dbt problem solving examples

DBT’s options for solving ANY problem

As San Francisco DBT therapists, we work with people who want help managing emotions and relationships.

We see all sorts of problems that result in all kinds of pain.

Even though there are as many different problems as there are human beings, there are really only four solutions to solve any problem, regardless of what the problem is.

What, you may wonder? Isn’t solving problems complicated? Yes and no. The details of how we go about solving any problem may be complex and take time, but our options are quite finite.

The 4 DBT problem-solving options*

Solve the problem.

Change or leave the situation.

Feel Better about the Problem

Regulate the emotions that the problem elicits.

Tolerate the Problem

Accept and tolerate the problem, as well as your response to it.

Stay Miserable

Don’t make any changes.

Let’s look at each of the 4 DBT problem-solving options in more depth:

With any problem situation, you can figure out if there is a way to change the situation, avoid the situation or leave the situation.

Example: Let’s take the problem of feeling lonely and isolated.

You could solve the problem by changing the situation to meet new people and form friendships. You could join social groups or volunteer for a cause where you will interact with others. You could initiate conversations with co-workers or neighbors, or try to re-connect with old friends you lost touch with.

Feel better about the problem

You can decide not to change the actual problematic situation, but to change your emotions in reaction to it.

Example: You could feel better about being lonely by reassuring yourself that being lonely does not mean you are unlikable or unlovable. And by reminding yourself that making new friends isn’t easy.

You could find ways to get more enjoyment out of the time you spend on your own, by making sure you still do things that you want to do even if you’re alone. Like going to see a movie or checking out a new restaurant – even if you do these things by yourself.

Tolerate the problem

If you can’t solve the problem, and you can’t feel better about the problem, you can still ease some of the emotional suffering that the problem brings up.

Example : If you can’t do things to build new friendships or feel better about being alone, you can respond to the problem by accepting and tolerating both the problem and your response to it.

Maybe your work schedule, home responsibilities or a disability means you can’t solve the problem by going out and joining a group to meet new people.

You may not be successful in your attempts to feel better about being alone, despite your use of skills.

But you can reduce your suffering by using the Distress Tolerance skill of Radical Acceptance . Radical acceptance doesn’t equal approval of the situation, but radical acceptance means you stop fighting reality .

No one can avoid pain, but resisting pain creates suffering and suffering is optional .

Stay Miserable:

You could choose to stay miserable. Or, you could also do things that will make the problem even worse.

To choose this option, don’t use any skills!

Solving your problems

So there you have it – the four DBT problem-solving options. Depending on the nature of your problem, you may choose a different option for different situations. Of course, it’s totally up to you. The important thing is that you take the time to think about and acknowledge how you’re dealing with the problem.

A DBT skills group will teach you the necessary skills to solve problems, feel better about problems and tolerate problems.

Contact us to see how therapy can help you. We offer individual and group DBT as well as couples counseling . Our offices are located in the Castro district of San Francisco.

* Adapted from the DBT Skills Training Handouts and Worksheets, Marsha Linehan Guildford Press 2015

How to Use the Four Options of DBT to Solve a Problem

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Have you ever come up against a situation in your life that seemed impossible? One that overwhelmed you, no matter how many ways you tried to solve it?

Life sometimes presents each of us with what seems to be an impossible situation. When we feel overwhelmed, many of us become paralyzed with indecision, our minds reeling as we consider and then reject one possible solution after another. What a conundrum! By taking a step back and utilizing a problem-solving method, we can uncover options in any situation.

DBT (Dialectical Behavior Therapy), a form of cognitive-behavioral therapy developed by Marsha Linehan in the late 1980s, aims to help individuals identify and regulate intense emotions, improve interpersonal relationships, and develop coping strategies to manage distressing situations. DBT offers four basic options for handling any challenge: solving the problem, finding ways to feel better about the problem, learning to accept the problem or situation, or staying miserable. When a situation seems overwhelming, this basic framework can help us explore our challenges with curiosity, compassion, and wisdom, increasing our chances of a successful outcome.

Define the Problem

The first step is to define the problem. We start by stating the problem to ourselves the way we might as a reporter or a detective: Just the facts, ma’am! Who, what, where, when, and why. For instance, “I’m tired of living with my partner’s personality and habits, and I can’t decide if I should stay or move out.”

Option 1: Solve the problem/make a change.

Once we have defined the problem, we evaluate the problem honestly: Is this a situation that is in my power to change or influence? If so, it is certainly worthwhile to try to make changes. We may not be able to change our partner, for instance, but we can change the way we communicate with our partner, and we may be able to negotiate a solution together.

Having defined the problem, we then need to consider possibilities for changing our situation. Brainstorming is one tried-and-true way to generate possible solutions to any given problem. We might start by taking a sheet of paper and writing down ideas, from the most practical to the seemingly ridiculous. When we review the list, we will probably find a few “gems”!

Once we have chosen a possible solution, the next step is to try it out. For instance, perhaps we have decided to talk to our partner about an annoying habit using an assertive communication technique. Having clarified our goal (what we would like to see change), we approach our partner to discuss our concerns. We may be able to work together to create this change, or at least achieve a compromise that is acceptable to both of us.

An important part of implementing a solution for change is to constantly evaluate the outcome. Is it working? If not, is there something we can tweak that would make a difference?

Option 2: Find ways to feel better about the situation by changing our perception of the situation.

Sometimes we are not able to change a situation to our liking, or we may not currently be willing to take the steps we need to make a change. Assuming we are not in an unsafe situation, the next possible option is to change our point of view. Here we are trying to get through a challenging situation, at the very least without making it worse, and possibly using it to grow inner strengths. For instance, we can use a difficult situation to develop a specific quality, such as understanding, wisdom, or compassion. In some traditions, this is expressed as using challenges as “fertilizer” for personal or spiritual growth. Or we might consciously and deliberately use the challenge to develop skills, such as interpersonal skills, emotion regulation skills, etc. (for example, seeing a challenging interpersonal situation as an opportunity to practice assertiveness skills). In the case of an uncooperative partner, we may choose to use our interactions to learn something about ourselves, or to practice humility. Perhaps we don’t always have the right solution or perfect perspective!

Option 3: Learn to accept the problem by practicing Radical Acceptance.

If we have no practical way to solve a problem, or if we are not yet willing to make a change, another approach we can try is to practice radical acceptance. Radical acceptance is based on the idea that it is often our resistance to a painful situation that causes extra or unnecessary suffering. You can think of this as a formula:

Pain x Resistance = Suffering

Practicing nonresistance in this case can decrease suffering because we are not constantly in an emotional struggle with reality. For instance, if our partner has a personality trait we find frustrating, we accept that his personality is unlikely to change. We may say to ourselves, “It’s true that I deeply wish my partner would change, but he has not, and possibly never will change.” We are practicing radical acceptance at two levels here: We are deeply acknowledging our own heartfelt desires without judgment, and we are accepting the truth of the situation with our partner. We acknowledge completely and with great self-kindness that we do not like the situation, without pouring unnecessary self-blame ourselves.

It is natural to want to be happy! It is natural to want things that are not likely to occur, so radical acceptance can also help us to generate self-compassion.

Radical acceptance also helps to counteract self-compassion’s close cousin, self-pity. In the face of difficult challenges, it is easy to get caught up in a “woe is me” attitude. We may ask ourselves, “Why do these things always happen to me? This is so unfair!” Radical acceptance instead recognizes that life brings to each of us its share of both joys and sorrows. Practicing acceptance of this basic fact can bring a sense of equanimity and balance, freeing our energy to be applied wisely and creatively.

But by no means is radical acceptance an act of helplessness! Radical acceptance does not necessarily mean that we condone a situation. It does not mean tolerating abuse. With radical acceptance, we look at our situation with a clear-eyed, nonjudgmental attitude and simply acknowledge that it is our current reality. As psychologist and mindfulness instructor Tara Brach, PhD, author of the book Radical Acceptance, describes it, we can acknowledge the situation by saying to ourselves, “Yes, this, too.” This, too, is a part of our current reality. It is what it is, at least for now.

Option 4: Stay Miserable

If we cannot or are not yet ready to make a change, are not ready to consider changing our perception, and can’t quite yet accept a situation, we may be realistically left with just feeling miserable. And that’s okay…if we don’t use it as an excuse to beat ourselves up! There is nothing to keep us from exploring the first three options, but the crucial piece here is awareness.

As we stay miserable, we notice and honestly evaluate: How does it feel? Does our situation stay the same or possibly get worse? How does it impact our thinking? What does it mean for our actions? We simply stay aware and just keep noticing what it is like to stay miserable.

Putting the Four Options of DBT into practice.

Now that you have learned about the Four Options, you are ready to put this information into action! Choose a problem or challenging situation that is present in your life and run it through the above options. It might be helpful to start with a smaller, less emotionally charged challenge the first time you try out this approach. In a sense, this approach is a “no lose” approach. Every time you utilize this process, you will learn something new. Make it your own! Armed with the Four Options, you never need to feel completely lost. You will always have a “road map” to making sense of your life’s challenges.

Anxiety & Stress

Overcoming Revenge Bedtime Procrastination for Better Mental Health

Rewiring Your Mind: Techniques to Challenge and Replace Negative Thoughts

Cognitive Therapy for Anxiety

Mindfulness

Distress Tolerance

Emotion Regulation

Interpersonal Effectiveness

Miscellaneous

Problem Solving

Emotion Regulation is the Dialectical Behavioral Therapy module that teaches how emotions work. It provides skills to help manage emotions instead of being managed by them, reduce vulnerability to negative emotions, and build positive emotional experiences.

When you find yourself experiencing a challenging emotion, you are faced with the choice between changing the emotion or changing the situation. Often this decision depends on whether your emotion is justified or not, which you can determine by using the skill Check the Facts. If your emotion and its intensity are justified, consider changing the situation by Problem Solving. This skill will help you find a solution to the problem situation and put it into action. There is also a handy flow chart to help you figure out whether Problem Solving or Opposite Action is the right skill to use.

There are 7 steps to Problem Solving that can help you figure out what to do next.

1. What is the problem? Describe the situation

2. Use Check the Facts to ensure you’re describing it accurately

3. Figure out your goal in solving the problem

What needs to happen so you can feel okay?

Keep it simple and realistically attainable

4. Brainstorm as many solutions as you can

Ask for suggestions from people you trust

Practice willingness – don’t be critical of any ideas at first

5. Choose a solution that fits the goal and is likely to work

If you’re having trouble choosing one, pick two

Do a Pro-Con 4-Square to compare them, then pick the best to try first

6. Take it step by stepTry the solution

7. Did it work? If not, go back to step 5 and choose another solution to tryEvaluate the results

Opposite to Emotion Action

Pleasant activities, check the facts, increasing positive emotions, reduce vulnerability with abc please, ride the wave, additional resources, mental health resources.

We aren't the only mental health resource out there. Check out these books, websites, social media accounts, and more for additional support. Read More

DBT Flashcards

Making DBT skills second nature takes practice. Use these flashcards on their page, download your own to print out, or purchase our pre-made set from our shop. Read More

DBT Encyclopedia

DBT has its own lingo which can be hard to understand for beginners. Visit our homemade DBT Encyclopedia to figure out what a term means. Read More

Mindfulness Exercises

Mindfulness practice is key to DBT. You don't have to meditate in silence everyday, though. Try these Mindfulness exercises to guide you. Read More

Diary Cards

Diary cards help track your emotions, urges, behaviors, and skill use. They help you see patterns. Learn how to use them and get samples. Read More

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Mastering Problem Solving with Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) is a comprehensive, evidence-based treatment that targets emotional dysregulation, self-destructive behaviors, and interpersonal difficulties. One of the core skills taught in DBT is problem-solving, which empowers individuals to navigate life's challenges more effectively. In this article, we will explore the role of problem-solving in DBT, its benefits, and how it is taught within therapy.

The Role of Problem-Solving in DBT

Emotional dysregulation often leads to poor decision-making and impulsive actions, exacerbating life problems. Problem-solving skills in DBT help individuals manage their emotions more effectively, allowing them to approach challenging situations with a clear mind and make rational decisions.

Interpersonal conflicts are a common source of distress for those seeking DBT treatment. Developing problem-solving skills allows individuals to address these conflicts constructively, fostering healthier relationships and improved communication.

Problem-solving skills in DBT help individuals identify and address the underlying issues contributing to self-destructive behaviors, such as self-harm or substance abuse. By learning to resolve these problems effectively, clients can reduce the frequency and intensity of these harmful behaviors.

Benefits of Problem-Solving Skills in DBT

Effective problem-solving helps reduce the anxiety, frustration, and distress accompanying unresolved issues. As individuals develop their problem-solving skills, they often experience improved emotional regulation. As a result, individuals can better manage their emotions and experience greater emotional stability.

Mastering problem-solving skills in DBT can lead to significant improvements in interpersonal relationships. By learning to navigate conflicts, communicate needs, and negotiate solutions effectively, individuals can build stronger connections with others and foster more satisfying relationships.

Problem-solving skills also promote greater resilience and adaptability in the face of life's challenges. When equipped with effective problem-solving strategies, individuals are better prepared to handle setbacks, cope with stress, and adapt to changing circumstances.

Teaching Problem-Solving Skills in DBT

The first step in teaching problem-solving skills in DBT involves helping clients identify the specific problem they are facing. This may involve breaking down complex issues into smaller, more manageable components and recognizing the factors that contribute to the problem. By clearly defining the problem, individuals can begin to develop targeted solutions.

Once the problem has been identified, therapists guide clients through generating potential solutions. This may involve brainstorming, considering alternative perspectives, and weighing the pros and cons of each option. After generating possible solutions, clients are guided in evaluating each option's feasibility and potential consequences, ultimately selecting the most appropriate solution for their situation. Therapists encourage clients to think creatively and consider a range of solutions rather than focusing solely on their initial ideas.

After selecting a solution, clients are supported in implementing their chosen strategy. This may involve developing a step-by-step action plan, identifying potential obstacles, and establishing a timeline for completion. Following the implementation, clients are encouraged to review the effectiveness of their chosen solution and make any necessary adjustments. This process of review and refinement helps clients learn from their experiences and continuously improve their problem-solving abilities.

Incorporating Problem-Solving Skills into Everyday Life

Mindfulness is a key component of DBT; incorporating it into everyday life can greatly support problem-solving skills. By practicing mindfulness, individuals can become more aware of their thoughts, emotions, and bodily sensations, which can help them approach problems with greater clarity and focus.

Developing self-compassion is essential in problem-solving, as it encourages individuals to treat themselves with kindness and understanding when facing challenges. By fostering self-compassion, individuals can better cope with setbacks and maintain motivation in the face of difficulties.

Problem-solving can be enhanced by seeking support from others, whether a therapist, a support group, or friends and family. Sharing challenges with trusted individuals can provide fresh perspectives, encouragement, and valuable feedback, helping to improve problem-solving skills and outcomes.

Common Challenges and How to Overcome Them

Perfectionism can hinder effective problem-solving, often leading to unrealistic expectations and excessive self-criticism. To overcome perfectionism, individuals can practice self-compassion and remind themselves that mistakes are okay and that no solution will be perfect.

Procrastination can be a significant barrier to practical problem-solving, as it delays action and prolongs distress. To address procrastination, individuals can break tasks into smaller steps, set realistic goals, and create a structured plan to tackle the problem.

Feeling overwhelmed by the complexity or magnitude of a problem can be paralyzing, making it difficult to take action. To manage overwhelmed, individuals can practice mindfulness techniques to reduce anxiety and approach the problem one step at a time, focusing on what can be accomplished in the present moment.

Final Thoughts

Problem-solving skills are an essential component of dialectical behavior therapy. By teaching clients how to navigate life's challenges effectively, DBT empowers them to improve emotional regulation, enhance interpersonal relationships, and build resilience. With the guidance of skilled therapists and a commitment to learning, individuals can develop the problem-solving skills necessary to overcome obstacles and live a more fulfilling life.

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M8: Wise Mind

Introduction

“Wise Mind” is a Dialectical Behavior Therapy ( DBT ) term first introduced by the founder of DBT, psychologist Marsha M. Linehan. Wise mind lies between the emotional mind (decision making and judging based entirely on our emotions, or the way we feel) and the reasonable mind (thoughts, decisions and judgments based entirely on facts and rational thinking).

In wise mind, individuals are aware of their emotions, but they also consider facts, logic, and their long-term goals. Wise mind is considered to be optimal functioning and can be practiced and cultivated through mindfulness practice.

Consider this example: Anna is a very successful college student, always in the top 5% of her class. Last week, one of her colleagues whom she respects a lot, told her that despite her great grades, she probably doesn't do in-depth learning. He doubted the quality of her knowledge. She got very emotional, and started believing what he said. She started putting in less effort and her grades started declining. She made a decision based on her emotional mind. But what if she asked her wise mind for guidance instead?

Instructions

Wise mind helps you make decisions by balancing your emotional and reasonable mind. This exercise lasts 10 minutes in total. Try to do this exercise (using your wise mind) three times a week. The more you practice it, the more skilled you will become.

Wise mind is an exceptionally useful skill. You can use this skill for guidance for problems, doubts, or confusions that have lingered on in your life for a while (or that are new). People often get stuck at one end of the spectrum from being either too emotional - or too factual. So, let's see what we can do about that.

Step One: Find a Comfortable Space

This is a skill that requires practice and a comfortable environment where you wouldn't be interrupted. Remind yourself that you are on the path of learning a skill that has the potential to really help you with your emotional decision making or too factual decision making.

Step Two: Thinking About a Problem in Your Life

Before we can proceed with asking our wise mind for help, we first need to settle into our breathing. Put your arm on your belly, and let's do a little abdominal breathing (covered in our previous exercise Mindful breathing). As you breathe, become aware of how your belly goes up and down as you inhale and exhale air. Breathe several times, and relax your body.

Now, try to think about a problem in your life that has been bothering you lately. Give yourself a couple of minutes and think about that. What do you feel has been an issue for you lately? Maybe you feel like you are not happy with your job and don't know what career path you really want to take, and that has been making you feel uneasy. Perhaps you started thinking about how bored you feel in your free time and how monotonous your past several months have been.

Tune in and gently observe what the main thing or issue that you started thinking about is.

Step Three: Using Your Wise Mind

After you have observed the problem that your mind started thinking about, practice wise mind decision making. Set your timer for 5 minutes and go through the steps below.

a.) Gather Information : Start gathering relevant information about the situation. Seek out facts, data, and opinions from reliable sources. Consider the logical aspects, pros and cons, and potential consequences of different options.

b.) Identify Your Emotions : Take some time to identify and acknowledge your emotions regarding the decision. Notice any strong feelings, fears, or gut instincts that arise. Name and validate your emotions without judgment.

c.) Reflect On Values And Goals : Consider your values, priorities, and long-term goals. Reflect on how the different options in this situation align with these aspects of your life.

d.) Mindful Awareness : Engage in mindfulness practices to cultivate present-moment awareness, as we have practiced before. Stay open and curious, allowing yourself to fully experience and understand your internal state.

e.) Integrate Rational And Emotional Factors : Reflect on the information you’ve gathered and your emotional awareness. Integrate both factors into your decision-making process. Ask yourself: What does logic suggest? What are my emotions telling me? How do these aspects align or conflict with each other?

f.) Take Time for Reflection : Avoid rushing into decisions. If this particular situation is more difficult to solve, consider stepping away from the situation for a bit, allowing yourself to fully process the information and insights. By doing this, you can return to the situation with a fresh perspective.

g.) Embrace Flexibility : Remember that decision-making is an ongoing process. Don’t forget to be open to adjusting your course if new information emerges or if you realize that your first choice actually doesn’t align with your desired outcomes.

Use the worksheet provided below and write down how this experience went for you. Writing it down helps deepen the experience and anchor it in your brain.

DBT Mindfulness: Wise Mind Worksheet

Example : Today, I'm thinking about whether or not I should further my education and pursue grad school. After I've settled into my breathing, and after I've become aware that this problem has been on my mind for months now, I start asking my wise mind what to do about it. After being mindful of the problem and trying to listen to my wise mind for an answer, what I got as a solution is that next year doesn't feel like the right time for me. I want to take care of my physical health, replenish my energy from a lot of work and make some healthier lifestyle changes. I observe that this is the answer that I got and I am not judging that this is what came to me.

How do I know that the answer I got using my wise mind is not really coming from the emotion mind or the reasonable mind?

To make sure that what you came up with as a solution or answer to your problem really comes from your wise mind, you can check whether you were aware of both your emotions and the facts about the situation.

Were you mindful about the objective facts of the situation or the problem? If you were still clouded by emotions and you didn't really take into account the facts of the situation then your solution probably is not based on your wise mind. When we are too emotional, it's often useful to cool down first and make the decision later.

Were you being too objective and blocking out your emotions completely? Were you unaware of your feelings about the situation - were you aware of how your body was reacting when you thought about the situation - or were you just pushing it all below the surface? It can be useful to take a few moments to reflect not just on the facts but on how it all makes you feel.

Carefully progressing through the outlined steps above will help you with this.

I understand the instructions when I read them, but the exercise is a little too abstract for me. I don't know if I'll be able to do it.

Although this exercise is more advanced than the previous mindfulness exercises we have done, as with every other skill, it can be learned with practice. Since we already practiced being mindful of our emotions and being mindful of our thoughts, using the wise mind is a step further, combining those two forms of mindfulness. Try to do the exercise, maybe you will find that it is easier for you than you thought. If no answer comes the first time, try again next time (maybe you will need time to get used to practicing this skill). Another option, if you feel like you are not sufficiently prepared for using your wise mind, is to go back to the other mindfulness exercises that we did before. Practice them for a while and then come back to this one.

I am aware of the problem that I have but my wise mind can't seem to come up with a solution.

As we mentioned earlier, this skill requires practice before we can become comfortable with it and have it at our disposal. For some people it may come more naturally, and for others it may take a little more practice. The next time you try it, you probably will be more comfortable with the exercise. Maybe the solution will come then. Another possible reason for why you can't seem to receive the answer is that maybe you haven't accepted the problem yet. Maybe you feel like it's not that big of a deal to be bothered about. Or you might feel skeptical about the concept of the wise mind. Just be aware of these thoughts and emotions, accept them and try the exercise again a little later.

Stepping away from the situation temporarily will help allow your mind time to process the information and insights you’ve gathered. If you’ve stepped away from the problem and are still struggling, perhaps consulting with an outside source, whom you trust, can be helpful. Consider their perspectives and insights, but remember that the decision is ultimately yours to make.

If you have any behavioral health questions or concerns, please talk to your healthcare or mental healthcare provider. This article is supported by peer-reviewed research and information drawn from behavioral health societies and governmental agencies. However, it is not a substitute for professional behavioral health advice, diagnosis, or treatment.

Comments About Wise Mind

My spouse and I have spent the last two weeks going through the DBT modules and have been practicing the skills. We absolutely love this website. Thank you very much.

I have been utilizing your site and downloading all the worksheets, but I don’t have a printer. Is there another way to access the worksheets – like an app? Thanks in advance.

ADMIN – Hi Mike,

At the moment we only have the worksheets available as a PDF download.

Mike – If you have Foxit PDF reader (free download) you can add text to it. And honestly, Paint might even be worth checking out. You can add text to pictures. The only thing is, once you click off the text box, you can’t edit it again I don’t think. Libraries an print as well.

Thanks for the website. I am new to DBT and wise mind, but am willing to try it.

Going through all of the DBT Dialectical Behavior worksheets really has helped me rethink the way I was approaching my life thank you I started doing your worksheets a month ago my therapist says they helped us make a faster progress in our sessions. Thank you again

I love the wise mind work. Im such an emotional thinker, I find this exercise is helping to remind myself to switch over to a different mindset and try and work through worries with less emotion and more reasoning.

I suffer with post traumatic stress and wondering if this works for ptsd. I suffer huge anxiety. My psychiatrist suggested I look up this site.

I am a medical intern and I am loving Dialecticalbehaviortherapy.com.

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Options for Solving Any Problem – DBT in Action

If you think about it, the human condition offers us of an almost infinite number of problems – issues with relationships, jobs, money, health, managing our homes, etc. Despite the wide range of problems we might encounter, there are a limited number of options for solving them.

According to DBT , there are four possibilities for action when addressing a concern:

• Solve the problem
• Feel better about the problem
• Accept the problem
• Stay miserable

As a simple example, let’s say you order a new couch. When it arrives, it just isn’t what you imagined it to be. Maybe the color is off. Or it doesn’t quite fit in your space. Whatever it is, you’re just not liking the piece. Using Option 1 (solve the problem) you might see about the store’s return policy or you might add some throw pillows to help with the color or add an accent chair if the couch is too small for your space. Option 1 relies on problem-solving and other skills from the emotion regulation and interpersonal effectiveness (when the problem is interpersonal) modules we teach in DBT.

Using Option 2 (feel better about the problem), you might focus on what you like about the couch. Maybe, despite its color or size, you find the couch comfortable or durable, so you bring your attention to that, focusing on what’s right or what works. You remind yourself that the couch is just one item in your home and that your happiness and well-being aren’t contingent upon everything you own. Maybe you focus on other pieces in your home you do enjoy. Option 2 calls upon the emotion regulation skills from DBT.

With Option 3 (accepting the problem), you accept that this is your new couch (even if you don’t like it). You drop the struggle, which means you stop fighting the reality that the couch isn’t right or should be different. You accept that you have a couch that you don’t like. While acceptance doesn’t mean that you like something, it does mean that you acknowledge that that is the reality. With Option 3, we make use of our distress tolerance and mindfulness skills from DBT.

Option 4 (stay miserable) is always an option, but it’s one that leads to suffering and one we hope you won’t often choose. With Option 4, you don’t use any DBT skills.

Can you think of a problem you’re currently facing? Now, see if you can workshop each of the options. What would each option look like in terms of addressing this concern? Keep in mind, you don’t necessarily have to pick only one; you can mix and match to arrive at a solution that works best for you. And, you might shift from one option to another over the course of time.

To learn all of the skills from the four modules of DBT (mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness) in a supportive group setting, contact us to learn more about our DBT skills training offerings.

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How to Solve a Problem in Seven Easy Steps

By Dovid Spinka , LMSW

Unwanted situations are an inevitable part of life. Fully embracing and radically accepting that fact is a firm basis to managing difficult emotions. Acceptance is especially important when there is nothing we can do, such as when the weather is too cold, hot, or rainy, or when roommates continue to be loud after repeated requests to keep the noise down.

But in many situations, we can solve or at least minimize the problems at hand. Here are seven steps to problem solving, taken from the principles and practices of Dialectical Behaviour Therapy (DBT) .

Step 1 – Describe the problem

Take the time to describe the situation you’re facing. Be specific and detailed, and include the consequences that you’re concerned about. For example, “I keep failing my exams despite the fact that I study a lot before taking them, which leaves me feeling anxious and fearful that I may not graduate.”

Step 2 – Check the facts ( all the facts)

Be mindful of extreme thinking and make sure that your description is correct. For example, did you really fail the exam? Or did you not get as high a grade as you had hoped for? How many exams have you failed? How much study and prep time did you actually put in beforehand? Is this a general exam issue or limited to a particular subject? Sometimes after checking the facts we realize that our description of the problem needs to be revised. If the facts are incorrect, go back to Step 1. If they’re correct, move on to Step 3.

Step 3 – Identify your primary goal

Take the time to clarify what needs to happen or change for you to feel ok. Keep it simple and be realistic – choose something that can actually happen. For example, “I want to improve the effectiveness of my studying, so I don’t fail any more exams”.

Step 4 – Brainstorm

Take the time to identify lots of solutions to achieve your goal. Think about as many solutions as possible, and don’t throw anything out because it seems strange or unrealistic. It is crucial not to judge brainstorming or evaluate ideas for feasibility at this stage. Have fun being a creative thinker. For example, could you… Study with your classmate Daniel who does well in exams? Ask to meet with your professor to get feedback and advice about the exams? Learn mindfulness and relaxation techniques to help improve your concentration during study time? Drop a few courses and take online classes for beginners, then try again next semester? Quit school and become a professional ballet dancer??

Step 5 – Choose a solution

Pick one of your brainstormed ideas that fits the goal and is most likely to work. Don’t aim for perfection – just pick the best answer. If necessary, do a pros and cons to decide between two or more good options.

Step 6 – Put the solution into Action

The entire enterprise of problem solving is aimed at this step: Putting effective solutions into action. However, people often get stuck with anxiety at this point. If thoughts such as “this is too hard” or “this isn’t going to work” arise in your mind, accept them and mindfully refocus on action. Stay focused and stay the course! For example if you selected studying with Daniel, call him up, explain the situation, and book a time to get together to study.

Step 7 – Evaluate the outcome

Take the time to think about how things went. Did your solution help you to achieve the goal? If the answer is yes, take even more time out to congratulate yourself and celebrate! And if not, don’t be disheartened – sometimes the best solutions come after several tries. Just go back to brainstorming (step 4) and try again until you succeed. Additionally, when solutions are carried out as planned, there are often secondary benefits that we can enjoy, so reap the benefit of those even if your planned outcome did not work out.

In sum, effective problem solving is a skill that needs to be learned, practiced, and honed over time. Therefore, we can be methodical, planned and deliberate about the process.

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20 DBT Worksheets and Dialectical Behavior Therapy Skills

If you’re as lost as I was when I first heard the term, then you’ve come to the right place. In this piece, you will learn what DBT is, how it works, and some of the most useful and applicable components of treatment.

Whether you are someone who is thinking about participating in Dialectical Behavior Therapy, a therapist who is looking for DBT worksheets to use with clients, or just a curious individual, read on to learn more about it.

Mindfulness is critical to DBT. Before you read on, we thought you might like to download our three Mindfulness Exercises for free . These science-based, comprehensive exercises will not only help you cultivate a sense of inner peace throughout your daily life but will also give you the tools to enhance the mindfulness of your clients, students or employees.

This Article Contains:

• What is Dialectical Behavior Therapy? A Definition
• About the Founder by Marsha Linehan

DBT vs. CBT: How Do They Differ?

4 essential dbt skills & techniques to master.

• 4 DBT Worksheets, Handout and Manuals (PDF)

What Is The Diary Card All About?

The 4 best books on dbt, treatment methods based on dbt and emotion regulation, certification possibilities & courses.

• What is DBT’s Role in Mindfulness?

A Take-Home Message

What is dialectical behavior therapy a definition..

Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy that focuses on the psychosocial aspects of therapy, emphasizing the importance of a collaborative relationship, support for the client, and the development of skills for dealing with highly emotional situations (Psych Central, 2016).

DBT was created for the treatment of individuals struggling with suicidal thoughts but has matured into a treatment for a range of other conditions that involve dysfunctional emotional regulation. It is currently considered the “gold standard” for borderline personality disorder and has even been applied to the treatment of substance abuse and eating disorders (Linehan Institute, n.d.).

DBT is generally characterized by its two main components:

• Individual weekly therapy sessions;
• Weekly group therapy sessions.

Individual Weekly Therapy Sessions

These individual sessions are an opportunity for the therapist and client to address the issues and solutions that came up over the last week, with special attention paid to self-destructive or potentially self-harmful behaviors. These behaviors are targeted not only because they are inherently worrisome, but also because they can seriously disrupt the treatment process and undermine treatment goals.

Clients and therapists work as a team in these individual sessions, with the focus on learning and improving social and coping skills . They may also discuss more general issues relevant to improving the client’s quality of life, or more specific issues like post-traumatic stress disorder .

Weekly Group Therapy Sessions

These sessions are usually scheduled for two and a half hours and generally focus on developing skills from one of four skill areas:

• Interpersonal effectiveness ;
• Distress tolerance/reality acceptance skills;
• Emotion regulation;
• Mindfulness skills.

Skill Modules

These four skill modules cover a wide range of useful skills that can be applied in daily life:

1. Interpersonal Effectiveness Module

The skills in this module are related to interacting with others, especially in difficult or potentially damaging situations.

These skills are intended to help clients function effectively when trying to change something (e.g., making a request) or in trying to resist changes (e.g., refusing a request). The intention is to aid the client in meeting their goals in each situation while avoiding any damage to the relationship or to the client’s self-respect (Psych Central, 2016).

2. Distress Tolerance Module

This module includes skills that are extremely important yet often overlooked: skills relating to accepting, tolerating, and learning from suffering.

Many other mental health treatment regimens focus on avoiding pain, changing difficult situations, or walking away from circumstances that cause suffering, but the distress tolerance skills taught through Dialectical Behavior Therapy focus on dealing with the pain and suffering that is inevitable to the human condition.

The distress tolerance module is split into four crisis survival strategies:

• Distracting;
• Self-soothing;
• Improving the moment;
• Thinking of pros and cons.

In addition, there are many skills that relate to accepting and tolerating the current situation, like radical acceptance and willingness vs. willfulness.

3. Emotion Regulation Module

Many clients who participate in DBT are struggling with personality or mood disorders and can benefit immensely from emotion regulation skills.

Some of these skills that can help clients deal with their  emotions include:

• Identifying and labeling emotions;
• Identifying obstacles to changing emotions;
• Reducing vulnerability to “emotion mind;”
• Increasing positive emotional events;
• Increasing mindfulness to current emotions;
• Taking the opposite action;
• Applying distress tolerance techniques (Psych Central, 2016).

4. Mindfulness Module

Readers of this blog are likely already aware of the numerous mindfulness-related skills that can benefit them in their daily life.

These skills include “what” skills or skills that answer the question “What do I do to practice core mindfulness skills?” like observing, describing, and participating. There are also “how” skills or skills that answer the question “How do I practice core mindfulness skills?”, like non-judgment and practicing “One-mindfully” effectively.

Many of these mindfulness skills feed into skills from the other modules; for example, the nonjudgment encouraged in mindfulness is also encouraged in distress tolerance, and the observing and describing skills can be helpful in identifying and labeling emotions.

About the Founder Marsha Linehan

Dialectical Behavior Therapy was developed by Dr. Marsha Linehan.

She is a Professor of Psychology and adjunct Professor of Psychiatry and Behavioral Sciences at the University of Washington and Director of the Behavioral Research and Therapy Clinics, a research consortium that explores treatments for severely disordered and suicidal individuals (The Linehan Institute, n.d.).

Dr. Linehan is dedicated to promoting effective and accessible resources for the treatment of individuals who are struggling.

Dr. Linehan founded Behavioral Tech LLC, an institute focused on developing and sharing treatment tools for DBT training, consultation, and treatment. Behavioral Tech Research, Inc., was also established by Dr. Linehan in an effort to incorporate online and mobile technology into the successful practice of DBT.

Dr. Linehan approaches her scientific research and development from a perspective that is relatively uncommon in the sciences: one based in spirituality. She has trained with a number of spiritual leaders and influential thinkers, including a Zen master.

This may help explain her affinity for mindfulness, which grew to prominence through a collaboration of traditional Buddhist philosophy and the modern scientific paradigm (The Linehan Institute, n.d.).

Of course, DBT is a type of CBT, so similarities are understandable. But DBT also has distinct features that set it apart from most CBT approaches.

DBT, like CBT, focuses on helping people address their dysfunctional thinking and behavior through modification of their thought patterns and, through changing their thoughts, their behavior as well. However, CBT is usually confined to a limited period of time and is often applied with one or two specific goals in mind.

On the other hand, DBT narrows the focus to psychosocial aspects of daily life. Many people have trouble with their thought and behavior patterns, but these issues are often at their most disruptive in the context of relationships with others. DBT was created to approach treatment from this angle, one that is often incorporated in general CBT but is not typically the main focus (Grohol, 2016).

This emphasis on relating to others is what explains the DBT-specific treatment component of group therapy sessions. The benefits of additional therapy to the treatment of severe emotion regulation dysfunction are clear, but it’s the group aspect that really helps explain its importance.

Adding group dynamics to the learning setting offers clients an opportunity to practice relational skills in a safe and supportive environment, a practice that has been shown to be extremely effective.

DBT also differs from general CBT in the use of clients’ history. Both incorporate the past in striving for a healthier future, but this discussion is not a focus of the therapy in DBT as it often is in CBT (Grohol, 2016). The perspective of DBT is that one can learn from their past, but that problems are inevitably rooted in current thoughts and behaviors, and the present is where these will be addressed.

We won’t go into all of them in detail, but these are the main skills and techniques applied in DBT.

Interpersonal Effective Skills

1) objectiveness effectiveness “dear man” skills.

• Appear confident;

2) Relationship Effectiveness “GIVE” Skills

• Interested;
• Easy manner.

3) Self-Respect Effectiveness “FAST” Skills

• Apologies / no apologies;
• Stick to value;

Distress Tolerance Skills

1) crisis survival “accepts” skills.

• Activities;
• Contributing;
• Comparisons;
• Pushing away;
• Sensations.

2) Self-Soothing Skills

3) improve the moment “improve” skills.

• Relaxation;
• One thing at a time;
• Encouragement.

4) Pros and Cons / Accepting Reality Skills

• Willingness;
• Turning your mind;
• Radical acceptance.

Download 3 Free Mindfulness Exercises (PDF)

These detailed, science-based exercises will help you or your clients enjoy the benefits of mindfulness and create positive shifts in their mental, physical, and emotional health.

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By filling out your name and email address below.

Emotion Regulation Skills

1) reducing vulnerability skills.

• Treat physical illness;
• Altering drugs (only those prescribed by a doctor);

2) Build Mastery Skills

• Build positive experiences;
• Be mindful of current emotion;
• Opposite to emotion action.

Mindfulness Skills

1) “what” skills.

• Participate.

2) “How” skills

• Non-judgmentally;
• One-mindfully;
• Effectively (Dietz, 2012).

As you can see, acronyms are front and center in DBT treatment, in part because it makes remembering these skills in important moments easier.

You may also notice that many of these skills are generally considered effective skills , rather than specific skills for specific problems. While Dialectical Behavior Therapy focuses on the treatment of severely distressed individuals, the means of working towards these goals are not mystical or mysterious. The methods of furthering treatment are grounded in common sense and the straightforward practice of skills.

In fact, these skills are so generally applicable that many of them have practical applications for everyone.

Mindfulness

Mindfulness is such a simple and beneficial practice that it’s hard to sum up the potential positive impacts in one section, let alone one article (but we gave it a shot anyway – see our piece on the benefits of mindfulness ).

“Mindfulness can be described as simply living your life in the present instead of being stuck in the past or the future. Practicing mindfulness helps us become more aware of our thought patterns, our emotions, and how our thoughts and feelings affect our reactions to events” (Tartakovsky, 2015A).

If your mind has you jumping on the thought train (i.e., one thought leads to another, which often leads to a “should” thought, which can lead to judgment), try to detach yourself from the thought by telling yourself about the thought you are having (e.g., “There’s a thought about the errand I need to run after work”).

This can help you refocus on your current practice and remind yourself that you have thoughts, but you are not your thoughts (Tartakovsky, 2015A).

If you’re interested in learning more about how to practice mindfulness, check out our post on mindfulness exercises and techniques .

Reality Acceptance

Accepting reality is an effective antidote for a common problem in our society: struggling against the pain and suffering that is inherent to life as a human. DBT and Acceptance and Commitment Therapy (ACT) have this in common – both teach that accepting our reality, including the unpleasant aspects of it, is the only way to thrive.

This skill can be harder to practice and build than it seems since there are all sorts of sneaky ways we find to deny the reality of our situation.

These examples from Psych Central can shed some light on when we fight reality and how we can stop this tendency:

• You need to rush home, but you’re catching every red light. Instead of getting frustrated, you take a deep breath and tell yourself: “ It is what it is. I’ll get home when I get there .”
• You need to fill up your car, but gas prices have skyrocketed. Again, you breathe deeply, and say to yourself: “ There’s nothing I can do about it. I need gas. Getting angry isn’t going to help. ”
• You have to walk to work because your car is in the shop. It’s not far, but it’s pouring. You take a deep breath and say: “ It’s just rain. I’ll bring a towel, and I’ll dry off when I get to work ” (Tartakovsky, 2015A).

The part-humorous, part-helpful Tumblr blog “ Shit Borderlines Do ” provides some steps towards practicing this skill in the moment:

• Observe that you are fighting the reality of your situation. Acknowledge that you are reacting to something that you cannot change;
• Remind yourself what the reality is, even if it’s difficult or upsetting;
• Consider the causes of the current reality and incorporate the skill of non-judgment to remind yourself that this is a random occurrence set in motion by a million other factors that are outside of your control;
• Accept this reality with your whole being, or your mind, body, and spirit. Pay attention to the bodily signs of fighting reality (e.g., posture, “fight-or-flight” response) as well as the spiritual signs (you may “know” that this is real, but you don’t “feel” like it’s real).

These steps are by no means exhaustive or required to accept reality, but they can be helpful in the moment.

Radical Acceptance

Dialectical Behavior Therapy’s radical acceptance technique can help in these situations.

Radical acceptance is simply acknowledging the reality of your circumstances instead of fighting it by thinking “ This shouldn’t be happening ” or “ This isn’t fair. ”

It can be difficult to accept pain, but fighting the reality of your pain only creates more pain, and this pain is optional. Instead of fighting pain, radical acceptance offers a way to accept it and address it.

In the words of psychotherapist Sheri Van Dijk:

“If you don’t like something, you first have to accept that it is the way it is before you can try to [change] it. If you’re not accepting something, you’ll be so busy fighting that reality that you don’t have the energy to put towards trying to change it” (Tartakovsky, 2015).

This explanation shows us that not only can radical acceptance help us accept the reality of things that we cannot change, it can also help us to realize what can be changed.

Non-judgmental Stance

Being non-judgmental means that you avoid assigning value to events and feelings.

Instead of facing a difficult situation and thinking “ This is awful ,” practicing non-judgment allows us to take a step back and realize that the value judgments we make are based on facts (the facts of what is happening) and the emotions we are feeling in reaction (Tartakovsky, 2015B).

For example, you may be stuck in accident-related traffic and thinking “People are such idiots.” If you make an effort to be nonjudgmental, this may translate to “ I’m stuck at a standstill in traffic because of an accident up ahead. This makes me frustrated and upset. ”

When you break a judgment down into a fact and your emotional reaction, you not only reduce the emotion(s) you are feeling, you can also be empowered to think about ways to solve the problem and make healthy decisions.

Say you are thinking about how selfish your significant other is being right now. Instead of stopping at “ My partner is so selfish ,” practicing non-judgment may lead to articulating the issue (“ My partner is not helping me with this problem, and that makes me angry and disappointed ”) and finding a way to solve it (“ This is not a wise use of my time and energy. I will talk to my partner about how his/her unwillingness to help me with this problem makes me feel, and try to negotiate a solution with him/her ”).

Handling emotional situations in this manner can not only help you reduce your emotional reaction and find smart solutions to problems, it can also improve your self-esteem and self-respect when you handle the issue in a way that makes you proud of yourself (Tartakovsky, 2015B).

4 DBT Worksheets, Handout, and Manuals (PDF)

This is where Dialectical Behavior Therapy worksheets, handouts, and manuals can prove to be extremely effective tools in building your skills and improving your ability to accept your situation, deal with difficulty, and solve problems.

We’ll go over some of the most popular and effective ones below.

DBT Interpersonal Effectiveness Skills

This handout lists and describes the interpersonal effectiveness skills we outlined earlier, and also provides useful tips to put these skills into practice.

For example, the section on objective effectiveness (the DEAR MAN skills) lists the following tips:

• Use clear and concrete terms to describe what you want;
• Don’t say: “Could you please clean?”;
• Do say: “Could you do the dishes before going to bed?”
• Let others know how a situation makes you feel by clearly expressing your feelings;
• Don’t expect others to read your mind;
• Try using this line: “I feel ___ because ___.”
• Don’t beat around the bush—say what you need to say;
• Don’t say: “Oh, well, I don’t know if I can cook tonight or not;”
• Do say: “I won’t be able to cook because I’m working late.”
• Reward people who respond well, and reinforce why your desired outcome is positive;
• This can be as simple as a smile and a “thank you.”
• Don’t forget the objective of the interaction;
• It can be easy to get sidetracked into harmful arguments and lose focus.
• Consider your posture, tone, eye contact, and body language.
• No one can have everything they want out of an interaction all the time;
• Be open to negotiation;
• Do say: “If you wash the dishes, I’ll put them away.”

The Wise Mind

It is a balance between the two minds and is characterized by the ability to recognize and respect your feelings, but also respond to them in a rational manner .

The worksheet offers space to describe an experience that you have had with each of these three “minds” to further your understanding of the minds and how they have come into play in your life.

Function of Emotion Worksheet

The Function of Emotion Regulation  worksheet helps you to identify the function of an emotional reaction you have had over the last week.

The worksheet moves through the following questions and steps:

• What was the prompting event?
• What was your interpretation?
• What was the emotion and intensity (0-100)?

Use the following to identify the function(s) of the emotion:

• Did the emotion communicate something to others or influence their behavior? If so, describe;
• Did the emotion organize or motivate you to do something? If so, describe;
• Did the emotion give you information, color your perception, or lead you to any conclusions? If so, describe.

These questions aid the individual in making the connections between a galvanizing event and the reaction s/he had to the event, as well as understanding how the emotional reaction impacts the self and others.

DBT Skills Training Manual: Second Edition

For a resource that can help you apply general DBT treatment, check out this manual from Dr. Linehan herself. It’s not free, but it is an extremely valuable resource for applying DBT with your clients.

This manual is separated into two parts: the first describes DBT and provides instructions on how to set up a treatment program and manage the problems that can arise, while the second gives detailed notes on teaching each DBT skill.

Check out the manual, buying options, and reviews from some very satisfied readers here .

According to dbtselfhelp.com :

“You use the card to track your urges, moods, how you did or did not use DBT Skills, your feelings, and whatever else is helpful to you. You bring these cards with you to your DBT therapist every week to help you look for behavior patterns and triggers that occur in your life. Such information is invaluable to help you to help yourself live a life worth living.”

There are many possible layouts for a diary card (see here , here , and here ), but they generally contain the same fields:

• Day/date of urge or behavior;
• Emotions felt;
• Actions taken or skills used (or not used);
• Triggers for the urges.

The diary card may also include space for a general rating for the day and any medications or substances used (legal or illegal).

The client is encouraged to fill out this card regularly and faithfully. While it is important that the client does so, they should know that no one is going to score them or judge them based on their diary card. It is not an assignment to be completed and graded, but a way for them to track their experience and evaluate their progression through DBT treatment and, hopefully, self-improvement.

Diary Card App

As with most problems or issues, technology is making an impact on how people keep diary cards.

If you hate to waste paper, don’t like getting ink on your hands, or just get tired of writing, there’s a diary card app that you can use instead.

Check out the app created by a licensed clinical psychologist here .

If you’re interested in learning more about Dialectical Behavior Therapy, as a client, therapist, or just a curious person, there are several books available.

Listed below are some of the most popular and highly reviewed books on DBT out there, and they’re all available for purchase on Amazon.com:

1. The Dialectical Behavior Therapy Skills Workbook – Matthew McKay, Jeffrey C. Wood, and Jeffrey Brantley

It walks the reader through descriptions of DBT and how it can help, introductory exercises, and more advanced skill chapters. This can be an excellent resource for any individual considering DBT or for therapists to recommend to their clients.

Available on Amazon .

2. DBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy – Sheri Van Dijk

It includes a section on the theory and research behind DBT and how it grew from traditional CBT approaches, as well as strategies for working with clients, an explanation of the four skill modules, and several handouts, case examples, and some sample therapy dialogue.

3. The Mindfulness Solution for Intense Emotions: Take Control of Borderline Personality Disorder with DBT – Cedar R. Koons and Marsha M. Linehan

It teaches readers about the seven powerful skills related to mindfulness and emotion regulation that can help people cope with a borderline personality disorder (BPD), post-traumatic stress disorder (PTSD), severe depression, and other emotion regulation problems.

4. Calming the Emotional Storm: Using Dialectical Behavior Therapy Skills to Manage Your Emotions and Balance Your Life – Sheri Van Dijk

With a rating of over 4.5 out of 5 stars from nearly 50 customers, it sounds like the description is accurate.

These books are an excellent start to learning about DBT and applying the skills in your clients’ lives, but if you’re looking for even more, visit this website to learn about other helpful books.

• Understanding one’s emotions;
• Reducing emotional vulnerability;
• Decreasing emotional suffering (Bray, 2013B).

There are several ways to work toward these goals.

One of the websites we mentioned earlier, dbtselfhelp.com , offers an outline of how to build emotion regulation skills:

Interpreting Emotions

We all have emotions, but there is a theory that there are only a few basic emotions while the rest is interpretation and evaluation.

You can work on your skills related to interpreting emotions by completing a writing challenge described here .

Describing Emotions

Emotions involve action urges, prompts to perform certain behaviors. These urges are not part of the emotion but can feel like they are. There is often a prompting event, followed by interpretation, body changes in response to the emotions, and action urges.

This can lead to an effective or dysfunctional expression of emotions, which can have a wide range of consequences. To work on describing emotions, try to describe the qualities of your emotions and pay attention to things that may interfere, like secondary emotions that spring from the original emotion.

Follow this link for more information on describing emotions.

Function of Emotions

Emotions have three major functions in DBT:

• They communicate to and influence others;
• They organize and motivate action, and;
• They can be self-validating.

You can learn about the function of emotions by answering questions like “What are some examples of situations where your expressions of emotion were misread?” and “Can you think of some times when you misread the emotions of someone else?”

See this page for more information.

Reducing Vulnerability

We are all vulnerable to negative emotions, but we can build our skills related to reducing vulnerability. You can keep track of the factors that affect your physical and mental wellbeing, like your diet, any mood-altering drugs, sleep, and exercise.

Refer to these skills in the emotion regulation module for more information.

Paying Attention to Positives

Increasing positive emotions can be an effective method for dealing with difficult emotions. To build this skill, focus on the positive experiences you have throughout the day (short-term experiences) and the bigger, more impactful ones (long-term experiences).

Focus on building and maintaining positive relationships, and give mindfulness a try to savor positive experiences.

Letting Go of Painful Emotions

On the flipside of savoring the positive, letting go of the negative also has a place in emotion regulation. While accepting that pain happens is healthy, dwelling on negative emotions is dysfunctional.

Practice observing your emotions, describing and accepting them but not allowing yourself to be overwhelmed by them.

See this page for more information on letting go.

Opposite to Emotion Action

This technique is used to change painful emotions that are harmful rather than helpful. It is not about suppressing our emotions, but accepting the emotion and using it to take a different action.

To practice this technique, list some examples of when you have acted opposite to your current emotion. Describe a situation in which it is not appropriate to act opposite to your emotion to help you learn about the difference between each situation.

Check out this handout for more information.

What is Dialectical Behavior Therapy for adolescents (DBT)? – UC San Francisco

Dialectical Behavior Therapy is a recognized treatment that is well supported by the evidence. There are many ways to learn about applying DBT, but getting certified is a great option. There are courses and online DBT training for both individuals interested in practicing DBT and for therapists and other mental health professionals who wish to apply DBT in their work.

For Therapists and Other Mental Health Professionals

Dr. Linehan’s Behavioral Tech Research Institute provides information on Dialectical Behavior Therapy certification for therapists. The certification is available through the DBT-Linehan Board of Certification and requires the following:

• A graduate degree in a mental health-related field from a regionally accredited institution of higher education;
• A mental health practitioner license;
• A minimum of 40 didactic training hours specific to DBT Clinical experience with DBT (at least three clients);
• DBT team experiences (at least 12 months of preparation and current participation on a DBT team);
• DBT skills knowledge/experience;
• You must have read the Skills Training Manual for Treating Borderline Personality Disorder by Marsha Linehan, completed all the homework assignments in the manual, and taught or participated in all modules of skill training;
• Successful pass of exam based on the Cognitive-Behavioral Treatment of Borderline Personality Disorder by Marsha Linehan;
• Letter of recommendation from your team leader;
• Work product demonstration (videotapes of three consecutive live therapy sessions);
• Mindfulness experience (at least one of the following: a mindfulness retreat, formal practice community participation, formally a student of a recognized Zen/contemplative teacher, or at least one formal training in mindfulness).

You can also become certified through the Dialectical Behavior Therapy National Certification and Accreditation Association (DBTNCAA). This allows you to list a specialized certification in DBT when you apply to Health Care Providers and HMO networks.

What is DBT’s Role in Mindfulness?

While DBT and mindfulness are not synonymous, they are certainly linked.

DBT is a therapy based on identifying, describing, and modifying thoughts and feelings. Mindfulness has clear applicability in this therapy, through its ability to help practitioners to become more aware of their feelings, thoughts, impulses, and behaviors (Bray, 2013A).

One description of the benefit of mindfulness in Dialectical Behavior Therapy is that it provides the individual with the ability to take control of the mind instead of having the mind control the individual.

Practicing mindfulness helps the individual in DBT to direct their attention to observing, describing, and participating in a nonjudgmental way, which enhances the individual’s skills and leads to improved ability to focus on the positive, let go of the negative, and regulate emotions.

As we’ve said before, mindfulness is an extremely useful skill for individuals dealing with difficult emotions or situations, but it can be an even more effective tool for people struggling with a diagnosis.

Top 17 Exercises for Mindfulness & Meditation

Use these 17 Mindfulness & Meditation Exercises [PDF] to help others build life-changing habits and enhance their wellbeing with the physical and psychological benefits of mindfulness.

Created by Experts. 100% Science-based.

The intention of this piece was to provide an overview of Dialectical Behavior Therapy and outline the skills and tools that can help you or your clients to address emotion regulation issues. I hope it has met this goal, and that you know much more about Dialectical Behavior Therapy than you did when you started!

I hope you also keep in mind that the skills involved in DBT are applicable for those that are not suffering from a diagnosed mental health issue as well. Skills like mindfulness, focusing on the positive, letting go of the negative, and accepting the reality of your situation have clear benefits for everyone, not just those who are in the midst of suffering.

Have you tried DBT? Have you applied DBT with your clients? As always, please let us know about your experiences in the comments.

Thanks for reading!

We hope you enjoyed reading this article. Don’t forget to download our three Mindfulness Exercises for free .

• Bray, S. (2013A). Core mindfulness in Dialectical Behavior Therapy. GoodTherapy. Retrieved from http://www.goodtherapy.org/blog/core-mindfulness-dialectical-behavior-therapy-0215134
• Bray, S. (2013B). Emotion regulation in Dialectical Behavior Therapy. GoodTherapy. Retrieved from www.goodtherapy.org/blog/emotion-regulation-dialectical-behavior-therapy-dbt-0318135
• Dietz, L. (2012). DBT skills list. DBT Self Help. Retrieved from www.dbtselfhelp.com/html/dbt_skills_list.html
• Grohol, J. (2016). What’s the difference Between CBT and DBT?  Psych Central. Retrieved from https://psychcentral.com/lib/whats-the-difference-between-cbt-and-dbt/ Linehan Institute
• Psych Central. (2016). An overview of Dialectical Behavior Therapy. Psych Central. Retrieved from https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/
• Tartakovsky, M. (2015A). 3 DBT skills everyone can benefit from. Psych Central. Retrieved from https://psychcentral.com/blog/archives/2015/08/28/3-dbt-skills-everyone-can-benefit-from/
• Tartakovsky, M. (2015B). What it really means to practice radical acceptance. Psych Central. Retrieved from https://psychcentral.com/blog/archives/2015/10/04/what-it-really-means-to-practice-radical-acceptance/
• The Linehan Institute. (n.d.).  Linehan Institute. Retrieved from http://www.linehaninstitute.org/about-Linehan.php

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What our readers think.

I appreciate you giving this information. In our online treatment, dialectical behavioral therapy is used. It works incredibly well for depression, substance abuse, and borderline personality disorder. Even the most serious cases respond very well to DBT, and we treat a wide range of clients.

I’ve been looking for this info!!! DBT saved my life and I believe EVERYONE could benefit from it. The reason I’ve been searching is for my boys. I never meant to pass that part of me to any of my children but I see it in them. I’m trying for them to avoid the wrong roads I took. I barely escaped the darkness. I couldn’t bare to see them in that place. So ty!! I can’t say it enough.

I have recently completed a DBT group therapy course which I found extremely helpful in managing my BPD and PTSD.

I would love to teach these skills to others worldwide, is it a requirement that you have a certain level of certification to teach cbt/dbt and if so what qualifications are required to go on to teach these skills to others online?

I believe I have enough personal experience, understanding and now knowledge of the skills and mental illness, but am confused on the law of teaching these skills without official certification, or even if that’s a must?

Please help

That’s great your experience was so helpful for you! To teach CBT and DBT skills to support people with mental illnesses, you need to become a licensed therapist or psychologist. This requires that you complete a master’s qualification. You can learn more about the process in our dedicated blog post: https://positivepsychology.com/how-to-become-a-therapist/

Hope this helps!

– Nicole | Community Manager

I have the same question. I work in mental health as a life coach and yoga instructior. I do not want to teach the program. My intention is to use the “My life Vision” worksheet and the wise mind model. What is the legal implications? I would sight the source while being clear on my role and title. The client would be provided resources for a licensed therapist.

This is outstanding!!!!!!

Just curious, you mention in the section – Working with Primary and Secondary Emotions While – “this webpage” but then there is no link to the webpage the article is referencing. I am wondering if you would direct me to the webpage please for further reference. As well, in the following paragraph on Emotion Regulation, again you mention “this worksheet” but don’t link a worksheet. Are you able to reference these for follow-up, please and thank you?

Hi Heather,

Thank you so much for being so observant and bringing this to our attention.

These links went to other websites, which may have restructured their content and caused dead links on our side. I have unfortunately not been able to trace the original worksheets discussed, but have amended our copy to prevent any further confusion.

Apologies for not being able to help you further.

Regards, Annelé

I wish DBT was more available in standard mental health services. In the UK, it’s thin on the ground.

BPD is prolific and causes so much suffering. Yet still much ignorance and stigma remains.

I hate the way so many blame and shame such lonely and fragile people.

We want love, but are terrified of our vulnerability being abused. I wish I could’ve got this treatment. My partners would not have had to put up with so much, maybe.

Damaged people damage people.

Thank you for sharing your thoughts on the availability of Dialectical Behavior Therapy (DBT) and the challenges faced by individuals with Borderline Personality Disorder (BPD). It is indeed disheartening to hear that access to this valuable treatment is limited in the UK and that stigma continues to surround BPD.

The importance of raising awareness about mental health conditions and advocating for better access to evidence-based treatments, such as DBT, cannot be overstated. It is essential to create a more understanding and compassionate society that supports individuals with mental health challenges instead of perpetuating shame and blame.

I encourage you to check out Psychology Today! It has a great directory you can use to find therapists in your local area. Usually, the therapists provide a summary in their profile with their areas of expertise and types of issues they are used to working with.

Please know that your voice matters and your experiences can contribute to raising awareness, challenging stigmas, and ultimately improving mental health care for those who need it most.

Warm regards, Julia | Community Manager

I have been waiting a very long time for DBT therapy for diagnosed Borderline Personality Disorder, being unable to work for 20 months now. I have finally been assigned a place but am unable to purchase DBT Skills Training Handouts and Worksheets Second Edition. Seeking help from so many places, I can’t even find a Microsoft Word version of the worksheets that I can complete online in order to participate in the group therapy. As a result, I cannot have the therapy I desperately need. I know this is a long shot, but does anyone have a version in Word (or Open.Office) that they can send to me?? Otherwise, I will continue to suffer as the NHS has taken so long to help me with a condition I have had for decades, together with my depression and anxiety. Thanking you in advance.

I’m sorry to hear you’ve had so much trouble receiving support. Please let me know which specific worksheet(s) you are trying to open, and I will let you know the best way to do so with free software.

Thank you for providing this information.

This sums up the group therapy session I have just graduated from! Modalities were based from Marsha’s core theories; it is alot of skills to practice.

Courtney, everything you wrote on this page IS TRUE, well written for any level audience. Well done.

Radical Acceptance, and Emotional identification is THE HARDEST part of BPD and DBT. I find it hard now to identify why I am in an “emotional crisis”, since I want to “Name it, to Tame it”. I really can’t identify why I become so deeply emotional (rage, crying, worthless…) but the emotions are EXTREME. I can’t identify what I was so emotional about, why I became so emotional in the first place ONCE I GET CAUGHT IN “THE DARK HOLE” as my husband refers to my “emotional crises”.

Just thought I would share my own personal experience; FYI I am an ongoing work in progress. Still have many ups and downs; however I can reflect on these events (usually AFTER the fact, but LIVE AND LEARN).

Super frustrting that it says “We hope you enjoyed reading this article. Don’t forget to download our 3 Mindfulness Exercises for free.” but you enter your information and then it tells you it cost $27.00. Why the false advertising…why say free just to get another person email to spam?

My apologies! Please try visiting this link to access the free downloads. The three exercises are definitely free! But if there’s a link in the text that tries to point you toward a paid resources, please let us know where it is so we can correct this 🙂

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Changing Behavior in DBT

Problem solving in action, heidi l. heard and michaela a. swales foreword by marsha m. linehan.

• description T his book delves into problem solving, one of the core components of dialectical behavior therapy (DBT). The authors are leading DBT trainers who elucidate the therapy's principles of behavior change and use case examples to illustrate their effective application. Particular attention is given to common pitfalls that therapists encounter in analyzing target behaviors—for example, a suicide attempt or an episode of bingeing and purging—and selecting and implementing appropriate solutions. Guidelines are provided for successfully implementing the full range of DBT problem-solving strategies, including skills training, stimulus control and exposure, cognitive restructuring, and contingency management. -->
• sample chapter
• about the authors Heidi L. Heard , PhD, has published numerous articles and chapters related to borderline personality disorder and DBT and is coauthor (with Michaela A. Swales) of Dialectical Behaviour Therapy: Distinctive Feature s. She collaborated with Marsha Linehan on the initial outcome trials for standard DBT and the adaptation for substance abuse and dependence, particularly focusing on the cost-effectiveness of DBT. Now retired, Dr. Heard was the founder of British Isles DBT Training and was a senior trainer for Behavioral Tech, which provides advanced training in DBT internationally. She provided consultation in the United States and Europe to DBT teams working in adult and adolescent outpatient programs and in adult secure inpatient programs, and to individual clinicians in adult outpatient, secure hospital, and prison settings. Michaela A. Swales , PhD, is Consultant Clinical Psychologist and Professor in Clinical Psychology on the North Wales Clinical Psychology Programme, Bangor University. She trained in DBT with Marsha Linehan and for 20 years ran a clinical program for suicidal young people in an inpatient service. Dr. Swales is Director of the British Isles DBT Training Team, an international affiliate of the Linehan Institute. She has trained more than a thousand professionals in DBT, seeding over 400 programs globally. She coauthored Dialectical Behaviour Therapy: Distinctive Feature s (with Heidi L. Heard) and is editor of the Oxford Handbook of Dialectical Behaviour Therap y. Her primary research interest is the effective implementation of evidence-based psychological therapies in routine clinical practice. Dr. Swales was a member of the Working Group on Classification of Personality Disorders reporting to the World Health Organization's International Advisory Group for the Revision of the ICD-10 Mental and Behavioural Disorders. -->

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Mindfully Healing

Mental health & well-being.

DBT – Options for Solving Any Problem

by Mitchell Olson, MA LPCC | Feb 20, 2017 | DBT Skills , Mental Health | 0 comments

Options for Solving Any Problem When life presents you with problems, what are your options? 1. Solve the Problem Change the situation . . . or avoid, leave, or get out of the situation for good. 2. Feel Better about the Problem Change (or regulate) your emotional response to the problem. 3. Tolerate the Problem Accept and tolerate both the problem and your response to the problem. 4. Stay Miserable

Or possibly make it worse! 1. To Problem-Solve: Use interpersonal effectiveness skills Walking the Middle Path (from interpersonal effectiveness skills) Use problem-solving skills (from emotion regulation skills) 2. To Feel Better about the Problem: Use emotion regulation skills 3. To Tolerate the Problem: Use distress tolerance and mindfulness skills 4. To Stay Miserable: Use no skills!

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Taking Hold of Your Mind: “How” Skills Non-judgmentally See, but don’t evaluate as good or bad. Just the facts. Accept each moment like a blanket spread out on the lawn, accepting both the rain and the sun and each leaf…

Radical Acceptance (When you cannot keep painful events and emotions from coming your way.) What Is Radical Acceptance? 1. Radical means all the way, complete and total. 2. It is accepting in your mind, your heart, and your body. 3.…

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Cope Ahead Skill

The Cope Ahead skill is intended to have us consider how we might be prepared in some way to help us reduce stress ahead of the time. When we are asked to do some task, it is helpful to think through to the completion of the task. All of us at one time or another have had to give a presentation. Before the presentation, we likely wrote up some notes or did some research on the subject. We do this in order to increase our chances of communicating a message to others successfully. This is an example of coping ahead of time.

• 1 Describe the situation that is likely to prompt uncomfortable emotions. Check the facts. Be specific in describing the situation. Name the emotions and actions likely to interfere with using your skills.
• 2 Decide what coping or problem-solving skills you want to use in the situation. Be specific. Write out in detail how you will cope with the situation and with your emotions and action urges.
• 3 Imagine the situation in your mind as vividly as possible. Imagine yourself in the situation now, not watching the situation.
• 4 Rehearse in your mind coping effectively. Rehearse in your mind exactly what you can do to cope effectively. Rehearse your actions, your thoughts, what you say, and how to say it. Rehearse coping effectively with new problems that come up. Rehearse coping effectively with your most feared catastrophe.
• 5 Practice relaxation after rehearsing.

Ken sent his resume and cover letter to a company for a position and was offered an interview. He used the Cope Ahead Skill to prepare for the interview.

Ken reviewed his resume and the job description and listed the skills he had already mastered. He also researched the company and prepared a list of questions to ask about the company. He realized he would likely feel anxiety and thought about how he had faced tougher situations than this in the past. He imagined how he would calm himself so that he would do well in the interview.

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DBT Skills: How to Change Your Emotions

by Laura Lanier | Aug 1, 2017

The process of managing what sometimes seems like a hot mess of emotions is actually relatively straightforward (thank goodness!). First, explore the logic and appropriateness of your identified emotion in context. Then, if your emotion is illogical, or acting on it would not be appropriate or helpful, practice “opposite action.” If however,  your emotion is logical and appropriate,  then practice  a skill called problem solving. Let’s dive a little deeper into these terms so that they can hopefully become useful tools in your own emotional toolkit!

The first step to changing your emotions is identifying a specific emotion you want to change. I highly recommend using a feelings wheel  (like the one included in my previous blog)  to help with this step. Next, identify the event or situation that caused the emotion. Begin by stating the facts of what happened using your five senses. For example, I heard the woman smacking her gum loudly and I smelled it too. Now, beyond the facts, how did you interpret this event emotionally or cognitively? What assumptions did you make? Could there be any other interpretations or points of view on this event? If you are feeling threatened, consider the likelihood of actual danger, as well as other potential outcomes. If there is an imminent threat or catastrophe, imagine how you would cope with it.

Finally, take all of this mental processing  into account  and consider whether or not your emotion and level of emotional arousal fits the facts of the situation. To continue our example, perhaps you interpreted the gum-smacking as intentionally rude and it hurt your feelings and caused you to become cold and rude. However, after thinking about how the woman with the gum may have a different perspective (perhaps she was not raised, as you were, to find gum-smacking rude), you  decide that it is unlikely that she is actually threatening or ignoring you in any way.

When Emotions Don’t Fit Facts (Opposite Action)

If you have determined that your emotional reaction is disproportionate to the situation or acting on the emotion would not be appropriate or helpful, you may change your emotion by practicing “Opposite Action.” This means figuring out what action your emotion is suggesting, such as anger telling you to gripe at the incompetent waiter at a restaurant, and doing the opposite. Smile at them, tip them well, tell them to have a good day. The key is to do  it all sincerely and without bitterness. You may feel silly, but in order for this to work, you must commit. And if it doesn’t work the first time, keep trying until it does!

When Emotions Fit Facts (Problem Solving)

If you have fact-checked and determine that your emotion is an appropriate response and not merely an overt reaction,  move to practice problem solving. Problem solving helps you cope with the situation and your emotions. First, set a goal for what solving this problem would look like. What would need to happen for you to feel stable? How would you know if the problem was fixed (what would look different)? Next, brainstorm solutions. Brainstorming means writing down any and every idea that pops into your head, without judgment or filter. The next step is to choose the idea you think is most likely to work and achieve the goal you’ve set. Finally, try out your chosen solution, and evaluate how well it worked. If it didn’t work, go back to your brainstorming notes and try again with a different solution.

An example of problem solving could be if you were forced to attend a family function in which you felt very threatened or uncomfortable because of past experiences or trauma. It is appropriate to feel uncomfortable because you have good reason to believe that this experience will  not be pleasant. You may choose to give yourself an escape plan such as a friend you could ask to call you or pick you up if you needed an excuse to leave. Or, you may bring a friend along who you know would be supportive and helpful.

It may be difficult or overwhelming to imagine practicing this all at once in the heat of extreme emotions. However, you may begin practicing by considering how you would apply these techniques to a recent experience. Once you’ve done this enough to familiarize yourself with the process, it will become easier and more natural to incorporate it into your daily life. Amazingly, you will find that your emotions  can actually change as they happen.

Intrigued by this idea of managing and changing your emotional reactions, I love to talk about how to learn and apply these skills in your particular situation. You can contact me at 940-222-8703 x705 or [email protected], or schedule an appointment online!

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