Alternative Approaches

Below are brief descriptions of alternative approaches to CBT. Note that some differ drastically from CBT, whereas others (DBT, ACT) have much in common with CBT, and share a number of similar tenets and strategies.

Dialectical Behavior Therapy (DBT)

  • Pioneered by psychologist Dr. Marsha Linehan, DBT was originally developed to help individuals with Borderline Personality Disorder and suicidality.
  • A major tenet of DBT is that one must aim for both acceptance and change; that is, accept one’s problems as they are, while at the same time work to address one’s problems.
  • A major tool for conveying acceptance is validation, or communicating to a person that his/her behaviors make sense or are reasonable given his/her current life situation.
  • DBT treatment teaches skills addressing four target areas: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
  • DBT is designed to have a group and individual therapy component. Family members are often encouraged to participate in the group component and/or work closely with individual therapists.
  • DBT emphasizes prioritization of treatment goals, such that critical goals (i.e. ending suicidality, addressing issues that interfere with successful therapy) are addressed before less critical (although still important) goals are addressed.

Acceptance and Commitment Therapy (ACT)

  • Pioneered by psychologist Dr. Steven Hayes, ACT stresses two major goals: acceptance of thoughts, feelings, and behaviors; and commitment to behavior change.
  • Regarding the former, in ACT individuals are taught to accept their thoughts and emotions just as they are, without judgment.
  • ACT also stresses the need to distance oneself from one’s thoughts and emotions, rather than assuming that these thoughts and emotions represent who someone is as a person (i.e. instead of thinking, “I am a sad person;” thinking, “I am feeling sad recently because of several losses I experienced in my life.”)
  • Regarding the “commitment” piece of ACT, individuals are asked to articulate their values in life, and then take actions consistent with these values.

Psychodynamic psychotherapy

  • In this form of therapy, a major goal is to gain insight into the unconscious processes that drive problematic behavior.
  • Emphasis is placed on exploring the origins of one’s problems and understanding past relationships.
  • Sessions are not highly structured (i.e. with a set agenda), as in CBT.
  • Homework is not considered to be a crucial element of therapy.
  • A person’s relationship with his/her therapist is viewed as a template for understanding relationships in the person’s outside life.
  • Therapists are less active and directive than in CBT, where therapists act as “coaches”


  • Pioneered by Sigmund Freud, psychoanalysis is one form of psychodynamic psychotherapy.
  • In classical psychoanalysis, an individual typically attends therapy four times/week.
  • Psychoanalytic psychotherapy is often the type of therapy portrayed in movies or on TV, where a person is asked to sit on a couch and “free associate;” that is, say whatever comes to mind, without censorship.
  • Psychoanalytic psychotherapists help people analyze their free associations to discover clues to their unconscious thoughts and desires.

Gestalt therapy

In CBT, there is usually homework assigned at the end of every session. Therapy sessions only last for 45 minutes each week; the real work is done between sessions, when you experiment with new techniques during your day-to-day life. In my experience, the people who do the best in CBT are the ones who do their homework regularly!

In addition, CBT is designed to be collaborative. My goal as a CBT therapist is to work collaboratively with you to ensure that you are meeting your goals. I will encourage you to always give me feedback about what is working and what is not. Together, we will figure out what works best for you.

Existential therapy

  • This form of therapy focuses on fostering free will and finding meaning in one’s life.

Client-centered or Rogerian therapy

  • In this type of therapy, therapists aim to convey absolute acceptance of and empathy towards all individuals.
  • The goal of therapy is for the individual to “self-actualize,” bridging the gap between his/her actual and ideal self.

Eclectic psychotherapy

  • If a therapist states that he or she is “eclectic” in style, this means that he/she employs techniques from several different schools of psychotherapy.