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DBT Skills
What is DBT?
DBT is used to treat those with severe or chronic mental health issues. Some issues that DBT treats are self-harmeating and food issuesaddictionPTSD, 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:
Intepersonal Effectiveness
Interpersonal Effectiveness



  • 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?

  • Feelings

  • Thoughts

  • Behaviors

  • 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

Middle Path

How can you validate?

  1. Are you listening mindfully?

    • Listening with empathy

    • Put aside distractions and put the focus on the other person

  2. 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​

  3. Ask questions to understand more clearly

    • Ask about what they are feeling, thinking, and wanting

  4. 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

  5. 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..."

  6. 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

Dialectical Thinking


  • 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:

  1.  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.

  2. Try looking at other perspectives. There are always multiple sides to a story. Find a kernel of truth in each perspective.

  3. Remember that no one has the absolute truth.

  4. Use "I feel _______" statements.

  5. Accept that opinions aside from your own can be legitimate, even though you don't have to agree. 

  6. Don't assume you can tell exactly what another person is thinking. Check to see if you are making assumptions.

  7. Don't expect that other people can read your mind.


Increases likelihood of behavior

Decreases likelihood of behavior

Something added

Something removed


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



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



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

Distress Tolerance
Distress Tolerance

Coping with Urges and Feelings


  1. Pain is part of life and cannot be avoided 

  2. If you can't deal with your pain and act impulsively

  3. When you act impulsively, you may end up hurting yourself or others or not getting what you want


A crisis is when the situation

  • Highly stressful

  • Short-term

  • Creates intense pressure to resolve the crisis

Use crisis survival skills when

  1. You have intense pain that cannot be helped quickly

  2. You want to act on your emotions, but it will only make things worse

  3. Emotion mind threatens to overwhelm you and you need to stay skillful

  4. You are overwhelmed but demands need to be met

  5. 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.










Get Active



Gently Avoid, be decent

Be open, approach


Be open

Avoid the person, distract yourself from thoughts of them; Remind yourself why love is not justified

Be close


Sabotaging, criticizing 

Accusing, spying


Let go of controlling others, share

Count your blessings




Credits to: McLean 3East Outpatient DBT Manual

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