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What Are Cognitive and Behavioural Approaches?

Cognitive and behavioural approaches examine the relationships between thoughts, emotions, physical sensations and actions.

For example, a person who believes they will fail may avoid an important task. That avoidance may provide temporary relief but increase anxiety, self-criticism and practical difficulties later. Therapy can help the client recognize the cycle, examine the thought and experiment with a more helpful response.

These approaches are often collaborative, goal-oriented and focused on concerns affecting the client’s current life. Depending on the therapist and the client’s needs, sessions may include reflection, skill development, behavioural practice, tracking patterns or exercises completed between appointments.

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What Is Cognitive Behavioural Therapy?

Cognitive Behavioural Therapy, commonly called CBT, helps clients understand how patterns of thinking and behaviour may influence emotional well-being.

CBT does not mean replacing every difficult thought with a positive one. Instead, clients learn to notice assumptions, interpretations and habits that may be inaccurate, incomplete or no longer helpful.

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A therapist may help you:

• Identify automatic thoughts

• Recognize recurring cognitive and behavioural patterns

• Examine the evidence supporting a belief

• Consider alternative explanations

• Reduce avoidance

• Approach feared or uncomfortable situations gradually

• Develop problem-solving strategies

• Practise new responses

• Strengthen coping skills

• Track changes between sessions

CBT may be structured or flexible depending on the therapist, presenting concern and treatment goals.

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What Is Dialectical Behaviour Therapy?

Dialectical Behaviour Therapy, or DBT, is a cognitive-behavioural approach that emphasizes both acceptance and change.

The word “dialectical” reflects the idea that two seemingly opposite things can be true at the same time. A person can accept their current experience while also working toward change. They can be doing the best they can and still need new skills.

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DBT commonly organizes skills into four areas:

Mindfulness

Learning to notice thoughts, emotions, physical sensations and surroundings with greater awareness and less immediate judgment.

Distress Tolerance

Developing ways to cope with intense emotions or crises without making the situation worse.

Emotional Regulation

Understanding emotions, reducing vulnerability and responding more effectively when feelings become intense.

Interpersonal Effectiveness

Communicating needs, setting boundaries, navigating conflict and maintaining self-respect within relationships.

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Is DBT the Same as a Comprehensive DBT Program?

No. Comprehensive DBT is a structured treatment model that typically includes individual therapy, group-based skills training, between-session coaching and a clinical consultation team.

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Everest Therapeutics clinicians may incorporate DBT principles and skills into individual counselling. This is usually described as DBT-informed therapy or DBT skills, rather than a comprehensive DBT program.

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The specific level of DBT training varies by clinician. Review each therapist’s biography to learn more about their education and approach.

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What Is the Difference Between CBT and DBT?

CBT and DBT share cognitive and behavioural foundations, but they place emphasis in different areas.

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CBT often focuses on identifying the connections between thoughts, emotions and actions. Clients may examine beliefs, reduce avoidance and practise behaviours that support their goals.

DBT places additional emphasis on acceptance, emotional regulation, crisis survival, mindfulness and relationship skills. It may be particularly useful when emotions feel intense, rapidly changing or difficult to manage.

The two approaches are not mutually exclusive. A therapist may draw from both CBT and DBT based on the client’s needs.

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What Can CBT and DBT-Informed Therapy Help With?

Cognitive and behavioural strategies may be incorporated into treatment for:

• Anxiety and excessive worry

• Depression and low motivation

• ADHD and executive functioning difficulties

• Emotional dysregulation

• Stress and burnout

• Panic symptoms

• Perfectionism

• Low self-esteem

• Relationship conflict

• Communication and boundary concerns

• Avoidance and procrastination

• Obsessive thoughts and compulsive behaviours

• Grief and difficult life transitions

• Anger and impulsive responses

• Self-harm urges

• Suicidal thoughts

• Trauma-related beliefs

• Body image concerns

• Youth and young adult mental health

Different concerns may require different adaptations or specialized protocols. Your therapist will consider your symptoms, goals, safety and preferences when discussing treatment options.

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What Does a CBT or DBT-Informed Session Look Like?

Sessions begin with understanding what you are experiencing and what you hope will change. You and your therapist may identify patterns, set goals and decide which strategies feel most relevant.

A session might include:

• Discussing a recent situation

• Identifying thoughts, emotions and physical responses

• Mapping a repeating behavioural cycle

• Examining an unhelpful belief

• Learning an emotional regulation skill

• Practising assertive communication

• Developing a plan for a difficult situation

• Exploring barriers to using a skill

• Reviewing what happened between appointments

• Adapting strategies to make them more realistic

Some clinicians use worksheets or between-session exercises, while others integrate CBT and DBT principles more conversationally. You can discuss how much structure and homework you prefer.

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CBT and DBT for ADHD and Neurodivergence

Traditional cognitive and behavioural strategies sometimes assume that a person can change simply by trying harder, planning better or thinking differently. That approach can feel invalidating for clients with ADHD, autism or other forms of neurodivergence.

Neurodivergent-affirming therapy adapts strategies to the client’s actual capacity, sensory needs, communication style and executive functioning. The goal is not to make someone appear less neurodivergent.

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Adapted CBT or DBT work may address:

• Emotional regulation

• Task initiation

• All-or-nothing thinking

• Rejection sensitivity

• Shame and self-criticism

• Sensory overwhelm

• Planning and organization

• Communication and boundaries

• Burnout and masking

• Recovering after emotional overload

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CBT and DBT Skills for Teenagers

Cognitive and behavioural strategies can help teenagers better understand emotions, manage stress, communicate needs and respond to difficult situations.

Depending on the clinician, therapy may address school anxiety, friendships, family conflict, self-esteem, emotional overwhelm, self-harm, identity, transitions and executive functioning.

The therapist will adapt the language, pace and expectations to the young person’s age and needs. Select Everest clinicians provide counselling for youth aged 12 and older.

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Explore Youth and Teen Counselling

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Cognitive and Behavioural Approaches for Relationships

CBT and DBT skills can also support healthier relationships. Therapy may help clients recognize assumptions, communicate clearly, tolerate conflict, set boundaries and respond less reactively.

DBT interpersonal-effectiveness skills can be particularly helpful for people who struggle to ask for what they need, say no, manage conflict or maintain self-respect in relationships.

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Cognitive and behavioural approaches may be integrated into individual or couples counselling, depending on the clinician.

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Explore Couples Counselling

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CBT, DBT and Trauma

Cognitive and behavioural strategies may help clients recognize trauma-related beliefs, reduce avoidance and develop emotional regulation skills. However, general CBT or DBT-informed therapy is not identical to a structured trauma treatment.

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Clients seeking focused treatment for PTSD may also consider Cognitive Processing Therapy. Your therapist can help determine whether general coping support, a trauma-specific approach or a combination is appropriate.

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[Learn About Cognitive Processing Therapy]

Explore Trauma Therapy

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Are Cognitive and Behavioural Therapies Right for Me?

CBT or DBT-informed work may be a good fit if you:

• Want practical strategies you can use outside sessions

• Appreciate collaboration and clear treatment goals

• Want to understand repeating patterns

• Need support managing intense emotions

• Want to improve communication or boundaries

• Feel stuck in avoidance, worry or self-criticism

• Prefer therapy that balances reflection with action

• Want to develop coping and problem-solving skills

These approaches may feel less suitable if they are applied too rigidly or without considering trauma, culture, neurodivergence and the client’s broader circumstances. Effective therapy should adapt the method to the person rather than forcing every client through the same process.

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You do not need to choose between CBT and DBT before booking. Your clinician can explain which strategies may be relevant and incorporate other approaches when appropriate.

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CBT and DBT-Informed Therapy at Everest Therapeutics

Everest Therapeutics offers cognitive and behavioural therapy through select clinicians in Moncton and Gander and through virtual appointments across five provinces.

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Our team has varied experience with CBT, DBT skills, communication strategies, youth-focused DBT, trauma-focused cognitive treatment and neurodivergent-affirming adaptations.

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In-person and virtual availability depends on the clinician and their professional registration. Review each therapist’s biography for information about their training, populations and counselling style.

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[Meet Our CBT and DBT-Informed Therapists]

Try the Therapist Fit Tool

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Frequently Asked Questions

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Is CBT just positive thinking?

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No. CBT does not require clients to ignore difficulties or replace every negative thought with a positive one. It involves examining thoughts and behaviours more carefully and developing responses that are realistic and helpful.

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Is DBT only for borderline personality disorder?

No. Although DBT was originally developed for people with complex and high-risk concerns, DBT skills are now used more broadly to support emotional regulation, distress tolerance, mindfulness and interpersonal effectiveness.

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Does Everest Therapeutics provide comprehensive DBT?

Everest clinicians incorporate DBT-informed therapy and skills into individual sessions. This is not the same as a comprehensive DBT program that includes all standard treatment components.

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Will I have homework?

Some therapists may suggest worksheets, reflection exercises or opportunities to practise skills between sessions. Homework should be collaborative, realistic and adapted to your needs.

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Can CBT help with ADHD?

Adapted CBT strategies may support planning, emotional regulation, task initiation, self-criticism and other ADHD-related concerns. Therapy should recognize executive functioning differences rather than interpreting them as laziness or lack of motivation.

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Are CBT and DBT available for teenagers?

Yes. Select Everest clinicians provide cognitive and behavioural support for youth aged 12 and older. Availability varies by therapist and province.

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Are CBT and DBT available in Moncton and Gander?

Yes. Select clinicians incorporate cognitive and behavioural approaches into in-person counselling in Moncton, New Brunswick, and Gander, Newfoundland and Labrador.

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Can I access CBT or DBT-informed therapy online?

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Yes. Virtual appointments are available through select clinicians in New Brunswick, Newfoundland and Labrador, Nova Scotia, Prince Edward Island and Ontario.

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Does insurance cover CBT and DBT?

Insurance typically bases coverage on the clinician’s professional designation rather than the therapy approach. Coverage depends on your individual policy. Direct billing may be available where permitted.

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Begin Cognitive and Behavioural Therapy

You do not need to have the right terminology or know which skills you need before reaching out. Our clinicians can help you understand your patterns, identify practical goals and determine whether CBT, DBT-informed therapy or another approach fits what you are experiencing.

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Find a CBT or DBT-Informed Therapist

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