Cognitive-Behavioral Therapy (CBT) versus Psychodynamic Therapy


What’s the Difference?
While both aim to reduce symptoms and distress, perhaps the most central difference between CBT and psychodynamic therapy is that psychodynamic therapy tries to get at why you feel or behave the way you do (i.e., uncover deeper and often unconscious motivations for feelings and behavior) whereas CBT does not. CBT simply attempts to alleviate suffering as quickly as possible by training your mind to replace dysfunctional thought patterns, perceptions, and behavior (without asking more about them) with more realistic or helpful ones in order to alter behavior and emotions.

Advocates of psychodynamic therapy argue that for many issues, a deeper treatment is required to produce lasting change. Advocates of CBT argue that their briefer methods are just as effective. And while a subject of controversy, the research data generally support both approaches.

Features of CBT:
  • It is relatively brief and time-limited (twelve weeks to six months).
  • It is highly instructional in nature and homework is a central element.
  • It is highly structured and directed with the therapist setting the agenda for each session (based on mutually set goals).
  • It focuses on the here-and-now only and not a person’s history.
  • The relationship with the therapist is not a focus of the treatment.
Features of Psychodynamic Therapy:
  • While it can be brief, it is often longer term (six months or longer).
  • It is less structured, typically without homework assignments.
  • The client, not the therapist sets the agenda for the session by talking about whatever is on their mind.
  • It focuses on the here-and-now as well as on personal history.
  • The relationship with the therapist is included as a focus of therapy.
Hear from the Experts:
Ryan Howes, PhD in “The Seven Questions Project” for Psychology Today recently asked very high ranking clinicians of different theoretical orientations and styles the same seven questions about their approach to psychotherapy. Links to the CBT and psychodynamic interviews are provided below. These responses will give you a sense of the difference between cognitive-behavioral and psychodynamic approaches.

CBT Respondents
Judith S. Beck, PhD, internationally renowned cognitive therapist
Donald Meichenbaum, PhD, co-founder of CBT

Psychodynamic Respondents
Glen O. Gabbard, MD, internationally renowned psychoanalytic/psychodynamic psychiatrist
Ryan Howes, PhD, psychodynamic psychologist, writer, musician and professor

Click
here for PROS and CONS of each type of therapy.