Dialectical Behavioral Therapy Skills

Dialectical Behavioral Therapy (DBT) is a therapeutic theoretical model developed by Marsha Linehan in the 1980s to treat individuals with significant mental health challenges, including emotional dysregulation and suicidal behaviors. Many mental health professionals consider DBT as the ‘gold standard’ for treating the mental health condition called Borderline Personality Disorder. However, DBT has since been adapted and proven to be effective for other mental health conditions, such as depression, anxiety, PTSD, and substance abuse.

In this DBT skills series, we’ll explore some of the basics of this model along with some practical strategies from each of the modules you can incorporate into your daily life.

Dialectical Behavioral Therapy is presented in 4 modules:

  • Mindfulness: observing yourself and situations in a nonjudgmental manner, identifying triggers and urges without automatically acting on them
  • Distress tolerance: dealing with overwhelming situations in a more effective way, without making the situation worse than it is
  • Emotion regulation: recognizing when intense emotions arise and manage them in more productive and effective ways
  • Interpersonal effectiveness: communicating with others in effective ways, and be able to set boundaries with others, while maintaining your self-respect and important relationships

“Mindfulness gives you time. Time gives you choices. Choices, skillfully made, lead to freedom.”
– Henepola Gunaratana

We’ll begin with Mindfulness. Mindfulness is awareness. Many of us spend our days in a state of “mindlessness”. We’re distracted and tuned out to our surroundings and often overlook important information that can help us make better choices. We can also spend TOO much time in our heads trying to process everything that we completely lose sight of reality and instead get caught up in negative self-talk.

If you’re brand new to the idea of mindfulness, it can feel overwhelming at first. It’s best to start with small simple practices. Try going outside and pay attention to what’s around you. Name the sounds, sights, smells, anything that you can take in with your 5 senses. Now take a few deep breaths. Feel the air go in and out and name what those sensations are. Is the air cold? Warm? How does your body feel when you take those deep breaths? Spend a few minutes observing and describing your experience, without judgement.

Another good way to practice mindfulness is to take a daily mundane task and slow it down. Break down each individual step and observe and describe what you experience. For example, try brushing your teeth using this practice. What does the toothpaste taste like? How does the toothbrush feel in your hand? What does it look like?

During these practices, you might notice thoughts of wanting to hurry up and speed through so you can get on with your day. That’s normal! We’re not used to slowing things down, it makes sense that you might have a sense of urgency with this practice. When that urge to rush comes up, try to take one deep breath and acknowledge that feeling, but don’t act on it just yet. Try to give yourself at least one deep breath and be aware of that desire without acting on it. Don’t beat yourself up or self-criticize because you don’t think you’re “doing it right.” If you’re showing up to the practice, you’re doing it right.

These exercises seem simple, but they can be difficult and feel strange if you aren’t used to them. As you practice, try to be aware of any self-judgments that come up. When you notice yourself getting caught up in criticism, gently guide your thoughts back to the practice. Over time, you’ll begin to cultivate a space to experience your thoughts, feelings, and experiences without judgment or self-criticism.

If you would like to try different mindfulness exercises and learn more about mindfulness practices, there are links below for further information.


In the next article, we’ll be staying with the mindfulness module and begin exploring the concept of “Wise Mind”.

The article is by Alissa Hager, LPC, LCMHC
Palmetto Counseling and Consulting, LLC