Many of us have heard the phrase, “Everyone can benefit from therapy.” That may or may not be true, but one thing is for sure: not everyone seeks out therapists, psychologists, or counsellors to receive therapy (also known as counselling). There are barriers to attending therapy including long wait times, stigma concerns, and cost (Moroz, Moroz, & D’Angelo). However, the benefits of therapy are vast and it is a common misconception that therapy is only for those with a diagnosed mental health disorder. Therapy can benefit those who are dealing with severe or long-term stress related to a job, family, loss, or relationships (National Institute of Mental Health, 2023). It can also help with changes in sleep or appetite, low energy, a lack of interest in activities you once enjoyed, irritability, excessive worrying, or a sense of discouragement and hopelessness. Lastly, it can benefit those who require support when someone close to them has been diagnosed with a condition that affects their mental health.
Not everyone requires therapy, but it is can be a good fit for people experiencing stress, depression, or grief that is not easily handled alone (Lindberg, 2023). It is recommended to check with a healthcare provider before commencing therapy to ensure there is not an underlying medical concern present (National Institute of Mental Health, 2023).
Psychotherapy, also known as talk therapy, aims to help people note and change negative emotions, behaviours, and thoughts (National Institute of Mental Health, 2023). It has been shown that talk therapy can improve symptoms of depression, anxiety, and mental health disorders. It is usually characterized by a one-on-one meeting with a mental healthcare professional, but it can occur in group or remote settings as well. It is supposed to be a safe space to discuss feelings and emotions (Lindberg, 2023). Your therapist aims to help you decrease the severity of your symptoms.
Even if you do not receive therapy and don’t want to, it can be beneficial to learn what it is and what it can do. There can be negative connotations related to therapy. Attending therapy does not signal having a “weakness”. Nor does it indicate that you have a mental health disorder. Learning about therapy, what it is, and how it works can help decrease the amount of misinformation that circulates regarding counselling.
We will be exploring two of the most common forms of psychotherapy: cognitive-behavioural therapy (CBT) and dialectical behavioural therapy (DBT).
Cognitive-Behavioural Therapy (CBT)
The basic principles of CBT are that behaviours influence thoughts, which influences feelings; and that thoughts influence behaviours, which influences feelings. Therapists will help clients recognize negative behaviours or thoughts with the expected outcome of improving their feelings (Lindberg, 2023). CBT operates on the understanding that psychological problems are (partly) based on faulty ways of thinking and patterns of unhelpful behaviour. There is hope that people can learn better ways of coping with these thoughts and behaviours, and by doing so they improve their symptoms (American Psychiatric Association, 2017).
This is the most common approach for depression, and it is frequently used for anxiety as well. It can also be used for alcohol and drug use problems, martial issues, eating disorders, and severe mental health conditions (American Psychiatric Association, 2017). It emphasizes thinking about how we feel and what we do. Unlike other forms of therapy, CBT emphasizes what is going on in the client’s current life and moving forward, rather than focusing on the past and what has led up to the problems.
Many research studies note that CBT can lead to significant improvement in quality of life and functioning (American Psychiatric Association, 2017). It has even shown to be as effective, or even more effective, than psychiatric medications. It is backed by a significant amount of scientific evidence, which makes it stand out in comparison to other forms of therapy.
Dialectical Behavioural Therapy (DBT)
DBT is also evidence-based, and it uses CBT principles. In fact, it is considered a form of CBT with some key differences. “Dialectical” means the existence of opposites (Centre for Addiction and Mental Health, n.d.). Clients are taught two seemingly opposite strategies:
1. Acceptance – your experiences and behaviours are valid.
2. Change – you must make positive changes to manage emotions and behaviours to move forward.
Skills that are commonly taught are mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation (Centre for Addiction and Mental Health, n.d.). It was developed for people with borderline personality disorder, and it is the only known empirically-supported treatment for this condition (May, Richardi, & Barth, 2016). It is also known to be effective for other disorders, such as substance use disorders, mood disorders, PTSD, and eating disorders. Its commonly targeted symptoms are an unstable sense of self, chaotic relationships, emotional instability, impulsivity, and fear of abandonment. Some of the skills taught are interpersonal skills, emotional regulation, mindfulness, and distress tolerance.
It can be taught in group settings, individual one-on-one therapy tailored to the client, or phone coaching where clients can call their therapist during negative situations that arise in between sessions (Schimelpfening, 2023). Clients will learn acceptance and change through strategies to tolerate emotions, circumstances, and the self. Behavioural patterns are also targeted, like in CBT, and replaced with healthy and effective ones. There is also a focus on changing thoughts and beliefs, which is another similarity to CBT. In addition, clients will learn how to communicate effectively and work well with others. Certain skills are taught that clients can apply to their lives outside of sessions. Lastly, there is support provided to bring out positive strengths and attributes.
What is the Difference?
Both CBT and DBT involve working on thoughts, feelings, and behaviour and how these influence one another (Skyland Trail, 2017). However, DBT emphasizes emotion regulation, mindfulness, and learning to accept pain. CBT is very effective for treating depression and anxiety, while DBT was created specifically for borderline personality disorder.
Ultimately, DBT is simply more specialized and focused on extreme emotional reactions.
In conclusion, therapy is extremely effective for some people and it can be even more effective than psychiatric medication in some cases (American Psychiatric Association, 2017). Not everyone benefits from therapy, and not everyone desires to have it. Regardless, it is good to know what it is in its various forms to reduce stigma. Attending therapy is not just for those with a diagnosed mental health disorder. Please remember that it’s a good idea to consult a medical professional prior to starting therapy.
(Image from Pikisuperstar. (n.d.). Freepik. Retrieved from https://www.freepik.com/free-vector/hand-drawn-visit-psychologist-concept_16692786.htm#query=therapy&position=4&from_view=search&track=sph)
Note: The Free Your Mind Mental Health Society is an independent youth-led organization. The contents of this blog are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. In the event of a medical emergency, please call your doctor or 911 or other local emergency numbers immediately.
American Psychiatric Association. (2017). What is cognitive behavioural therapy? Retrieved from https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
Centre for Addiction and Mental Health. (n.d.). Dialectical behaviour therapy (DBT). Retrieved from https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/dialectical-behaviour-therapy
Lindberg, S. (2023). What is talk therapy and can it help? Healthline. Retrieved from https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/dialectical-behaviour-therapy#:~:text=What%20is%20%E2%80%8BDialectical%20Behaviour,manage%20emotions%20and%20move%20forward).
May, J. M., Richardi, T. M., & Barth, K. S. (2016). Dialectical behavior therapy as treatment for borderline personality disorder. The Mental Health Clinician, 6(2), 62–67. https://doi.org/10.9740/mhc.2016.03.62
Moroz, N., Moroz, I., & D’Angelo, M.S. (2020). Mental health services in Canada: Barriers and cost-effective solutions to increase access. Healthcare Management Forum. 2020;33(6):282-287. doi:10.1177/0840470420933911
National Institute of Mental Health. (2023). Psychotherapies. Retrieved from https://www.nimh.nih.gov/health/topics/psychotherapies#:~:text=Psychotherapy%20(sometimes%20called%20talk%20therapy,patients%20in%20a%20group%20setting.
Schimelpfening, N. (2023). How dialectical behavioural therapy (DBT) works. Verywell Mind. Retrieved from https://www.verywellmind.com/dialectical-behavior-therapy-1067402
Skyland Trail. (2017). 4 differences between CBT and DBT and how to tell which is right for you. Retrieved from https://www.skylandtrail.org/4-differences-between-cbt-and-dbt-and-how-to-tell-which-is-right-for-you/#:~:text=CBT%20seeks%20to%20give%20patients,potentially%20destructive%20or%20harmful%20behaviors.