Dialectical Behavior Therapy (DBT) VS Acceptance and Commitment Therapy (ACT), which one is the right one for you?

Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT) are two powerful approaches within modern psychotherapy. Both therapies integrate mindfulness and behavior change principles, but they come from different theoretical backgrounds and use distinct tools to support healing. Understanding the differences can help clients and professionals choose the right fit for a person’s needs.

Different goals, different paths

The core goal of DBT is to help individuals manage overwhelming emotions and reduce self-destructive behaviors. It is structured to teach skills that improve emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness. DBT is especially helpful for people who experience intense emotional swings or struggle with black-and-white thinking, such as those with borderline personality disorder or chronic self-harm patterns.

In contrast, the main goal of ACT is to increase what’s called psychological flexibility. That means helping people learn how to stay present, open up to difficult emotions, and take committed action toward personal values—even when things feel uncomfortable. Instead of trying to control or eliminate distressing thoughts and feelings, ACT teaches people how to make room for them while still living a meaningful life.

Structure and techniques

DBT is a highly structured therapy. It typically includes weekly one-on-one therapy sessions, weekly group skills training, phone coaching for support between sessions, a strict adherence to the DBT skills manual. The structured nature of DBT gives clients a clear roadmap and repeated practice with coping skills, often making it a good fit for people who need stability and predictability in treatment.

ACT, on the other hand, is more flexible and individualized. It doesn’t rely on group training or phone coaching. Instead, therapists use experiential exercises, metaphors, and values clarification to help clients observe their inner experiences and respond in new ways. While ACT does include core processes—like acceptance, defusion from thoughts, and committed action—therapists can adapt how they apply these tools depending on the client’s goals.

Approach to emotions and thoughts

In DBT, the emphasis is on changing how you respond to emotions and learning tools to tolerate or reduce distress. It’s about finding ways to survive intense emotional moments without making the situation worse.

ACT, by contrast, doesn’t try to change or suppress uncomfortable feelings. Instead, it teaches clients how to accept them as part of the human experience. The goal is to help people stop struggling against emotions and instead focus on behaving in ways that are consistent with their values—even if they’re feeling anxious, sad, or uncertain.

Target concerns and populations

DBT was originally developed by Marsha Linehan for people with borderline personality disorder and chronic suicidality. Over time, it has expanded to include applications for eating disorders, mood disorders, trauma, and addiction. DBT is often the go-to therapy when someone has a pattern of emotional dysregulation or life-threatening behaviors.

ACT, on the other hand, is used for a wide range of problems including anxiety disorders, depression, OCD, chronic pain, trauma, addiction, and even everyday struggles like procrastination or fear of failure. It is especially helpful when people are stuck in avoidance patterns—trying to escape, suppress, or fight their emotions instead of facing them.

How to understand which therapy is right for you: DBT or ACT?

Choosing between Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT) depends on what you’re struggling with, what you hope to change, and how structured you prefer your therapy experience to be. While both therapies aim to help people live better lives, they take different routes to get there. Here’s how to explore which may be right for you:

What are you struggling with most right now?

Start by identifying the core issue you’re trying to resolve.

If your emotions feel extreme, unpredictable, or hard to control—like intense anger, sadness, or fear—DBT may be a better fit.

If you often avoid difficult feelings, overthink, or feel stuck because you’re trying to control your thoughts, ACT may be more helpful.

Choose DBT if:

• You have frequent emotional outbursts or rapid mood shifts.
• You struggle with self-harm, suicidal thoughts, or severe anxiety.
• You feel like your emotions control you rather than the other way around.

Choose ACT if:

• You feel numb, stuck, or disconnected from your values.
• You struggle with anxiety, perfectionism, or people-pleasing.
• You’re constantly trying to avoid discomfort—even at the cost of what really matters to you.

Do you prefer structure or flexibility in therapy?

Therapy styles matter. Some people feel safer when there’s a clear structure and set of tools; others want a more fluid, explorative process.

DBT is highly structured. You’ll typically learn specific skills each week in a planned order, often within group therapy. This structure can be life-saving for those in crisis or who need emotional stability before diving into deeper self-exploration.

ACT is more flexible. It adapts to where you are in each session. Your therapist may use metaphors, mindfulness practices, or values-based reflections depending on what’s showing up for you in the moment.

Do you want to reduce symptoms or change your relationship with them?

This is a subtle but important difference.

DBT is focused on reducing symptoms. You’ll learn ways to lower emotional distress, stop harmful behaviors, and improve relationships.

ACT helps you change your relationship with symptoms. Instead of eliminating anxiety, for example, you learn how to coexist with it so you can take meaningful action anyway.

If you need relief now—because your emotions are too intense or unsafe—DBT may be the more immediate solution. If your goal is to stop avoiding life due to internal discomfort, ACT may provide deeper, long-term change.

Are you looking for emotional control or emotional acceptance?

These therapies reflect two philosophies.

DBT says: “Let’s give you tools to manage and regulate emotions better.”

ACT says: “Let’s help you stop fighting emotions and focus on what matters.”

Some people eventually combine the two. For example, a person might use DBT to learn emotional safety, then transition to ACT for longer-term life meaning and resilience.

Talk to a therapist who knows both

You don’t have to decide alone. A mental health professional trained in both DBT and ACT can assess your situation and help guide you toward the most effective approach.

Conclusion

DBT and ACT may share some mindfulness roots, but they serve different psychological needs. DBT provides a lifeline for emotional regulation and stability, while ACT opens the door to acceptance and meaning. Working with a trained therapist can help you explore which path supports your healing journey best.