Dialectical Behavior Therapy (DBT)
The Purpose of DBT
Linehan (2015a, 2015b) describes the purpose or functions of DBT as:
- to enhance an individual’s capability by increasing skillful behavior;
- to improve and maintain the client’s motivation to change and to engage with treatment;
- to ensure that generalization of change occurs through treatment;
- to enhance a therapist’s motivation to deliver effective treatment;
- to assist the individual in restructuring or changing her environment in ways that support and maintain progress and movement toward goals.
DBT Skills Training
DBT teaches a balance of ‘acceptance skills’ and ‘change skills.’ These include:
- Mindfulness skills (acceptance) including core mindfulness skills (nonjudgmental observation) and more complex mindfulness practice (wise mind, loving kindness, balancing ‘doing’ and ‘being’).
- Distress tolerance skills (acceptance) including crisis survival skills, reality acceptance skills, and distress tolerance skills related to addiction.
- Emotion regulation skills (change) including recognizing emotions, changing emotional responses (including cognitive restructuring), and reducing vulnerability to the emotional mind.
- Interpersonal effectiveness skills (change) including objectives, relationship, and self-respect effectiveness skills.
Treatment Strategies in DBT
Treatment strategies in DBT include:
- Dialectical strategies in which attention is paid toward balancing acceptance and change. Techniques include the use of metaphor and paradox, cognitive challenging, and restructuring.
- Core strategies include problem solving and validation. Problem solving involves analysis and acceptance of a problem followed by an attempt to generate, evaluate, and implement adaptive solutions. Chain analysis is frequently used to analyze problem behaviors in the context of chains of actions, emotions, physiological responses, and cognitions. Skillful (wise) responses are generated and practiced.
- Communication strategies are closely attended to in DBT. DBT therapists balance reciprocal communication that responds to the client’s agenda with an irreverent communication style intended to promote insight and change.
- Case management strategies are used in DBT to guide the therapist’s interactions, including regular supervision and consultation on the grounds that complex clients should not be treated/‘held’ by a sole clinician.
Linehan, M. M. (1993). Cognitive–behavioral therapy of borderline personality disorder. New York: Guilford Press.
Linehan, M. M. (2015a). DBT skills training handouts and worksheets(2nd ed.). New York: Guilford Press.
Linehan, M. M. (2015b). DBT skills training manual(2nd ed.). New York: Guilford Press.
- Reasons for Living Scale – Long download archived copy
- Reasons for Living Scale – Short download archived copy
- Reasons for Living Scale – scoring download archived copy
- Borderline Symptom List download archived copy
- Modified DBT group therapy manual for working with adolsecents experiencing substance misuse download archived copy
- Dialectical Behavior Therapy – Youth & coaches workbook download archived copy
- Self-validation skills for use in DBT group skills training download archived copy
Exercises, Worksheets & Workbooks
- Dialectical Behaviour Therapy Skills Handbook download archived copy
- DBT Training – Part 1 download archived copy
- DBT Training – Part 2 (behavioral skills) download archived copy
- DBT Training – Part 3 (core mindfulness) download archived copy
- Worksheets at iLoveDBT download
- Distress tolerance handouts download
- Emotion regulation handouts download
- Nightmare protocol download archived copy
- DBT skills quick reference sheet download archived copy
- States of mind handout download archived copy
- 6 levels of validation handout & worksheets download archived copy
- Reality acceptance skills overview download archived copy
- DBT multi-purpose pros & cons worksheet download archived copy
- DBT skills training pros & cons worksheet download archived copy
- Guided mindfulness script for practicing mindfulness to emotion download archived copy
- Distress tolerance worksheet download archived copy
- Emotion myths worksheet download archived copy
- Check the facts handout & worksheet download archived copy
- Opposite action handout & worksheet download archived copy
- Working with primary and secondary emotions worksheet and handout download archived copy
- DBT target behavior chain analysis worksheet download archive.org
- DBT behavior chain & solution analysis worksheet (fillable) download archived copy
- DEAR MAN GIVE FAST handout & worksheet download archived copy
Overcoming distress intolerance (facing your feelings)
- Understanding distress intolerance download
- Accepting distress download
- Improving distress download
- Tolerating distress download
Improving your assertiveness
- What is assertiveness? download
- How to recognise assertive behaviour download
- How to think more assertively download
- How to behave more assertively download
- Reducing physical tension download
- How to say “no” assertively download
- How to deal assertively with criticism download
- How to deal with disappointment assertively download
- How to give and receive compliments assertively download
- Putting it all together download
- The chain analysis in dialectical behavior therapy | Henry Schmidt III | 2012 download archived copy
- Linehan, M. M., & Wilks, C. R. (2015). The course and evolution of dialectical behavior therapy. American journal of psychotherapy, 69(2), 97-110. download archived copy
- Palmer, R. L. (2002). Dialectical behaviour therapy for borderline personality disorder. Advances in Psychiatric Treatment, 8, 10-16 download
- Valentine, S. E., Bankoff, S. M., Poulin, R. M., Reidler, E. B., & Pantalone, D. W. (2015). The use of dialectical behavior therapy skills training as stand‐alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology, 71(1), 1-20. download archived copy