Cognitive & Dialectical
Therapies in Seattle

Cognitive Behavioral Therapy (CBT) focuses on identifying and changing unhelpful thought patterns that drive anxiety, depression, and substance use. Dialectical Behavior Therapy (DBT) builds on CBT by adding skills in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. CBT is typically best for clients dealing with distorted thinking and avoidance, while DBT is especially effective when intense emotion dysregulation is part of the picture.

Most clients begin noticing changes within 6 to 12 sessions of CBT, with a typical course lasting 12 to 20 weeks. DBT is usually a longer commitment — comprehensive DBT programs run 6 months to a year because skill-building takes consistent practice. Timelines vary based on conditions treated, session frequency, and how actively clients apply skills between sessions.

Yes. Because CBT and DBT are evidence-based therapies recognized by major medical and mental health organizations, they are covered by most insurance plans, including PPO, HMO, Medicaid, and Medicare in many cases. Mountain View Treatment accepts a wide range of insurance providers and offers a free benefits verification before you start.

Both are effective, and the right choice depends on what’s driving the substance use. CBT helps clients identify the thoughts and triggers that lead to drinking or drug use, then build healthier coping strategies — making it a strong fit for relapse prevention. DBT is often recommended when addiction is paired with intense emotional dysregulation, trauma, or self-destructive behaviors.

Yes. Both therapies translate well to virtual sessions, and research shows online CBT and DBT produce outcomes comparable to in-person care for most conditions. Mountain View offers HIPAA-compliant telehealth across Washington State, though some clients prefer in-person work.

CBT and DBT treat a wide range of mental health and substance use conditions, including depression, anxiety disorders, PTSD, OCD, panic disorder, bipolar disorder, borderline personality disorder, eating disorders, alcohol and drug addiction, self-harm, and co-occurring disorders.

A CBT session starts with a check-in and agenda-setting, followed by reviewing homework, working through a specific thought pattern, and assigning new exercises. DBT sessions often include a diary card review, targeted skills work, and rehearsal of strategies for upcoming challenges.

The best way to know is a clinical assessment. During your consultation at Mountain View, a licensed therapist will discuss your symptoms, history, and goals, then recommend the approach most likely to help. Generally, CBT may be a strong starting point for worry or negative thinking; DBT may be a better fit if you experience overwhelming emotions or impulsive behaviors.