Dialectical Behavioral Therapy Worksheets
This section reviews the four central components of Dialectical and Behavior Therapy (DBT), which was created by Marsha Linehan: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. These four components are critical in influencing client change and helping clients approach life in a more managed and healthy way. DBT is designed to be support oriented, cognitively based, and effective with your most difficult clients. In this section, there are five worksheets corresponding to each of the four components, and these are designed to assist in the growth and development of emotional, behavioral, and overall well-being while lessening personality disorder spectrum pathology in your clients. Many frontline clinicians do not have the time or resources to complete the extensive DBT program, but even parts of the program, such as the worksheets included in this workbook, can help clients build essential skills and attenuate problems related to personality disorders.
Mindfulness is a core component of DBT. Mindfulness skills are to be the first skills taught and comprise psychological and behavioral skills, including meditation. The worksheets presented here will help your clients gain mastery of these invaluable skills as they learn to observe, describe, and participate in the present without reacting. They will also help clients gain a better understanding of their feelings in the moment and help them stay present.
Interpersonal Effectiveness is aimed at building social potency within a wide variety of contexts. Interpersonal effectiveness is based on changing automatic behaviors that are typically triggered by repeated situations and works to develop new responses or add a greater variety of possible responses when difficult situations arise. Assertiveness and problem-solving skills are central to getting one’s needs met in a productive and healthy manner. The included worksheets address critical concepts to help clients authentically interact with the people in their life by building healthy relationships and moving away from unhealthy ones. Clients are also taught how to balance “wants and shoulds,” as well as several other key strategies.
Emotion Regulation entails managing intense and labile mood states often seen in individuals along the personality disorder spectrum. Although Linehan’s therapy was developed for BPD, it has been found to be useful with other individuals along the different personality disorder spectra. Emotion regulation is aimed at assisting the client in managing painful emotions that encourage or exacerbate acting out and other inappropriate behaviors. Worksheets included in this section include those that address identifying and working with primary and secondary emotions, replacing negative emotions, identifying painful emotions, and enhancing the ability to cope in stressful situations.
Distress Tolerance skills are designed to help the individual learn to manage painful circumstances and emotions in a more effective manner. The client is taught the skills of tolerating and accepting emotional discomfort as part of a normal and healthy life and coming to terms with change and how to “do it differently.” If these skills are not learned, clients on the borderline and other personality disorder spectra will continually be wedded to immediate reactions that thwart healthy change and growth.