problem solving examples dbt

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

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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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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.”

Use the Four Options of DBT to Solve the Problem

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.

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Choosing Happiness: Exploring DBT 4 Ways To Solve A Problem

• Published By: Elsie Aviles
• Post Modified: July 2, 2024 | Originally Posted: March 17, 2024

In the journey of life, we inevitably encounter challenges and obstacles that demand our attention. How we choose to address these problems can significantly impact our well-being and overall satisfaction. Surprisingly, many individuals unknowingly gravitate towards an option that perpetuates their misery rather than seeking constructive solutions. Let’s dive into the DBT four ways for dealing with problems , as outlined by Dialectical Behavior Therapy (DBT), and how we can navigate them to cultivate happiness and resilience.

Understanding the Four Options

• Solve the Problem: This option involves actively addressing the issue at hand and seeking tangible solutions. Whether it’s improving communication in a relationship or seeking therapy for a fear, solving the problem requires taking concrete steps to overcome obstacles.
• Feel Better About the Problem: Instead of focusing solely on solving the problem, this option emphasizes finding ways to alleviate emotional distress associated with it. It involves shifting perspectives, engaging in activities that bring joy, and seeking support from others to enhance emotional well-being.
• Tolerate (or Accept) the Problem: Tolerating or accepting the problem entails acknowledging its existence without necessarily seeking to change it. It involves adopting a mindset of radical acceptance, recognizing that some aspects of life are beyond our control, and learning to coexist with them peacefully.
• Stay Miserable: Unfortunately, many individuals inadvertently choose this option by continually dwelling on their problems without taking proactive steps to address them. This mindset perpetuates a cycle of negativity, hindering personal growth and happiness.

Applying DBT 4 Ways To Solve A Problem

Let’s explore how these options manifest in real-life scenarios and how we can navigate them effectively:

Scenario 1 : Conflict in a Marriage

• Solve the Problem: Initiating open and honest communication with your partner, seeking couples counseling, or considering the possibility of ending the relationship if irreconcilable differences persist.
• Feel Better About the Problem: Engaging in self-care activities, nurturing friendships and hobbies, and reframing conflict as a normal aspect of relationships.
• Tolerate (or Accept) the Problem: Acknowledging that certain aspects of your partner may not change immediately and embracing them as they are, focusing on gratitude for the positive aspects of the relationship.
• Stay Miserable: Constantly dwelling on frustrations and grievances within the relationship, venting to friends and family without seeking constructive solutions.

Scenario 2: Fear of Flying

• Solve the Problem: Seeking professional treatment or therapy to address the fear, undergoing exposure therapy to desensitize oneself to flying-related anxieties.
• Feel Better About the Problem: Exploring alternative modes of transportation, joining a support group for individuals with a fear of flying, practicing relaxation techniques to manage anxiety.
• Tolerate (or Accept) the Problem: Fully acknowledging the fear of flying without allowing it to dictate life choices, embracing the discomfort and choosing to fly despite the fear.
• Stay Miserable: Dwelling on missed opportunities and experiences due to the fear of flying, perpetuating a sense of limitation and distress.

The Pitfall of “Yes, But…”

In evaluating these options, it’s essential to recognize the subtle trap of “yes, but…” mentality. When we respond to potential solutions with excuses or dismissals, we inadvertently choose to perpetuate our misery. Instead, adopting an open-minded and proactive approach allows us to embrace constructive change and cultivate happiness.

Embracing Happiness Through Choice

Ultimately, the key to happiness lies in our ability to consciously choose our responses to life’s challenges. By embracing the DBT 4 ways to solve a problem, we empower ourselves to navigate obstacles with resilience and optimism. Whether we opt to solve the problem, seek emotional relief, practice acceptance, or actively pursue happiness, each choice brings us closer to a fulfilling and meaningful life journey.

So, the next time you encounter a problem, remember that you hold the power to choose your response. Will you choose happiness or perpetuate misery? The choice is yours.

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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.

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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.

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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 link 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.

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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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Article feedback

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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DBT – 5 Ways to Solve a Problem

The 2nd Edition DBT Skills Training Handouts and Worksheets 2nd Edition book by Marsha M. Linehan has been a big resource for me in my DBT career. One of the first skills that is discussed is “Options for how to solve a problem” – General Handout 1

Marsha has 4 ways to solve the problem but I like how I saw it in the DBT Skills Manual for Adolescents – 1st Edition and they break it down into 5 problems.

• Solve the Problem: It sounds so easy and kinda sarcastic, but yet it is that easy. If you are cold, put on a jacket, if your hot, turn on a fan. If you know how to problem solve and fix the problem then DO IT!
• Change how you feel about he Problem: What is the emotion you are feeling from the problem? If you are mad about missing a car payment, can you change how you “feel” about the situation. Such as validate the anger and then change the anger to sadness then disappointment and then graduate for just missing one payment.
• Radically Accept the Problem: Sometimes we can not fix the problem due to many reasons, but its keeping you in a miserable state to not accept that it is indeed a problem and that it has happened. “Acceptance is not approval” and it may feel radical to not stay caught up in the negativity of the problem.
• Stay Miserable: This is ALWAYS an option! You have a right to feel your feels and wallow in emotion. Sometimes if we stay miserable we can continue to be the “victim” and tell our story to others and get the benefit of being validated over and over. Yet, I want you to know you have a choice.
• Make it worse: Yes, havn’t you ever thought ” it cant get any worse” and then it does by your own hand? Such as, waking up late for work, rushing around, speeding, then you get a ticket, and then you get to work and get yelled at by your boss or possibly written up. It really can get worse, by your own hand! You have control to make it worse and to make it better.

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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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15 Printable DBT Worksheets and Handouts

Are you feeling overwhelmed by emotions? Do you need help managing difficult situations? You're not alone. DBT worksheets can help you navigate challenges and build a more fulfilling life.

With our printable DBT worksheets and handouts, you can learn to unmask your emotions, master mindfulness, regulate your emotions, build healthy relationships, and embrace radical acceptance.

What are DBT Worksheets?

DBT worksheets are written exercises that clearly and concisely explain core DBT skills, such as identifying and challenging unhelpful thought patterns. They also offer practical activities to help you learn and practice these skills, such as filling out charts, journaling prompts, and roleplaying scenarios.

As a whole, DBT worksheets are a type of self-help tool that helps individuals learn the basics and identify areas to focus on during therapy sessions.

What are DBT Worksheets Used For?

DBT worksheets are used for various purposes throughout DBT therapy and can be helpful for both therapists and clients.

For clients, DBT worksheets impart essential DBT skills and provide practical exercises to solidify various lessons. They often include prompts for self-reflection, helping clients identify areas for improvement and track their progress over time.

On the other hand, therapists can use DBT worksheets to guide sessions and introduce new skills to clients. They can also use DBT worksheets as “homework,” allowing clients to practice their newfound skills outside therapy settings.

Incorporating DBT worksheets into your therapy sessions and daily life can help you overcome challenging situations and emotions. Here are 15 of our most helpful worksheets and handouts. Many of our worksheets have corresponding handouts to further describe the DBT skill being presented, so don’t forget to check out our entire collection of DBT worksheets and handouts on our site.

1. What Is DBT?

Answering the question “What is DBT?” can help you set realistic expectations for yourself and your therapy sessions. Our handout comprehensively explains the components and benefits of DBT, setting a better scene for clients to maximize its advantages and identify specific goals.

Download it here

2. DBT What Makes It Hard To Regulate Emotions

When you understand what makes it hard to regulate emotions, you can begin challenging these factors and improving your mindset. Our handout dives deep into factors like biology and genetics, moodiness, emotional overload, and lack of skills and provides information to increase awareness and understanding.

3. DBT SMART Goals Worksheet

Once you’ve gauged your emotion regulation skills and identified areas of improvement, it’s time to set SMART goals. DBT SMART goals are:

Setting SMART goals can help increase focus and direction, enhance motivation, and improve collaboration between clients and therapists.

4. DBT Check the Facts

Our emotions can cloud our judgment, especially when intense and overwhelming. We can avoid reacting to assumptions and jumping to conclusions by pausing to check the facts.

Checking the facts also promotes better decision-making and reduces conflict among the people involved. Taking the time to verify information demonstrates respect for others and fosters trust in relationships.

Our handout asks clients to reflect on what is true about the situation and what may need clarification.

5. DBT Thinking Errors

Identifying thinking errors and cognitive distortions can improve emotional regulation as individuals gain the power to challenge these thoughts. Individuals can also develop a more compassionate inner voice and replace negative thoughts with more helpful ones.

Our handout enumerates and explains the common thinking errors a person might experience and encourages clients to question their assumptions.

6. DBT Pros and Cons Worksheet

When you encounter a challenging situation, you may wonder whether acknowledging and coping with the stressor is worth it. This DBT worksheet of pros and cons helps you weigh the negative and positive consequences of acting on the crisis urge and encourages you to reflect on what steps to take.

7. DBT Mindfulness Skills

Mindfulness plays a crucial role in DBT. In fact, mindfulness is the foundation upon which DBT skills are built.

Our mindfulness skills handout explains these components and provides practical tips for improving distress tolerance, breaking emotional reactivity, and increasing self-awareness. It breaks these lessons into “how” and “what” skills, providing examples like breathing exercises and relaxing the muscles.

8. DBT Emotion Regulation Skills

Emotion regulation skills enable individuals to develop healthy ways to manage their emotions, particularly intense and overwhelming ones. Our handout breaks down critical aspects of emotion regulation and proposes exercises to help people better understand their feelings, validate them, decrease vulnerabilities, and develop strategies for change.

9. Self-Soothe DBT Worksheets with 6 Senses

Our nervous system becomes aroused during emotional distress, leading to a "fight-or-flight" response. This response can manifest in physical symptoms like increased heart rate, sweating, and muscle tension. Soothing the six senses in DBT helps activate the body's relaxation response, counteracting the adverse effects of distress and promoting emotional regulation.

For instance, a recent study showed that exposure to nature-related imagery reduced stress and anxiety in participants [ * ]. Similarly, another study found that listening to classical music provided the same stress relief [ * ].

Our self-soothe DBT worksheets with six senses suggest activities for each sense and encourage individuals to participate in sensory or movement-based healing.

10. Behavior Chain Analysis DBT Worksheet

The behavior chain in DBT, or functional analysis, is a technique for identifying the sequence of events and internal experiences leading to problematic behavior. Our behavior chain analysis DBT worksheet describes how to perform this analysis, visualizing the chain like a series of interconnected links.

For example, these elements might include:

• Vulnerability factors
• Precipitating events
• Body sensations
• Consequences

Individuals can identify these links and identify potential points of intervention, reducing vulnerability factors, managing triggers, and challenging negative thoughts.

11. DBT Positive Affirmation Cards

An activity as simple as reciting positive affirmations can do wonders for the human psyche. Positive affirmations can boost self-esteem, increase motivation, challenge negative thinking patterns, and support distress tolerance when used alongside other core skills.

Our positive affirmation cards include practical and easy-to-remember sayings you can place in your office, bedroom, or anywhere you can repeat them to yourself.

12. Radical Acceptance Coping Statements Worksheet

Imagine your child does poorly on an exam. Fighting against this reality (e.g., blaming themselves, dwelling on "what ifs") will likely lead to increased distress. However, by radically accepting the situation, they can start to focus on what they can control—finding more productive ways to study or getting a tutor.

Radical acceptance in DBT isn’t just about passively accepting everything—it’s about acknowledging reality with wisdom and compassion, reducing self-blame, improving problem-solving skills, and promoting emotion regulation.

Our radical acceptance coping statements worksheet includes positive ones, encouraging individuals to adopt a more optimistic perspective.

13. DBT Journal Prompts

Journaling is a powerful tool throughout DBT for tracking emotions, expressing difficult ones, challenging negative thoughts, practicing gratitude, reflecting on interactions, and preparing for difficult conversations.

Our DBT journal prompts ask clients to reflect on the following:

• How they feel in the moment
• Changes they’ve observed in their emotional responses to stressors
• DBT skills they want to practice more
• A time they endured a difficult situation

14. DBT Cheat Sheet

DBT involves dozens of moving parts that can be challenging to reference in one moment. Our DBT cheat sheet provides a quick reference for techniques clients can apply to difficult situations, such as the PLEASE technique for emotion regulation, the STOP technique for distress tolerance, and “what” and “how” skills for mindfulness.

15. DBT Walking the Middle Path

Walking the middle path means balancing two seemingly opposite extremes in your thoughts, emotions, or behaviors. It's a core concept emphasizing the importance of avoiding "all-or-nothing" thinking and navigating situations more nuanced and flexibly.

Our handout for walking the middle path encourages clients to find a balance between opposite ideas. For instance, it encourages students to balance work and rest and individuals to care about themselves while caring about others.

Frequently Asked Questions

Can i use dbt worksheets on my own, without a therapist.

Despite limitations, you can use DBT worksheets independently without a therapist. Therapists provide crucial guidance. They can tailor DBT to your specific needs, explain new concepts, and help you identify and address unhelpful thinking patterns that may arise while using worksheets.

How often should I use DBT worksheets?

DBT worksheets offer a flexible approach. Depending on your goals and learning style, you can use them as frequently as you want. It's recommended to start with a manageable pace, such as one or two worksheets a week, and adjust as needed.

After completing a worksheet, reflecting on what you’ve learned is essential. This step is crucial in reinforcing your understanding and applying the concepts in real life. Take the time to consider how the worksheet has impacted your thoughts and behaviors.

Are DBT worksheets effective for everyone?

Research suggests that DBT worksheets can be practical for people struggling with various mental health conditions [ * ]. However, the effectiveness of DBT worksheets alone may vary due to individual differences and the severity of the problem.

The Bottom Line

Remember, change takes time and practice. However, regularly using our printable DBT worksheets and handouts can help you build a more resilient and emotionally healthy you!

Explore our entire collection of DBT worksheets and handouts covering mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.

• Ewert A, Chang Y. “Levels of Nature and Stress Response.” Behavioral sciences, 2018.
• Wazzan M, Estaitia M, Habrawi S, et al. “The Effect of Music Therapy in Reducing Dental Anxiety and Lowering Physiological Stressors.” PubMed, 2022.
• Peprah K, Argáez C. “Dialectical Behavioral Therapy for Adults with Mental Illness: A Review of Clinical Effectiveness and Guidelines.” Nih.gov, 2017.

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Mindfulness

Distress Tolerance

Emotion Regulation

Interpersonal Effectiveness

Miscellaneous

Check the Facts

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.

The facts of any given situation aren’t necessarily what causes us distress. It is more often our interpretation of the situation or thoughts or emotions related to it that cause the upsetting emotions we experience as distress. An event happens and we start having thoughts and feelings about it, which sometimes can warp our memory of the original facts of the situation.

For example, maybe you were expecting a call from your sister on Wednesday but she didn’t call. You feel disappointed, sad, and a little rejected. You may say to yourself, “my sister never calls” because it certainly feels that way. However, if you check your phone, you’ll see that she called you last week. 

Checking the facts is an important first step to use when there’s an emotion you want to change.

HOW TO CHECK THE FACTS

Ask yourself these 6 questions to Check the Facts

• What emotion do you want to change?
• Describe what you observed with your senses
• Challenge judgments and black and white thinking
• What are other interpretations of the event? 
• Look at other points of view.
• Label the threat & assess the possibility of it occurring
• Think of other outcomes
• Imagine it occurring and you coping with it well
• Ask Wise Mind

Your Emotions Fit the Facts If….

• Example: you shoplift an item you don’t need and you consider yourself a law-abiding person
• Example: your child spent all the money in your savings fund for a new car
• Example: You are punched in a fight
• Example: Someone accuses your friend group of all being liars
• Example: Jenny got the promotion you wanted instead of you
• Example: You love your partner and they make you happy and improve your life
• Example: You love doing math and you want a job in accounting
• Example: Your mother is diagnosed with cancer
• Example: you touch rat poison
• Example: someone who assaulted you hugs your friend
• Example: You’re in a car being driven by someone who is intoxicated
• Example: Your mother says she’s giving her jewelry to your sibling, not you
• Example: Your ex-partner says they are taking your shared cat with them
• Example: someone you love has died
• Example: you become disabled and are no longer able to live abroad as you once planned

Intensity and duration of an emotion are justified by…

• How likely it is that what you expect will actually happen
• How important that outcome is to you
• How effective the emotion you’re feeling is in your life right now

Opposite to Emotion Action

Pleasant activities, problem solving, increasing positive emotions, managing extreme emotions, nightmare protocol, 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

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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