DBT Worksheets: 8 Printable Skills Worksheets by Module

If you're looking for DBT worksheets to give a client this week, this page is built to be printed. It starts with a short overview of the four DBT skill modules, then gives you eight short worksheets we wrote ourselves: two each for mindfulness, distress tolerance and emotion regulation, one for interpersonal effectiveness, and a weekly practice log that works with all of them. Print this page or save it as a PDF, and fill in the first worksheet together in session. For a one-line description of every skill and an acronym key, see our DBT skills list.

After the worksheets comes the part for you: which worksheet fits which problem, how to use worksheets between sessions so clients actually practice, how to adapt them for teens, how to document skills practice in a progress note, and when a worksheet is the wrong tool.

About these worksheets. The skills on this page come from Marsha Linehan's dialectical behavior therapy (DBT). Our explanations are based on her DBT Skills Training Manual, 2nd edition (Guilford Press, 2015); Guilford published a revised edition in 2025 that keeps the same skills. Linehan's handouts and worksheets are copyrighted, and we don't reproduce them. The wording and layout of every worksheet here are our own, kept short so a client can fill one in in a few minutes.

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

How to print this page or save it as a PDF

The four DBT skill modules in brief

Linehan developed DBT for adults with chronic suicidal behavior, many of whom met criteria for borderline personality disorder, and the National Institute of Mental Health refers to it as an established treatment for that disorder (NIMH). In comprehensive DBT, skills are taught like a class, usually in a weekly group, while individual therapy helps the client use them in their own life.

The skills sit in four modules. Two lean toward acceptance: mindfulness and distress tolerance. Two lean toward change: emotion regulation and interpersonal effectiveness. The 2015 edition also added general skills for orienting clients to skills training and for analyzing behavior, such as chain analysis.

Mindfulness

The core module. Clients learn to notice what's happening inside and around them without judging it, so they can choose a response instead of reacting on autopilot. In a standard skills group it's taught again before each of the other modules, so clients keep coming back to it.

Distress tolerance

Getting through a crisis without making it worse, and accepting what can't be changed right now. These skills don't solve the problem. They stop the client from adding a new one.

Emotion regulation

Understanding emotions, changing the ones that don't fit the situation or don't help, and becoming less vulnerable to emotion mind in the first place.

Interpersonal effectiveness

Asking for what you want and saying no, while keeping the relationship and your self-respect.

Our DEAR MAN worksheet and therapist guide covers this module in depth, with example scripts and a role-play method.

What the 2025 revised edition changed. In August 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 throughout, including more inclusive language and changes that reflect technology and daily life. The handouts book now groups each skill's handouts and worksheets together (Guilford Press). Skill names on this page follow the 2015 edition.

Mindfulness worksheets: wise mind check-in and observe and describe

Worksheet 1: Wise mind check-in

Sometimes your feelings are in charge: urges are loud and the facts get blurry. That's emotion mind. Sometimes you're all logic: facts and plans, with no room for what you feel. That's reasonable mind. Wise mind is where the two meet. You know what you feel, you know what's true, and you can choose what to do. Everyone has a wise mind, even when it's hard to reach.

Use this when you're stuck on a choice, or when you notice you're swinging between "I don't care" and "I can't stand this".

Now slow down. Sit with your feet on the floor. Breathe in, then breathe out a little longer, three times. Ask yourself quietly: "Holding both of these, what do I know is right here?" Then wait and listen for a minute, instead of arguing it out.

If no answer comes, that's fine. You can try again later. Wise mind can't be forced.

Worksheet 2: Observe and describe, one minute a day

Observing means simply noticing: a sound, a taste, a feeling in your body, a thought passing through, without trying to change it. Describing means putting what you noticed into words, using facts only. Practice with ordinary things when you're calm, so the skill is there when feelings run high.

How to do it:

My practice:

Distress tolerance worksheets: STOP practice and TIPP plan

Worksheet 3: STOP practice

STOP is for the moment a strong urge hits and you're about to act on it: send the text, say the cutting thing, walk out, quit, or hurt yourself. It buys you a few seconds to choose.

Plan it before you need it:

After you use it:

Worksheet 4: My TIPP plan

When an emotion is so strong you can't think, talking yourself down rarely works. TIPP skills work through your body to bring the intensity down quickly, so that you can think again and use your other skills. Fill this plan in when you're calm, so you don't have to work it out in the middle of a crisis.

Check with a doctor first if you have a heart problem or another medical condition, take medicine that affects your heart rate, or have an eating disorder. Very cold water slows your heart rate quickly, and hard exercise speeds it up. Never put ice directly on your skin; wrap it in a cloth.

T, Temperature. Cold on your face can calm your body quickly. Hold your breath, lean forward and put your face in a bowl of cold water, or hold a cold pack or a bag of ice wrapped in a cloth over your eyes and cheeks, for up to 30 seconds.

I, Intense exercise. Short, hard movement burns off the energy a strong emotion builds up: running, fast stairs, jumping jacks, dancing hard. Do it for as long as you safely can, even a few minutes.

P, Paced breathing. Slow your breathing right down and make each breath out longer than the breath in, for example in for 4 and out for 6. Keep going for one to two minutes.

P, Paired muscle relaxation. As you breathe in, tense one group of muscles (fists, shoulders, face) for about five seconds. As you breathe out, let go, and notice the difference.

Putting it together:

After you use it:

Emotion regulation worksheets: check the facts and opposite action

Worksheet 5: Check the facts

Emotions are often a fair response to what's going on. Sometimes, though, they're responding to a guess about what happened, or they're much bigger than the situation calls for. Checking the facts helps you tell which it is. It isn't about deciding your feelings are wrong.

Worksheet 6: Opposite action log

Every emotion comes with an urge. Fear says avoid. Anger says attack. Sadness says pull away. Shame says hide. When an emotion doesn't fit the facts, or acting on it would make things worse, doing the opposite of the urge can turn the emotion down. Check the facts first (Worksheet 5).

Some examples:

Do it all the way. Opposite action works best when your body, face, voice and thoughts join in, not only your actions: approach with your shoulders down and your voice steady, not braced for the worst.

Entry 1:

Entry 2:

If the emotion doesn't drop the first time, that's normal. Opposite action usually takes repeating.

Interpersonal effectiveness worksheet: DEAR MAN prep

Worksheet 7: DEAR MAN prep

DEAR MAN helps you plan a hard conversation: asking for something, or saying no. DEAR is what you'll say. MAN is how you'll say it. Short and clear beats long and perfect.

After the conversation:

For a longer version with example scripts and a practice log, use our full DEAR MAN worksheet.

Weekly DBT skills practice log

Worksheet 8: My skills week

Skills get stronger with practice, the way a muscle does. Write down each time you use one, even if it only helped a little. If your therapist gave you a diary card, use that instead.

If you're in crisis, don't wait for your next session. Call or text 988 in the US, call 911, or go to the nearest emergency room.

End of the worksheets.

Which DBT worksheet to use when

Worksheets work best when they match the problem in front of you. A quick guide:

A common sequence for a new skills client: Worksheet 2 for a week or two, then Worksheet 3 and a TIPP plan, then check the facts and opposite action. The order matters less than teaching one thing at a time.

How to use DBT worksheets between sessions

Linehan describes three stages of learning a skill: acquiring it (knowing what it is), strengthening it (practicing with feedback until it's reliable) and generalizing it (using it in the situations where it matters). A worksheet done in your office helps with the first two. Worksheets done at home are how the third happens.

By video. If your video platform lets you share your screen, fill in the worksheet together on screen. Otherwise, ask the client to open this page and write on paper as you go, then hold it up to the camera. Send the link at the end of the session so they have it.

Adapting DBT worksheets for teens

DBT for adolescents keeps the four modules, teaches skills to teens and their caregivers together (usually in a multifamily group), and adds a fifth module, Walking the Middle Path, for the dilemmas families get stuck in. The standard reference is Rathus and Miller's DBT Skills Manual for Adolescents (Guilford Press, 2015); Guilford lists a new edition for December 1, 2026 (Guilford Press).

The evidence for teens is about DBT as a whole, not worksheets. In a Norwegian study of 77 adolescents with repeated self-harm, DBT for adolescents did better than enhanced usual care at reducing self-harm, suicidal ideation and depressive symptoms (Mehlum et al., 2014). In a US study of 173 adolescents aged 12 to 18 at high risk for suicide, six months of DBT did better than individual and group supportive therapy on suicide attempts, nonsuicidal self-injury and overall self-harm at the end of treatment; over the following six months the difference narrowed and was no longer statistically significant (McCauley et al., 2018). The authors concluded that, with two independent studies, DBT is the first well-established treatment for repeated suicide attempts and self-harm in youths.

Ways to adapt the worksheets on this page:

How to document DBT skills practice in progress notes

"Reviewed DBT homework" tells a reviewer almost nothing. A useful note names the skill, ties it to a treatment goal, and records what the client can now do.

What to record:

Phrases you can adapt:

An example in DAP format. Invented client: a 27-year-old graduate student we'll call Maya, in her sixth video session of DBT-informed individual therapy. Goal 1: reduce impulsive conflict texts. Goal 2: reduce avoidance of coursework and email from her advisor.

A treatment plan objective that this note supports: "Within 8 weeks, client will use STOP or a TIPP skill before acting on urges to send conflict texts in at least 4 of 5 recorded episodes, measured by the weekly practice log."

The same content fits other formats. In a BIRP note, the skill you taught goes under Intervention and the client's practice and ratings under Response. In a SOAP note, the client's report of practice is Subjective and the rehearsal you watched is Objective. Our DAP notes examples include a risk note written in full, and the progress notes cheat sheet lists intervention terms for skills work.

Completed worksheets and the record. If you keep a completed worksheet, or a photo of one, treat it as part of the clinical record under your record-keeping policy. Many therapists summarize the worksheet in the note and hand the paper back, so the client keeps their own practice.

DBT or DBT-informed? What the evidence supports

Comprehensive DBT has four parts: weekly individual therapy structured around a diary card, a weekly skills group that teaches new material and reviews homework, phone coaching between sessions, and a weekly consultation team for the therapists. The DBT-Linehan Board of Certification notes that adults do best when they complete the full skills curriculum twice (DBT-LBC).

Using DBT worksheets in individual therapy, without the group, coaching and team, is DBT-informed skills work. It's useful and common, but it isn't comprehensive DBT, and clients searching for "DBT" may be looking for the full program. Describe what you offer accurately on your website and in your notes ("DBT-informed skills training") unless you deliver the whole model. The DBT-Linehan Board of Certification certifies clinicians and programs that do. If you haven't trained in DBT, take a course before teaching these skills, and ask a DBT-trained colleague to look over how you're using them.

What the research shows:

None of these studies tested a worksheet. What's supported is learning and using the skills. A worksheet is a way to make that practice happen and to see whether it is happening, which is why the 0 to 10 ratings are on every page above.

When a worksheet is the wrong tool

How this works in TranqBay

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

At practice.tranqbay.health you can look through the practice website designs and their sections, such as "My approach" and "Services", where you'd describe DBT-informed work, and see the booking page a client would use.

Frequently asked questions about DBT worksheets

Before you print

Pick one client and one skill. Print the worksheet, fill in the first entry together using something from their week, agree on when they'll practice, and look at it together at the start of the next session.

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 your DBT-informed services, and the booking page clients use to book the session where you review their practice. If you're deciding whether to join, this page explains how joining TranqBay works.

For acting against an emotion's urge when the emotion doesn't fit the facts, see our opposite action DBT worksheet.

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