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DBT Skills (List): 4 Clever Coping Strategies from Dialectical Behavior Therapy

Updated 21 July 2023
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What is Dialectical Behavioral Therapy?

DBT Skills

What is DBT?

Dialectical Behavioral Therapy (DBT) is a form of psychotherapy that was initially designed to help treat borderline personality disorder (BPD) but is now used for a variety of other mental health and substance use disorders.

DBT came about from psychologist Marsha Linehan’s efforts to find treatment for suicidal women.

Through the research of various psychosocial treatments for other mental health disorders, Linehan found that the focus on cognitive and behavioral changes in other forms of treatment led many patients to feel invalidated or misunderstood.

Because of this, she instead focused her DBT treatment intervention on acceptance of yourself, your emotions, your thoughts, and the world.


What Are DBT Skills in a Nutshell?

The four main skills of DBT include:

  • Mindfulness
  • Interpersonal Effectiveness
  • Emotion Regulation
  • Distress Tolerance
4 Main Skills of DBT

Does DBT Rewire Your Brain?

Research suggests that DBT can change the brain and the way people think.

It is considered one of the most effective treatments for borderline personality disorder because of its effect on the brain and mind.


Can I Teach Myself DBT Skills?

There are some DBT skills that you can work on yourself or can do outside of therapy.

But, if you are just starting, it is generally considered to be most effective with the help of a therapist.


Who is DBT Not Recommended For?

Like any other treatment approach, DBT does not work the same for everyone.

It is also not recommended for individuals with intellectual disabilities or psychotic disorders.

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DBT Coping Skills

What is DBT Skills Training?

DBT skills training is commonly done in a group setting, which helps teach individuals behavioral skills and how to implement them in their everyday lives.

The 4 skills that are focused on are mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.


How Often Should DBT Be Done?

The frequency and length of time DBT is done are dependent on each individual and their unique needs.

There is a certain level of commitment when it comes to DBT, so it is often done in weekly sessions, for about 1 hour each.


What Are the 5 Areas of Dysregulation in DBT?

Individuals with BPD commonly exhibit 5 areas of dysregulation that DBT addresses, which include:

  • Emotion dysregulation
  • Cognitive dysregulation
  • Behavioral dysregulation
  • Interpersonal dysregulation
  • Self-dysregulation
The 5 Areas Of Dysregulation In DBT infographic

What Strategies Are Used in DBT?

The four strategies used in DBT are centered around acceptance and change.

Acceptance-focused strategies include mindfulness and distress tolerance, while change-focused strategies involve emotion regulation and interpersonal effectiveness.


What Are the Disadvantages of DBT Therapy?

When considering DBT therapy, it is important to address the pros and cons, ask questions, and discuss it with your healthcare provider or a mental health professional.

One disadvantage of DBT is that it can take some time. For someone looking for a quick change, DBT may be frustrating, or it may seem that it is not working.

Along with the length of DBT is the level of commitment. The outcome of treatment is impacted by how committed a person is and how willing they are when they step into therapy.


What Are the Benefits of DBT?

DBT is an evidence-based treatment approach that can improve the health and well-being of many individuals.

It can help a person learn how to manage and regulate their emotions, improve their communication skills with others, increase self-worth, and reduce the symptoms of stress, anxiety, and depression, among many other benefits.

Benefits and Disadvantages of DBT Infographic

DBT Communication Skills

What Are DBT Skills For Effective Communication?

Some of the most common effective communication skills taught in DBT include:

  • Expressing how you feel
  • Speaking up about what you want
  • Being confident and assertive
  • Reinforcing
  • Being willing to negotiate or come to an agreement
  • Practicing mindfulness
DBT Skills for Effective Communication

What Are the Two Communication Styles Balanced in DBT?

The two communication styles primarily balanced in DBT include reciprocal communication and irreverent communication.

Reciprocal communication involves the therapist’s attention to the individual they are working with and prioritizing their concerns when treating them.

With reciprocal communication, the therapist not only communicates as a therapist but as their authentic self as well.

Irreverent communication is used to shift emotions, thoughts, or behaviors.


What Are Examples of Effective DBT?

An example of effective communication skills from DBT could be a conversation between a parent and their adult child.

The adult child has been feeling that their parent is treating them like a child and crossing boundaries, so they decide to speak up for themselves.

Their body language shows they are confident, they express how they have been feeling, they are clear about their thoughts and the boundaries that they are setting, and they are open to having a conversation about it and listening to their parent.

Example of effective DBT communication Infographic

DBT Skills List

What Are the 4 Skills Taught in DBT?

The 4 skills taught in DBT are:

  • Mindfulness
    Mindfulness is centered around being present in what is happening now and can help a person gain insight and can help a person learn how to cope with stress and other difficult feelings.
  • Distress Tolerance
    Distress tolerance can help cope with difficult situations and involves reacting less to distress.
  • Interpersonal Effectiveness
    Interpersonal effectiveness can help build and maintain healthy relationships with both yourself and others. These skills can teach a person how to communicate effectively, set boundaries, and respect others.
  • Emotion regulation
    Emotion regulation focuses on controlling your emotions rather than your emotions controlling you. It can help a person learn how to accept their emotions and how to build healthy coping mechanisms.


What Are the 5 Essential Functions of DBT?

The five essential functions of DBT are:

  1. Motivating the individual
  2. Teaching skills
  3. Improving the skills of the therapist
  4. Generalizing skills to the natural environment
  5. Structuring the treatment environment
5 Essential functions of DBT Infographic

What is the Easiest DBT Skill?

Learning to self-soothe is considered one of the easiest DBT skills to practice in your everyday life.

Self-soothing involves calming yourself and your emotions through various techniques that are unique to each individual.

Grounding and practicing mindfulness are ways to bring yourself to the present moment and become more aware of your physical surrounding instead of becoming stuck on what is happening internally.

Some people may meditate, others may take a shower or spend time with their pet, but everyone self-soothes in different ways.


What is the Most Effective DBT Skill?

Radical acceptance is a DBT skill many people have found impactful and effective.

With radical acceptance, a person can learn how to let go of reality and an attachment to pain. Radical acceptance involves accepting the things that you do not have control over.

Doing this can help a person end a lot of suffering from attachment to pain.


In What Order Should DBT Skills Be Taught?

The first DBT skill that should be taught is mindfulness.

Followed by distress tolerance, emotion regulation, then interpersonal effectiveness.

However, these skills may be taught in a different order depending on the therapist and the needs of the individual.

DBT Mindfulness Skills

What Are DBT Mindfulness Skills?

DBT mindfulness skills involve:

  • Observing
  • Describing
  • Participating in the present moment

When performing these actions, it is also important to do so non-judgmentally, to do one thing at a time, and to do what works best for you.


How Many Mindfulness Skills Are in DBT?

Mindfulness skills in DBT are broken up into “what” and “how” skills.

There are 6 skills that are focused on when discussing mindfulness in DBT. The “what” skills include observing, describing, and participating at the moment.


How Does DBT Use Mindfulness?

Mindfulness is used in DBT as a skill that can help a person find acceptance and learn to manage their emotions to find relief and calmness.

Practicing mindfulness helps bring a person to the present moment and takes attention away from any worries from the past or about the future. It allows you to be aware and practice gratitude as well

The “how” skills are non-judgemental, one-mindfully, and effective.

Practicing Mindfulness for DBT

What Are Distress Tolerance Skills in DBT?

In DBT, distress tolerance skills focus on developing healthy coping mechanisms to use when faced with difficult feelings or situations.

Common distress tolerance skills in DBT include:

  • TIP
    The TIP skill uses temperature changes, intense exercise, and paced breathing to help calm the mind and regulate emotions.
  • STOP
    STOP stands for stop, take a step back, observe, and proceed mindfully. This is especially helpful in high-stress situations.
  • Half smile
    The “half smile” technique involves making a “Mona Lisa smile” in order to relax the face and help regulate emotions.
  • Willing hands
    The “willing hands” skill involves relaxing the arms and turning the palms upward to communicate openness and receptiveness to the environment.
  • Radical acceptance
    Radical acceptance emphasizes accepting difficult situations without judgment and recognizing that some emotionally stressful things may be out of the patient’s control.
Distress Tolerance Skills In DBT infographic

What is an Example of Distress Tolerance?

An example of distress tolerance can be seen in a scenario where a person is feeling overwhelmed. Maybe they are having a difficult time at school or work or just argued with their partner.

Instead of automatically responding to the stressful situation impulsively, the person takes a step back to take a mental break. They possibly go outside, go in the bathroom to splash their face with water, or use breathing techniques to calm down and become more present.


What is the Goal of DBT Distress Tolerance?

With distress tolerance in DBT, the goal is to accept the things you cannot control and focus your attention on the present and the things that are in your control.


What Are DBT PTSD Techniques?

DBT can be helpful for individuals living with Post-traumatic stress disorder (PTSD).

With PTSD, trauma triggers a person’s distress and can make it very difficult to regulate emotions and cope with difficult memories, feelings, and situations.

When DBT is used to help treat PTSD, techniques like mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness can help a person learn to become more aware of themselves, tolerate and cope with stress, regulate emotions, and build healthy interpersonal relationships.

What is the goal of DBT distress tolerance infographic

DBT Emotional Regulation Skills

What is Emotion Regulation Skill in DBT?

Common emotion regulation skills used in DBT include:

  • Reality checking
  • Emotion acceptance
  • Opposite action

Emotion regulation skills in DBT can help you gain control over your emotions.


What Are the Stages of Emotional Regulation?

The process of emotion regulation includes:

  • Situation selection
  • Situation modification
  • Attention deployment
  • Cognitive change
  • Response modification
What Are The Stages Of Emotional Regulation infographic

What Are Examples of Emotional Regulation Strategies?

An example of emotion regulation strategies is learning to accept your emotions.

If a person is upset, instead of ignoring it and trying to push it to the side so they can get things done, they begin to accept their emotions and give themselves time to process it.

They may do this by practicing breathing techniques, taking a break outside, or writing out their feelings.

If they would have ignored it, they may build up their emotions that end up resulting in anger or conflict.


What Causes Poor Emotional Regulation?

Different factors can impact emotion regulation, including:

  • Experiencing traumatic events
  • Stress
  • Personality traits


How Do You Teach Emotional Regulation?

Different ways to help teach emotion regulation to both children and adults are by:

  • Asking them how they feel and validating their emotions
  • Teaching them how to talk about their emotions
  • Modeling healthy emotion regulation
  • Talking about your own emotions

DBT Interpersonal Effectiveness Skills

What Are the DBT Interpersonal Effectiveness Skills?

Some of the interpersonal effectiveness skills that are focused on in DBT include:

  • DEAR MAN skill
    Which stands for describe, express, assert, reinforce, mindfulness, appear confident, and negotiate.
  • GIVE
    Which stands for gentle, interested, validation, and easy manner.
  • FAIR
    Involves fairness, no apologizing, sticking to your values, and truthfulness.
  • Boundary building
    Learning, identifying, understanding, and communicating your boundaries is important to interpersonal effectiveness in relationships.
Interpersonal Effectiveness Skills Infographic

How Do You Practice Interpersonal Effectiveness in DBT?

Interpersonal effectiveness skills in DBT help individuals in building self-respect and improving and maintaining healthy relationships.

You can practice interpersonal effectiveness skills by communicating your feelings and desires in a clear and confident way.

Communicating also involves being a good listener and open to hearing another side. But, it is also important to set clear boundaries and stick to your values.


What are Examples of Interpersonal Effectiveness Skills?

Examples of interpersonal effectiveness skills can include setting boundaries, being able to describe exactly what you need, not being afraid to express your emotions, and validating others’ feelings.


What is the DBT Triangle of Interpersonal Effectiveness?

Interpersonal effectiveness skills in DBT have 3 main goals:

  • Objective effectiveness, which involves getting what you want
  • Connection effectiveness, which includes improving and maintaining relationships
  • Self-respect effectiveness, which focuses on self-respect
DBT Triangle of Interpersonal Effectiveness infographic

DBT Stop Skills

What Are STOP Skills in DBT?

The STOP skill in DBT consists of 4 steps:

  1. Stop
  2. Take a step back
  3. Observe
  4. Proceed mindfully


What Are STOP Skill Examples?

STOP skills can be used in many different settings.

For example, if a person is faced with a situation that makes them angry, they can physically stop what they are doing and intentionally not act on their urges.

Next, they would take a step back. This can mean they remove themselves from the situation or go outside and talk a walk for a little while.

Then, they observe what is happening around them. Becoming aware of each sense can help bring clarity and calmness to the thoughts and feelings a person has. They might pay attention to the sounds they hear, the smells around them, or their feelings about their surroundings.

Finally, they proceed mindfully. After taking the time to ground themselves and calm down, they move forward and make a decision on how to handle the situation, whether it is talking with the person, taking space from them, or just doing what is best for their mental health conditions.

STOP Skills Example Infographic

How Do You Practice STOP Skills?

You can practice STOP skills whenever you are faced with difficult emotions or situations that make you want to act impulsively.


What Type of Skill is the STOP Method?

The STOP method is a distress tolerance skill used in DBT.

DBT Skills for Teens

What are the DBT Techniques for Adolescents?

DBT techniques can be helpful for adolescents who may be facing challenges with anxiety, depression, self-harm, and other problems.

When DBT is used for adolescents, caregivers or family members can play an important role in DBT skills training.

Along with the other four DBT skill modules (mindfulness, interpersonal effectiveness, distress tolerance, and emotional regulation), DBT for teens includes an additional module called the middle path.

This skill module can help decrease conflict between family members to help improve the outcome of therapy sessions.

Adolescent DBT Techniques Infographic

What is DBT Distress Tolerance Skills for Children?

Common DBT distress tolerance skills for children can include:

  • Radical acceptance
  • STOP skill
  • TIP skill


What is the Stop Skill in DBT Kids?

The STOP skill can help kids manage difficult emotions and situations by stopping, taking a step back, observing, and proceeding with a clear mind.


You have questions. We have answers.

Our goal is to provide the most helpful information. Please reach out to us if you have any additional questions. We are here to help in any way we can.

In DBT, radical acceptance is when one acknowledges the things that are out of their control and stops fighting reality.

Radical acceptance relates to the idea that suffering doesn’t come from pain but rather from holding on to pain.

Cognitive Behavioral Therapy (CBT) is similar to mindfulness in how it looks at how thoughts, feelings, and behaviors are connected.

However, DBT focuses more on emotion regulation, mindfulness, and learning acceptance.

The 24-hour rule is applicable when a person self-harms or makes a suicide attempt.

If this happens, a DBT therapist will not provide you with phone coaching or calls after you have engaged in self-harming behaviors.

This rule is set in place so that harmful behaviors are not reinforced.

Some of the most popular and highly reviewed DBT worksheets and workbooks include:

  • The Dialectical Behavior Therapy Skills Workbook – Matthew Mckay, Jeffrey C. Wood, and Jeffrey Brantley
  • The Mindfulness Solution For Intense Emotions: Take Control Of Borderline Personality Disorder With DBT- Cedar R. Koons and Marsha M. Linehan
  • DBT Made Simple: A Step-By-Step Guide to Dialectical Behavior Therapy– Sheri Van Dijk

DBT workbooks can be very helpful in learning how to implement the skills that you learn in therapy and better understanding the ideas.

Many therapists recommend the use of DBT workbooks outside of individual therapy or group therapy.

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Dialectical behavior therapy (DBT) is an evidence-based therapeutic approach that focuses on acceptance and change. Sandstone Care is here to support teens and young adults with mental health and substance use disorders.