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Dialectical Behavior Therapy: DBT Skills and Resources

DBT combines acceptance-based strategies with behavioural change methods to help people respond more effectively to intense emotions, crises and relationship difficulties.

Dialectical Behavior Therapy (DBT) was developed by psychologist Marsha M. Linehan. It is a structured form of cognitive behavioural treatment originally developed for chronically suicidal people with borderline personality disorder. DBT has since been adapted and studied for other populations, but evidence and recommended treatment format differ by condition. A worksheet or skills article is not equivalent to comprehensive DBT.

What comprehensive DBT includes

Comprehensive DBT is more than skills training. Standard programmes commonly combine individual therapy, group skills training, between-session coaching and a therapist consultation team. The exact arrangement depends on the service and population. Skills can also be taught in other formats, but those formats should be described accurately rather than presented as the full treatment.

The four DBT skills modules

Mindfulness

Practise observing, describing and participating in present experience using a nonjudgmental, one-mindful and effective stance.

Distress Tolerance

Use crisis-survival and reality-acceptance skills when immediate problem-solving is not possible or strong urges could worsen the situation.

Emotion Regulation

Understand emotions, reduce avoidable vulnerability, check facts, change ineffective action urges and solve problems when action is possible.

Interpersonal Effectiveness

Balance objectives, relationship needs and self-respect while making requests, saying no, validating and negotiating.

What the evidence supports

DBT has its strongest and most established evidence base for borderline personality disorder, recurrent suicidal behaviour and self-harm within appropriately delivered treatment programmes. NICE recommends considering a comprehensive DBT programme for women with borderline personality disorder when reducing recurrent self-harm is a priority. NICE also recommends considering DBT adapted for adolescents with significant emotional dysregulation and frequent self-harm. Adapted DBT approaches have been researched for additional problems, but findings should not be interpreted as proof that every DBT skill or worksheet treats every condition.

How to use this resource library

  • Use module pages to understand where a skill fits and what it is intended to do.
  • Use individual skill pages for steps, examples, limitations and safety guidance.
  • Use the DBT worksheet library for printable practice materials.
  • Discuss high-risk urges, trauma reactions, severe symptoms or treatment decisions with an appropriately qualified professional.

DBT is not simply positive thinking

DBT does not ask people to deny pain, suppress emotions or accept abuse. Its dialectical stance holds two ideas together: a person’s experience can be understandable as it is, and change may still be necessary. Skills are selected according to the function of a behaviour, the facts of the situation, immediate safety and longer-term goals.

References

Evidence and editorial note

Resource type: Educational overview of a DBT skill or skills module. It supports learning and practice but is not comprehensive Dialectical Behavior Therapy.

Evidence basis: Marsha M. Linehan’s DBT Skills Training Manual, Revised Edition (2025), official Behavioral Tech training information, current NICE guidance and peer-reviewed evidence reviews where treatment claims are discussed.

Review status: Written and evidence-checked by the CounselorAid editorial team. Last evidence review: 3 August 2026. No named independent clinical reviewer is being claimed. Please report factual or safety concerns through the contact page.

Important: This information cannot diagnose a condition, assess personal risk or replace care from an appropriately qualified professional. In an immediate crisis or medical emergency, use local emergency or crisis services.