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What is DBT?
DBT is used to treat those with severe or chronic mental health issues. Some issues that DBT treats are self-harm, eating and food issues, addiction, PTSD, and borderline personality. DBT was originally designed to treat people who had chronic suicidal thoughts as a symptom of borderline personality.
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About Each Module
DBT has four main concepts:
It communicates to another person that their feelings, thoughts, or actions make sense and are okay to feel, and are understandable
Validation is not an agreement
Why is validation important?
Validation helps improve relationships
It can help de-escalate a situation or disagreement
What can validation demonstrate?
We are listening
We are trying our best to understand
We are being nonjudgemental
We care about the relationship with the other person
We can disagree without having a serious and angry argument
What should we validate in ourselves and others?
Validate the valid, not the invalid
You can validate the feeling, but perhaps not the action that the person took and caused the way they feel
How can you validate?
Are you listening mindfully?
Listening with empathy
Put aside distractions and put the focus on the other person
Accurately reflecting and acknowledging what the other person is feeling
Try to summarize what they expressed to you and make sure to ask them if you are getting it right and trying to understand their emotions might be as well as what they said
Try not to interpret the situation, so that you can understand it without judgment
Ask questions to understand more clearly
Ask about what they are feeling, thinking, and wanting
Validation of causes of behavior or experiences
Validate part of a behavior in terms of the causes
Current biological conditions
Validate basic feelings, that you sincerely can understand
Describe how you understand the context of this problem
If you believe a person's actions are reasonable and justified
Communicate that the person's behavior is reasonable, meaningful, and effective
Validating feelings like saying "this makes sense to me considering..."
Radical genuineness: expressing equality and respect
Expressing to the person that you do not see them as a weak, fragile, or incapable person
Allow that person to experience; without attempting or forcing the person to change how they
They help teach us that there is more than one way to view a situation and more than one way to solve the problem at hand
They show how important it is to look at the world with an open mind
They point out that the only constant is change
Ways To Think or Act Dialectically:
Try to move away from "either-or" thinking and try to think in the "both-and" thinking. Try to not use words such as "always or never" Describe in a mindful way, trying your best not to make judgments.
Try looking at other perspectives. There are always multiple sides to a story. Find a kernel of truth in each perspective.
Remember that no one has the absolute truth.
Use "I feel _______" statements.
Accept that opinions aside from your own can be legitimate, even though you don't have to agree.
Don't assume you can tell exactly what another person is thinking. Check to see if you are making assumptions.
Don't expect that other people can read your mind.
Increases likelihood of behavior
Decreases likelihood of behavior
Increasing behavior by providing a rewarding consequence
Actions used to decrease a behavior that doesn't have a natural consequence
Reduction in a behavior because the reinforcement is removed
Increasing behavior by removing a consequence
Keeping and improving the relationship
Keeping or improving self-respect
Acting in a way that the other person keeps liking and respecting you
Investing and maintaining wise mind relationships
Respecting your own wise mind values and beliefs
Acting in a way that makes you feel capable and effective
Use to reach your objectiveness goal
Describe the situation
Express your feelings about the situation
Assert yourself by asking what you
Reward the person ahead of time by describing the positive effects of getting what you want
Mindful, keep the focus on what you want
Appear confident, use a confident tone of voice
Negotiate, be willing to GIVE to GET
HOW TO KEEP A GOOD RELATIONSHIP
Gentle (be), be courteous and respectful
Interested (act), listen to the other person
Validate feelings, show that you understand the other person's about the situation
Easy manner (use an), ease the person along
HOW TO KEEP YOUR SELF-RESPECT
Fair (be), to YOURSELF and to the OTHER person
Apologies (no), no overly apologetic behavior
Stick to values, stick to YOUR OWN WISE MIND VALUES
Truthful (be), DON'T LIE
Choices for responding to any problem situations
Save it, and use your interpersonal skills to solve the problem
Change it, change my reaction, challenge my interpretation of the problem
Radically accept it, cope better with my reaction, use Distress Tolerance skills to cope, non-judgemental accept my reaction
Entertain misery. keep complaining, keep being dissatisfied by the outcome
Worsen the problem, act non-skillfully, engage in ineffective behaviors
Coping with Urges and Feelings
THE IMPORTANCE OF COPING WITH PAIN
Pain is part of life and cannot be avoided
If you can't deal with your pain and act impulsively
When you act impulsively, you may end up hurting yourself or others or not getting what you want
WHEN TO USE CRISIS SURVIVAL SKILLS
A crisis is when the situation
Creates intense pressure to resolve the crisis
Use crisis survival skills when
You have intense pain that cannot be helped quickly
You want to act on your emotions, but it will only make things worse
Emotion mind threatens to overwhelm you and you need to stay skillful
You are overwhelmed but demands need to be met
You are feeling very emotional, but your problem can't be solved in the moment
Choices for responding to any problem situations
Activities, do something
Contributing, do something nice for someone else
Comparisons, compare yourself to back when you were less effective
Emotions, create different emotions
Pushing away, push painful situations out of your mind temporarily
Thoughts, replace your thoughts
Sensations, intensify other sensations
Accumulative Positive Emotions in the Long-Term
Step 1. Avoid Avoiding
Start now to do what is needed to build a life you want.
Step 2. Identify Wise Mind Values That Are Important to You
What values are important to you right now in your life.
Step 3. Identify One Value to Work on Now
What is important to me right now to work on?
Step 4. Identify a Few Goals Related to This Value
What specific goals can I work on that will make this value part of my life?
Step 5. Choose One Goal to Work on Now
Start to join some activities and work on
Step 6. Identify Small Action Steps Towards Your Goal
What small steps can I take to get to my goal?
Step 7. Take One Action Step Now
Do something RIGHT NOW
How to Check the Facts
Ask: What is the emotion I want to change and what is the event prompting my emotion?
Describe the facts you observed while using mindfulness.
Ask: What are my interpretations, thoughts, and assumptions about the event?
Think of other possible interpretations. Test to see if your interpretations fit the facts.
Ask: Am I assuming a threat?
Label the threat. Assess the probability of the threating event. Think of as many possible outcomes as you can.
Ask: What's the catastrophe?
Imagine the catastrophe occurring. Imagine how you would cope effectively in the situation.
Ask: Does my emotion and/or its intensity fit the actual facts?
Check the facts that fit each emotion. Use your Wise Mind.
Steps for Problem-Solving Opposite Action
Step 1. Get yourself in Wise Mind
Step 2. Ask: Can the problem be solved?
Step 3. OBSERVE and DESCRIBE the problem.
Step 4. BRAINSTORM lots of solutions.
Step 5. CHOOSE the potential solutions that you think will work.
Step 6. Put the potential solution into ACTION. Try the solution.
Step 7. It WORKED? Give yourself a reward.
Step 8. It didn't WORK? Give yourself a reward for trying.
ACTION URGE EXAMPLE:
Gently Avoid, be decent
Be open, approach
Avoid the person, distract yourself from thoughts of them; Remind yourself why love is not justified
Let go of controlling others, share
Count your blessings
Credits to: McLean 3East Outpatient DBT Manual
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