Dialectical behavior therapy (DBT) teaches four sets of skills: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Psychologist Marsha Linehan developed it for people with intense, fast-changing emotions, and the skills are now taught much more widely. This page lists the main skills in each module and says when each one is useful.
What DBT is, in two sentences
DBT is a structured therapy that combines acceptance ("this is how things are right now") with change ("and here is what I can do differently"). Full DBT includes individual therapy, a weekly skills group and coaching between sessions; the skills below are the part taught in the group.
A 2020 Cochrane review of psychological therapies for borderline personality disorder found that DBT may reduce symptom severity and self-harm compared with usual treatment, though the certainty of the evidence was low.
The four modules at a glance
Mindfulness skills
Wise Mind. The overlap between "emotion mind" (driven by feelings) and "reasonable mind" (driven by facts). The skill is pausing to ask what both would say together.
What skills: Observe, Describe, Participate. Notice an experience, put words on it, then enter fully into what you are doing.
How skills: Non-judgmentally, One-mindfully, Effectively. Describe without labelling good or bad, do one thing at a time, and do what works rather than what feels "right".
Distress tolerance skills
STOP. Stop, Take a step back, Observe, Proceed mindfully. For the first seconds of an urge to act on impulse.
TIPP. Temperature (cold water on the face), Intense exercise, Paced breathing, Paired muscle relaxation. Fast, body-based ways to bring arousal down. If you have a heart condition or another medical problem, check with a doctor before using cold water or intense exercise.
ACCEPTS. Activities, Contributing, Comparisons, Emotions (opposite ones), Pushing away, Thoughts, Sensations. Short-term distraction until the wave passes.
Self-Soothe. Comforting each of the five senses on purpose.
Radical Acceptance. Fully acknowledging a painful fact you cannot change, so that you stop adding struggle on top of pain. Acceptance here is not approval.
Emotion regulation skills
Check the Facts. Ask whether the emotion and its intensity fit what actually happened, as opposed to your interpretation of it.
Opposite Action. When an emotion does not fit the facts, or acting on it would not help, do the opposite of what it urges: approach instead of avoid, be gentle instead of attack.
ABC PLEASE. Accumulate positive experiences, Build mastery, Cope ahead; and look after the body: treat Physical iLlness, balanced Eating, avoid mood-Altering substances, balanced Sleep, Exercise.
Interpersonal effectiveness skill
DEAR MAN for making a request or saying no: Describe, Express, Assert, Reinforce; stay Mindful, Appear confident, Negotiate.
GIVE for keeping the relationship: be Gentle, act Interested, Validate, use an Easy manner.
FAST for keeping self-respect: be Fair, no unnecessary Apologies, Stick to your values, be Truthful.
Which skill for which moment
Learning DBT with and without a therapist
The skills are written to be practised, and many people learn them from workbooks, classes or apps. Self-study is practice, not treatment. If you are dealing with self-harm, suicidal thoughts or emotions that regularly feel unmanageable, the skills work best inside a DBT programme with a trained clinician.
If thoughts, rather than urges, are the main difficulty, a CBT thought record is the matching tool from cognitive behavioral therapy.
Frequently asked questions
How many DBT skills are there? There is no single official count. Linehan's skills manual groups the skills and their sub-skills into the four modules, and the total depends on how the sub-skills are counted.
Can I learn DBT skills on my own? You can learn and practise individual skills on your own. That is different from receiving DBT, which includes therapy and coaching.
Who is DBT for? It was developed for people with borderline personality disorder and chronic suicidal thoughts. The skills are also taught to people who want better tools for strong emotions and difficult conversations.
How long does it take to learn the skills? A standard skills group covers all four modules in about six months, and many programmes repeat the cycle once.
RIVA PSY walks through each skill step by step, and your entries stay on your phone. [Store link or "Notify me at launch" form]
This article is educational and is not a substitute for care from a qualified professional. If you need urgent help, see the crisis page.
Sources
Linehan, M. M. (2015). DBT Skills Training Manual, 2nd ed. Guilford Press