Dialectical Behavior Therapy teaches skills, not just insight. They are grouped into four modules, and together they cover what to do with your attention, with a crisis, with strong emotions and with other people. This page is an overview of the core skills in each module, with a short explanation and a link to a full guide where we have one.
DBT was developed by Marsha Linehan, and the skills below follow her DBT Skills Training Manual (2nd ed., 2015). If you are new to the treatment itself, start with how DBT differs from other talk therapy or CBT vs DBT.
The Four DBT Modules at a Glance
- Mindfulness. Noticing what is happening, inside and around you, without being swept along. The core of every other module.
- Distress tolerance. Getting through a crisis without making it worse, and accepting what cannot be changed right now.
- Emotion regulation. Understanding emotions, reducing vulnerability to painful ones, and deciding whether changing an emotion or how you express it would be useful.
- Interpersonal effectiveness. Asking for what you want, saying no, and keeping relationships and self respect intact.
Two modules lean toward acceptance (mindfulness and distress tolerance) and two lean toward change (emotion regulation and interpersonal effectiveness). Holding both at once is the dialectic at the heart of DBT, explained in the dialectical philosophy under DBT skills.
Mindfulness Skills
Mindfulness is taught first and comes back between every other module, because no skill works if you do not notice the moment to use it.
- Wise Mind. The place where emotion and reasonable thinking overlap. Most DBT skills aim to help you act from here.
- What skills: observe, describe, participate. What you do when you are being mindful.
- Observe. Noticing sensations, thoughts and surroundings without words or judgment.
- Describe. Putting words on what you observe, sticking to facts rather than stories.
- How skills: nonjudgmentally, one mindfully, effectively. The way you practice: without judging, one thing at a time, and doing what works.
- Loving kindness. A practice from the other perspectives on mindfulness, for warmth toward yourself and others.
Related practice: affectionate breathing.
Distress Tolerance Skills
Distress tolerance is for moments when the pain is high and you cannot fix the problem right now. The goal is to get through without making things worse. It has two parts: crisis survival skills and reality acceptance skills. For what counts as a crisis in DBT, see defining crisis in DBT.
Crisis survival skills
- STOP. Stop, take a step back, observe, proceed mindfully. A pause before acting on an urge.
- Pros and cons. Comparing acting on the urge with resisting it, short term and long term.
- TIPP. Temperature, intense exercise, paced breathing and paired muscle relaxation, to bring extreme arousal down through the body.
- Temperature. Cool water on the face to slow the heart, the first letter of TIPP in detail.
- Wise Mind ACCEPTS. Distracting yourself with activities, contributing, comparisons, emotions, pushing away, thoughts and sensations.
- Self soothe. Comforting yourself through the five senses.
- IMPROVE the moment. Imagery, meaning, prayer, relaxing actions, one thing in the moment, vacation and encouragement.
Reality acceptance skills
- Radical acceptance. Accepting, fully and with your whole self, what you cannot change, so pain is less likely to turn into suffering.
- Turning the mind. Choosing acceptance again, each time you notice yourself fighting reality.
- Willingness. Doing what the situation needs instead of refusing or trying to control it.
- Half smile and willing hands. Using the face and hands to soften the body toward acceptance.
- Mindfulness of current thoughts. Noticing thoughts as thoughts rather than facts.
Related skills often taught alongside DBT: urge surfing, grounding techniques and box breathing.
Emotion Regulation Skills
Emotion regulation is about understanding what emotions do, lowering how vulnerable you are to painful ones, and deciding when changing an emotion, or how you express it, would actually help. If emotions often feel too big, read understanding emotion dysregulation first.
- Understanding and naming emotions. Learning what emotions are for and how to identify them in the body, thoughts and urges.
- Check the facts. Asking whether the emotion and its intensity fit what actually happened.
- Opposite action. Acting opposite to an emotion’s urge when the emotion does not fit the facts, or acting on it would not be effective.
- Problem solving. Changing the situation when the emotion does fit the facts.
- ABC. Accumulate positive emotions, build mastery, cope ahead.
- PLEASE. Treat physical illness, balance eating, avoid mood altering substances, balance sleep, get exercise.
- Mindfulness of current emotions. Riding the wave of an emotion without pushing it away or holding on.
Related: mindfulness of emotions, values to build resilience and life worth living goals.
Interpersonal Effectiveness Skills
Interpersonal effectiveness skills help you get what you want from other people while keeping the relationship and your self respect. They come in three sets, one for each goal.
- DEAR MAN. Describe, express, assert, reinforce, stay mindful, appear confident, negotiate. For asking and saying no.
- GIVE. Be gentle, act interested, validate, use an easy manner. For keeping the relationship.
- FAST. Be fair, no excessive apologies, stick to values, be truthful. For keeping self respect.
- Validation. Communicating that another person’s experience makes sense, which is different from agreeing.
- Walking the middle path. Dialectics, validation and behavior change skills, first written for teens and families.
More on validation: validation as a way to connect and using curiosity and compassion to validate.
How Do You Choose Where to Start?
- Crises are frequent. Start with STOP and TIPP, then add radical acceptance.
- Emotions feel too big or come out of nowhere. Start with mindfulness of current emotions and check the facts.
- Relationships are where it goes wrong. Start with DEAR MAN and validation.
- You feel scattered or on autopilot. Start with Wise Mind and the What skills.
For a longer guide, read finding the right DBT skill for you. Skills stick when you practice them on ordinary days, not only in hard ones.
Learning DBT Skills With Support
Reading about skills is a good start. Most people learn them best in a DBT skills group, with homework and someone to troubleshoot with. Dr. Jesse Finkelstein is the co author, with Shireen Rizvi, of Real Skills for Real Life, a DBT guide to 26 core skills for everyday life. He offers DBT therapy in NYC and individual therapy at Axis Psychological Services. You can book a free consultation.
References
Linehan, M. M. (2015). DBT Skills Training Manual (2nd ed.). Guilford Press.
Linehan, M. M. (2015). DBT Skills Training Handouts and Worksheets (2nd ed.). Guilford Press.
Rizvi, S. L., & Finkelstein, J. (2025). Real Skills for Real Life. Guilford Press.
Common questions about DBT skills
What are the four DBT skills modules?
Mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Mindfulness is the core that the other three build on. Distress tolerance and mindfulness lean toward acceptance, emotion regulation and interpersonal effectiveness lean toward change.
How many DBT skills are there?
It depends on how you count. Linehan's 2015 skills manual includes well over a hundred handouts, but most people work with a core set of roughly twenty to thirty named skills, such as Wise Mind, STOP, TIPP, radical acceptance, check the facts, opposite action, PLEASE and DEAR MAN.
Which DBT skill should I learn first?
Most DBT programs start with mindfulness, especially Wise Mind and the What and How skills, because every other skill depends on noticing what is happening. If you are in frequent crises, STOP and TIPP from distress tolerance are a practical place to begin.
Can I learn DBT skills on my own?
You can learn and practice many skills from a book or articles like these, and that is useful. Comprehensive DBT, with individual therapy, a skills group and coaching between sessions, is what the research supports for more serious difficulties.
What is the difference between DBT skills and DBT therapy?
The skills are the teachable part of DBT. DBT therapy is the full treatment: weekly individual sessions, a skills group, phone coaching and a consultation team for the therapist. Skills training on its own is a recognized adaptation and can be a good fit, though it is structured differently from comprehensive DBT.
