart. Read the paper
  8. Awareness of and attitudes toward CBT, DBT, and ACT in an acute psychiatric sample. JM Kuckertz, AL Silverman, JR Bullis. Read the paper
  9. Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and Morita therapy (MT); comparison of three established psychotherapies and implications for the integrative psychotherapy of eating disorders. JM Dijkstra, T Nagatsu. Read the paper

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About the author

Dr. Azhar Qureshi

Dr. Azhar Qureshi

As a physician and cardiologist, my training encompassed a comprehensive range of invasive and noninvasive procedures, providing extensive hands-on experience in echocardiography, cardiac stress testing, diagnostic catheterization, and coronary interventions. In addition, I developed skills in psychological assessments and formulating detailed case reports. This multifaceted training has equipped me with a strong foundation across cardiology, psychological studies, and documentation to support my medical research. I am passionate about medical writing and exchanging knowledge to help the global community. Social

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