As a licensed psychologist, I’ve had the privilege of working with highly sensitive, intelligent individuals. My clients are often high-achieving professionals, university students, and emerging adults who are ready to build a life that feels authentic and fulfilling. They come to me seeking practical solutions for managing stress, regulating emotions, and navigating complex life challenges.
In my practice, which serves clients across 43 states, I integrate evidence-based behavioral therapy methods that support emotional resilience and mental well-being. Two of the most effective approaches are Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT). Understanding the differences between these two powerful therapies is a crucial step in choosing the right therapist and the right path for your personal growth.
Understanding Cognitive Behavioral Therapy (CBT) (Cognitive Behavioral Therapy Exercises & CBT Techniques)
What CBT Is and How It Works
Cognitive Behavioral Therapy, or CBT, is a well-established therapeutic approach that focuses on the connection between your thoughts, feelings, and behaviors. The core idea is that our thoughts, not external events, are what primarily influence our emotional responses. By learning to identify and change unhelpful thinking, we can improve our mental well-being and create positive changes in our daily life. CBT also helps individuals recognize and challenge irrational beliefs that contribute to emotional distress.
Mental health professionals widely use CBT techniques to treat a range of mental health conditions, including clinical depression, anxiety disorders, and eating disorders. It is a structured, goal-oriented therapy that equips you with tools to challenge automatic thoughts and develop healthier coping strategies. The focus is on the present moment and finding practical solutions to current problems.
Common Cognitive Distortions That Shape Negative Thinking
A central part of CBT involves recognizing common cognitive distortions—patterns of negative thinking that are often inaccurate and self-defeating. These irrational thoughts can amplify stress, worsen depressive symptoms, and lead to physical symptoms. A few examples include:
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- Catastrophic thinking: Assuming the worst-case scenario will happen.
- All-or-nothing thinking: Seeing things in black-and-white terms, where anything less than perfect is a total failure.
- Overgeneralization: Taking one negative event and turning it into a never-ending pattern of defeat.
- Personalization: Blaming yourself for things that are not entirely your fault.
- Focusing on negative aspects: Disqualifying the positive by paying attention only to the negative aspects of a situation and ignoring any positive elements.
These negative beliefs and unhelpful thoughts can have a significant impact on your life, affecting your emotions, stress levels, and even causing physical tension.
Core Component of CBT: Cognitive Restructuring
The primary goal of CBT is to help you break free from these unhelpful thought patterns. A key technique for this is cognitive restructuring. In therapy sessions, I guide clients to challenge negative beliefs and reframe a negative situation in a more balanced and realistic way.
For example, if a client thinks, “I failed the presentation, so I’m a complete failure at my job,” we work together to examine the evidence. Was the entire presentation a failure? What parts went well? What other evidence contradicts the idea of being a “complete failure”? The goal isn’t just to think positive thoughts but to replace distorted thinking with thoughts that are helpful, supportive, and grounded in reality.
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Practical CBT Exercises You’ll See in Therapy Sessions (Cognitive Behavioral Therapy Exercises)
Thought Records & Identifying Cognitive Distortions
A common CBT exercise is keeping a thought record. This involves writing down a situation, the automatic thought that came with it, the resulting emotion, and then identifying cognitive distortions at play. Another structured CBT exercise is the ‘ABCDE’ technique, which guides you through identifying and challenging irrational beliefs and self-defeating thoughts. This process helps you become more aware of your unhelpful thoughts, which is the first step toward changing them and reducing negative emotions.
Breathing Exercises & Progressive Muscle Relaxation
CBT also incorporates techniques to calm the body’s stress response. Deep breathing exercises can help ease anxiety in the moment, while progressive muscle relaxation involves tensing and then releasing different muscle groups to reduce physical tension. These techniques are also effective in helping to reduce physical symptoms associated with anxiety, such as muscle tightness, rapid heartbeat, or shallow breathing. These tools are effective for managing stress and the physical symptoms associated with anxiety and clinical depression.
Exposure Therapy for Avoidance Behaviors
For anxiety-related issues, exposure therapy can be very effective. This involves gradually and safely confronting feared situations or objects to reduce avoidance behaviors. Using a method called successive approximation, you slowly re-engage with things you’ve been avoiding, learning over time that your feared outcome is unlikely and that you can handle the anxiety.
Behavioral Activation
When struggling with depressive symptoms, it’s common to withdraw from meaningful activities. Behavioral activation is a CBT technique that encourages you to schedule and engage in positive behaviors, even when you don’t feel like it. This re-engagement often leads to a natural improvement in mood and helps counteract negative thinking.
Where CBT Shines & Where Clients Sometimes Feel Stuck
When CBT Works Well
CBT is incredibly effective for treating anxiety, reducing negative thoughts, and improving self-esteem. It provides practical solutions for problem-solving in daily life and gives clients a clear, structured way to challenge their thinking.
Where CBT Has Limits
However, some clients find that CBT has its limits. They may intellectually understand that their thoughts are irrational but still struggle with intense emotions or behavioral urges. This is where phrases like, “I know this is irrational, but I still feel…” come in. For some, especially those who feel emotions very deeply, logic alone isn’t enough. It can also be less effective for individuals needing more support with emotional regulation or anger management.
Introducing DBT: A Middle Ground for Thoughts, Emotions & Actions
What Makes DBT Different
Dialectical Behavior Therapy (DBT) was developed as an evolution of CBT, specifically to help individuals who experience emotions with great intensity. DBT is built for highly sensitive people and masterfully addresses thoughts, emotions, and behaviors in real time. While it includes many CBT principles, it also integrates concepts of mindfulness and acceptance. It is highly effective for treating anxiety, depression, chronic stress, and emotional overwhelm.
Mindfulness Meditation & Present-Moment Awareness
A core component of DBT is mindfulness meditation. This practice teaches you to anchor your attention in the present moment without judgment. As a therapist who integrates DBT skills, I have seen how this helps professionals reduce anxious thoughts, regulate intense emotions, and stay grounded during high-stress situations.
Distress Tolerance: Handling Tough Situations Without Making Life Worse
DBT provides concrete skills for surviving crises without making them worse. These distress tolerance techniques are about getting through a negative situation without reacting impulsively. For example, learning grounding techniques can help you stay regulated when you feel a spiral coming on.
Emotion Regulation: Reducing Negative Emotions & Building Positive Ones
DBT teaches you how to name your feelings, understand their function, and reduce emotional vulnerability. It also emphasizes intentionally building positive experiences into your daily life to foster a more resilient emotional baseline.
Interpersonal Effectiveness
Finally, DBT offers a module on interpersonal effectiveness. These skills are designed to help you build stronger relationships, set healthy boundaries, and manage conflict by expressing your needs clearly and respectfully.
DBT Exercises That Create Real Change (Challenge Negative Beliefs, Cognitive Restructuring, Breathing Exercises)
Mindfulness & Breathing Exercises to Reduce Anxiety
Similar to CBT, DBT uses mindfulness and breathing exercises to help you control emotions and manage physical symptoms of stress. The focus is on non-judgmental awareness, which can be incredibly powerful for reducing anxiety in everyday life.
Opposite Action
This DBT technique is designed to change emotions by acting opposite to the current emotional urge. For example, if you feel anxious and want to withdraw, Opposite Action would encourage you to approach the situation with confidence. The body often follows the action, helping to shift the emotion itself.
Checking the Facts
This skill parallels CBT’s cognitive restructuring but adds an emotional context. It involves asking if your emotional reaction fits the facts of the situation. It helps you explore whether you are misinterpreting events and allows for a more balanced response.
TIP Skills for Intense Emotional Distress
When emotions become overwhelming, DBT offers the TIP skills to rapidly de-escalate:
- Temperature: Change your body temperature by splashing cold water on your face.
- Intense exercise: Engage in brief, intense physical activity.
- Paced breathing: Slow down your breathing rate.
- Paired muscle relaxation: Tense and relax your muscles while breathing out.
CBT vs DBT: Which One Is Right for You?
When CBT May Be Enough
For an individual whose primary struggle is with cognitive distortions and negative thought patterns, CBT might be the perfect fit. Those who appreciate structured worksheets and logical, step-by-step problem-solving often thrive with this approach.
When DBT Might Be the Better Fit
DBT is often a better fit for highly sensitive people or anyone who feels emotions with great intensity. If you are someone who “understands” your thoughts are irrational but still feels stuck emotionally, or if you struggle with avoidance behaviors or emotional impulsivity, DBT can provide the missing piece.
Why Many of My Clients Benefit from an Integrated Approach
In my experience working with clients across 43 states, I’ve found that an integrated approach is often the most effective. By combining CBT techniques for cognitive restructuring with DBT skills for mindfulness and emotion regulation, we can create a comprehensive toolkit for sustainable change. This blended model supports overall mental well-being and empowers individuals to build lasting resilience.
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How I Help Clients Break Through Stuck Points at Groundbreaker Therapy
My mission is to empower individuals to heal from the past, grow into their potential, and build meaningful lives. It can be confusing to know which therapy is “right,” but you don’t need to have it all figured out before you start. The most important step is finding the right therapist who can help you find the right middle ground for your unique needs.
Whether it’s challenging catastrophic thinking or learning to navigate intense feelings with mindfulness, we will work together to find what works for you. My approach is personalized and compassionate, designed to help you move forward with clarity and confidence.
Ready to Work With a Licensed Psychologist Who Understands Both CBT & DBT?
If you are ready to move beyond just understanding your patterns and start changing them, I invite you to schedule a consultation. Together, we can explore how an integrated, evidence-based approach can support your journey.
With the right support, you can move from surviving to thriving.