DBT Skills List: Every Skill by Module, for Therapists

DBT skills are the practical behaviors clients learn in dialectical behavior therapy: noticing what's happening without judging it, getting through a crisis without making it worse, changing emotions that don't fit the facts, and asking for what they need without losing the relationship or their self-respect. This page is a working reference for clinicians. It lists every skill in the four modules, plus the general skills, with a one-line description of each and a key to the acronyms. Then it covers which module to reach for with which problem, how skills training sits inside comprehensive DBT, what the research supports, and how to document skills practice in a progress note.

About this list. The skills come from Marsha Linehan's DBT Skills Training Manual, 2nd edition (Guilford Press, 2015), and skill names here follow that edition. Linehan's handouts and worksheets are copyrighted, and we don't reproduce them. Every description below is written in our own words and kept to a line, so it works as a map, not a substitute for the manual. If you want something to hand a client, our DBT worksheets are our own and printable.

Every client and example in this article is invented. Any resemblance to a real person is a coincidence.

What are DBT skills?

Linehan developed DBT for adults with chronic suicidal behavior, many of whom met criteria for borderline personality disorder. Her biosocial theory, in brief: some people are born more emotionally sensitive and reactive than others, and when that sensitivity meets an environment that dismisses, punishes or ignores their emotions, they may never learn workable ways to manage them. Behaviors such as self-harm, substance use or rage can then become the fastest way to get relief.

Skills training is the part of DBT that fills that gap. The treatment assumes that many problem behaviors come from missing skills, and teaches those skills directly, the way a class would. Researchers call this the skills deficit model, and an analysis of 108 women across three DBT studies found that increased skills use fully accounted for the drop in suicide attempts and depression (Neacsiu, Rizvi & Linehan, 2010).

"Dialectical" means holding two things that seem opposed at once, above all acceptance and change. The four modules reflect that balance. Mindfulness and distress tolerance lean toward acceptance: seeing what is, and getting through it. Emotion regulation and interpersonal effectiveness lean toward change: shifting emotions and getting different results with other people.

In 2025 Guilford published revised editions of the manual and of DBT Skills Training Handouts and Worksheets. The publisher says all skills, guidelines and examples from the second edition were kept, with updates to language and to reflect changes in technology and daily life, and that the revised handouts book has more than 225 reproducible handouts and worksheets (Guilford Press). If you trained on the second edition, the skills you teach haven't changed.

The 4 DBT skills modules at a glance

Two more pieces sit around the modules. The 2015 edition opens with general skills for orienting clients to skills training and for analyzing behavior. And DBT for adolescents, from Rathus and Miller's DBT Skills Manual for Adolescents (Guilford Press, 2015), teaches Walking the Middle Path as a fifth module for teens and caregivers together; in the adult manual, walking the middle path sits inside interpersonal effectiveness.

Guilford lists the revised manual's teaching chapters in this order: general skills, mindfulness, interpersonal effectiveness, emotion regulation, distress tolerance (Guilford Press). Programs choose their own order for teaching, so a client may meet distress tolerance first.

DBT acronyms: a quick key

DBT is known for its acronyms. Here is what each letter stands for, with a plain description in our own words. Each acronym belongs to one module.

WISE MIND (mindfulness). Not an acronym, although it's often written in capitals. Wise mind is the state where emotion mind and reasonable mind overlap: you know what you feel, you know the facts, and you can choose what to do. It also appears as a prefix, as in "wise mind ACCEPTS".

STOP (distress tolerance). For the moment a strong urge hits.

TIP, often written TIPP (distress tolerance). Fast ways to bring extreme arousal down through the body, so the client can think again. Ask about heart conditions, heart-rate medicines and eating disorders before suggesting cold water or hard exercise, and have the client check with a doctor if any apply.

ACCEPTS (distress tolerance). Ways to distract from a crisis until the urge passes.

IMPROVE (distress tolerance). Ways to make a painful moment more bearable while it lasts.

ABC PLEASE (emotion regulation). Ways to become less vulnerable to emotion mind, day to day.

DEAR MAN (interpersonal effectiveness). For getting what you ask for, or saying no. Our DEAR MAN guide has example scripts and a role-play method.

GIVE (interpersonal effectiveness). For keeping the relationship.

FAST (interpersonal effectiveness). For keeping your self-respect.

The full DBT skills list, by module

Each skill is named as it appears in the 2015 edition, followed by one line on what it does.

General skills: orientation and analyzing behavior

Mindfulness skills

States of mind

The "what" skills (what you do when practicing mindfulness)

The "how" skills (how you do it)

Other perspectives on mindfulness (added in the 2015 edition)

Distress tolerance skills

Crisis survival skills (getting through the moment)

Reality acceptance skills (living with what can't be changed now)

Skills for when the crisis is addiction (added in the 2015 edition)

Emotion regulation skills

Understanding and naming emotions

Changing emotional responses

Reducing vulnerability to emotion mind

Managing really difficult emotions

Interpersonal effectiveness skills

Getting what you want skillfully

Building relationships and ending destructive ones

Walking the middle path

Which DBT module to use when

A quick guide from the problem in front of you to the skills that usually fit. It assumes you have assessed risk first.

A common starting point in individual DBT-informed work: observe and describe for a week or two, then STOP and a TIP plan for crises, then check the facts and opposite action. The order matters less than teaching one skill at a time and practicing it until the client can use it without the sheet.

How skills training fits in comprehensive DBT

Comprehensive DBT is more than skills. The DBT-Linehan Board of Certification lists four components (DBT-LBC):

Each part has a job. The group builds new capabilities. Individual therapy builds motivation and works out why skills aren't being used, often through chain analysis. Coaching carries skills into daily life. The team supports the therapists, who are treating people at high risk. In individual sessions, the targets come in a fixed order: life-threatening behavior first, then behavior that interferes with therapy, then problems that seriously affect quality of life, while skills are built throughout.

How a skills group usually runs. Most standard groups follow the same rhythm: a short mindfulness practice, a review of each member's homework, a break, then the new skill taught and practiced, and the next practice assigned. Groups are often led by two trainers. The Linehan Institute says groups typically meet weekly "for about 2.5 hours, and it takes 24 weeks to cover the full skills curriculum," a cycle often repeated to make a year-long program (Linehan Institute). The Board notes that adults do best when they complete the full curriculum twice.

Skills-only and DBT-informed use. Many therapists teach DBT skills without the rest of DBT: a stand-alone skills group, skills woven into individual therapy, or a few skills in a broader treatment plan. That's common and can help, but it isn't comprehensive DBT, and clients searching for "DBT" may be looking for the full program. Three things change when you leave out the other parts:

Describe what you offer accurately, in your notes and on your website: "DBT-informed individual therapy" or "a DBT skills group" unless you deliver the whole model.

Running a DBT skills group in private practice

A skills group is one of the most practical ways to offer DBT skills in a small practice. Some things to settle before the first session:

What the research says about DBT skills

DBT has a substantial evidence base, but most of it tests the whole package. These are the studies most relevant to skills.

What this means in practice: teaching skills is well supported as part of DBT, and the skills appear to be part of how it works. Skills taught on their own have growing but weaker evidence, so say "DBT-informed" or "DBT skills group" and keep a risk plan, rather than presenting skills alone as the full treatment.

How to document DBT skills practice in a progress note

"Reviewed DBT skills" tells a reviewer almost nothing. A useful note names the skill and its module, ties it to a treatment plan goal, and records what the client can now do. Our progress notes cheat sheet has intervention and response wording for skills work. A skills section you can paste into any note format:

In a DAP note, the practice report and what you taught go in Data, and your reading of the client's grasp goes in Assessment. In a GIRP note, the skill you taught is the Intervention and the client's practice and ratings are the Response. Two short examples follow.

Example 1: one member's note from an online skills group. Invented client: a 34-year-old office manager we'll call Dana, in session 3 of an 8-week distress tolerance skills group. She also sees an individual therapist.

Example 2: a between-session coaching contact. If you offer skills coaching, write each contact as its own dated note, not an addition to the last session's note. Invented client: a 41-year-old carpenter we'll call Luis, in DBT-informed individual therapy for alcohol use and anger.

Phrases you can adapt:

Diary cards and worksheets in the record. If you keep a completed diary card or worksheet, or a photo of one, treat it as part of the clinical record under your record-keeping policy. Many therapists summarize it in the note and hand the paper back.

Learning to teach DBT skills: training for therapists

You don't need certification to teach a DBT skill, but you do need to understand it well enough to teach it, coach it, and know when it's the wrong tool. Options, roughly in order of depth:

Whatever your training, practice each skill yourself before you teach it. Clients can tell the difference between a therapist reading a handout and one who has used opposite action on a Monday morning.

Going deeper: DBT skills pages on this blog

This page is the map. These pages go deeper on single skills and on the tools around them:

How to describe DBT skills work on your practice website

People searching for help with intense emotions often type "DBT" and may be looking for a full program, a group, or just a therapist who knows the skills. Clear wording helps the right people book. If you run a skills group, a starting point for the "Services" section of your website:

Change the last paragraph if you do offer comprehensive DBT. If you teach skills in individual therapy instead, say so in your "My approach" section: "I teach skills from dialectical behavior therapy (DBT) in individual sessions" is accurate and specific.

How this works in TranqBay

TranqBay is practice software for therapists in private practice: a practice website, online booking, video sessions, session notes and forms in one place. Here's where DBT skills work fits.

At practice.tranqbay.health you can look through the practice website designs, including the "Services" section where you'd list a skills group or DBT-informed therapy, and see the booking page a client would use.

Frequently asked questions about DBT skills

Before your next session

Pick one client and one skill from the list that fits the problem in front of you. Teach it in session using something from their week, plan exactly when they'll practice, and write it into your note with the skill's name, module and target, so the next session starts with the review.

If you're building a practice around skills-based work, see how TranqBay works for private practice: you can browse the practice website designs where you'd describe a skills group or DBT-informed therapy, and the booking page clients use to book the sessions where you review their practice. If you're deciding whether to join, this page explains how joining TranqBay works.

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