The ABCs of CBT, DBT and ACT: A very brief introduction to the therapies behind the acronyms
Most people have preconceptions about what therapy means and would be like. More often than not their ideas would correspond to reality in some forms of therapy, but not in others. This is because there are many therapy approaches that vary in a multitude of ways, and are often optimised for treating particular mental health conditions. Three of the most common psychotherapy approaches that have emerged in the area of mental health treatment are Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT) and Acceptance and Commitment Therapy (ACT). While many people have heard of one or more of these modalities, their titles and acronyms make them somewhat confusing. Importantly, however, all of these approaches are evidence-based, meaning that there is research that indicates that they are effective in treating the range of psychological difficulties they are recommended for.
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy, or CBT, is the most well-known and widely used psychotherapy modality and, as the name suggests, it draws on both thought-based and behavioural techniques. CBT largely focuses on the connections between thoughts, feelings and behaviours. Understanding how each of these domains influence each other, and how changing patterns in one area can lead to changes in another, are central to CBT. For example, through identifying and changing maladaptive thought patterns and beliefs, negative influences on feelings and behaviour can be improved. Fundamental to CBT is the idea that the development of more helpful or realistic thought patterns will lead to improved behaviour patterns, and so to increased positivity and confidence in daily life.
Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy, or DBT, is a form of psychotherapy that originally derived from CBT. DBT aims to help people manage their emotions, cope with distress, and improve relationship difficulties. It does this by helping recognise and regulate emotions, reactions and behaviours. Accordingly, DBT focuses on four main areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, and includes life skills training. DBT often combines individual and group therapy formats.
Acceptance and Commitment Therapy (ACT)
Another evidence-based psychotherapy approach derived from traditional CBT is Acceptance and Commitment Therapy, or ACT. As suggested by its title, central to this technique is the ability to accept, and ‘just be’ with, difficult feelings and thoughts. In contrast to traditional CBT, the focus is on our relationship to our inner private experiences, rather than on the content of these experiences. ACT aims to change our relationship with our thoughts, feelings, memories and physical sensations so we can disentangle ourselves from them and their consequences, and actively pursue our values. This allows a more flexible and meaningful life to emerge. The six core principles of ACT are cognitive defusion, acceptance, being in the present moment, observing the self, values, and committed action.
These are just three of the evidence-based approaches that may be used during psychotherapy. There are, of course, many more, such as Schema Therapy. Working out which type of therapy may be most suited for an individual takes many factors regarding the person and the situation into account. These factors include the individual context, treatment goals, history and personality of the person. However, many people will have a preference for a particular therapy modality, naturally gravitating towards a particular approach and strategies they feel an affinity with. Furthermore, while each of these therapy techniques has its unique approach and features, there are also commonalities between them, and many mental health professionals use a combination of these approaches to tailor treatment to each individual’s needs.
