30+ Dialectical Behavior Therapy Techniques & Interventions

Dialectical Behavior Therapy (DBT) has roots in CBT and is an ideal treatment approach for clients who experience intense emotions and unhealthy relationship patterns. Understanding the term “dialectical” is important because you can see this theme throughout DBTinterventions and techniques. Dialectical refers to having two opposite ideas at the same time. This can feel messy and uncomfortable for many, but it is common in the human experience. As an example, you may grieve the passing of a loved one, but feel relieved knowing that expectations of you have shifted. Keep reading 

With DBT, you can help clients accept the reality of their experiences and learn how to better respond to challenges. DBT was originally developed as a treatment for Borderline Personality Disorder (BPD), though it can be effective for clients experiencing a range of emotional and psychological stressors. In reality, most of our clients could benefit from emotion regulation, distress tolerance, and interpersonal skills taught in DBT skills groups.

While traditional DBT treatment involves a team of professionals, this is not always a realistic option. Some clients may be resistant to having multiple treatment sessions per week or have other barriers that prevent traditional approaches. Because of this, clinicians find creative ways to incorporate DBT into their clinical work.

For more valuable resources, view our DBT Tools and Resources hub

24 DBT Techniques

DBT techniques are specific skills that you can teach your client to improve emotion regulation, distress tolerance, and their relationships. These are well-established skills that your clients can use in moments of distress, allowing them to improve their overall functioning. You can introduce your client to techniques based on their current symptoms and challenges.

1) Wise Mind

Wise mind is a core mindfulness skill taught in DBT. This skill can help clients improve their decision-making skills.

What It Is: Wise mind is a practice that seeks a healthy balance between your client’s emotional and rational mind.

How It Helps Clients: Wise mind is a DBT technique that improves emotion regulation, reduces impulsivity, and supports value-based decision-making.

How To Do It: For this practice, encourage your client to begin by taking several slow, deep breaths. Have them ask themselves, “What does my wise mind say?” They will then take time to notice their physical sensations and their intuitive gut instincts. Your client will then make a logical, emotionally grounded decision.

2) STOP Skill

The STOP Skill is a distress tolerance skill that can be used in intense and overwhelming moments.

What It Is: STOP is an acronym for Stop, Take a step back, Observe, and Proceed mindfully.

How It Helps Clients: This skill can help prevent impulsivity and create space between feeling an emotion and acting on it. Clients can use this space to make healthier decisions.

How To Do It: Encourage your client to go through the different steps of the acronym, including:

•  Stop: Freeze your body
•  Take a step back: Take a moment to breathe, or disengage from the task at hand
•   Proceed mindfully: Consider your options, and choose the next right step

3) TIPP Skill

TIPP skill is a body-based technique used to lower intense emotional experiences.

What It Is: TIPP is an acronym that stands for Temperature, Intense exercise, Paced breathing, Paired muscle relaxation.

How It Helps Clients: The TIPP skill can help clients become aware of physiological reactions and emotions.

How To Do It: Encourage your client to move through the different letters of the acronym:

• Temperature: Hold an ice cube or splash water on their face
• Intense exercise: Do 30 to 60 seconds of vigorous movement
•  Paced breathing: Bring your breathing down to 5 to 6 breaths per minute
•  Muscle relaxation: Focus on tensing your muscles and then releasing the area of your body( ie, hand or toes)

4) Opposite Action

Opposite action is an emotion regulation skill that focuses on unhelpful emotional urges.

What It Is: Your clients will act in a way that is opposite to the urge that was driven by an emotion that is not effective.

How It Helps Clients: This skill can decrease avoidance, withdrawal, and impulsiveness

How To Do It: For this, your client will begin by identifying their emotion and the urge it causes. They will evaluate the appropriateness of the emotion with the given facts. If the emotion is ineffective or unhelpful, they will choose to engage in an opposite behavior and fully commit to it.

5) Using the Senses for Self-Soothing

This is a distress tolerance skill that focuses on using the senses to calm worry, stress, fear, and other concerning emotions.

What It Is: Your client will use their sight, smell, hearing, touch, and taste to calm their nervous system. 

How It Helps Clients: This skill provides your client with healthy alternatives to unhealthy coping behaviors.

How To Do It: Encourage your client to bring their attention to their senses and observe their current experiences with each one. It could look like the following:

•  5 things they see
•  4 things they hear
• 3 things they touch
• 2 things they smell
• 1 thing they taste

6) Radical Acceptance

Radical acceptance is a distress tolerance skill that can be used when clients are struggling to accept their reality.

What It Is: This skill focuses on acknowledging reality as it is, without approval or defeat.

How It Helps Clients: This skill can help reduce the suffering your clients experience when they fight or hyperfocus on situations that cannot be changed.

How To Do It: Your client can move through the following steps:

•  Recognize what you’re fighting against
• Remember, this is what’s happening now
• Say acceptance statements like “This feeling will pass” or “It makes sense I feel like this.”
•  Repeat the sentence as needed when distress arises

7) Observe

This foundational mindfulness skill teaches clients how to notice their internal and external experiences without reacting.

What It Is:
A core mindfulness “What” skill that involves noticing thoughts, emotions, sensations, and environmental stimuli without attempting to change them.

How It Helps Clients:
Builds awareness, reduces impulsivity, and strengthens distress tolerance.

How To Do It:
Encourage your client to simply notice experiences as they arise, returning attention to the present moment when distracted.

8) Describe

This mindfulness skill strengthens emotional literacy and cognitive clarity.

What It Is:
A “What” mindfulness skill that involves labeling internal experiences with words.

How It Helps Clients:
Improves emotional regulation by reducing confusion and emotional intensity.

How To Do It:
Guide clients to state observable facts and label emotions accurately (e.g., “I notice anxiety” instead of “This is unbearable”).

9) Participate

This skill encourages full engagement in the present moment.

What It Is:
A mindfulness “What” skill focused on becoming fully involved in current activities.

How It Helps Clients:
Reduces rumination and self-consciousness.

How To Do It:
Encourage clients to immerse themselves completely in an activity without multitasking or overanalyzing.

10) Nonjudgmentally

This skill reduces evaluative and critical thinking patterns.

What It Is:
A mindfulness “How” skill that emphasizes describing reality without attaching judgments.

How It Helps Clients:
Decreases shame and emotional escalation.

How To Do It:
Help clients replace judgmental language (“good,” “bad,” “should”) with factual observations.

11) One-Mindfully

This skill builds attentional control and reduces overwhelm.

What It Is:
A mindfulness “How” skill that involves doing one thing at a time with full awareness.

How It Helps Clients:
Improves focus and reduces emotional reactivity.

How To Do It:
Encourage clients to bring their full attention to one task and gently redirect when distracted.

12) Effectively

This skill shifts clients toward practical, goal-directed behavior.

What It Is:
A mindfulness “How” skill focused on doing what works in a given situation.

How It Helps Clients:
Promotes flexibility and reduces rigid thinking.

How To Do It:
Ask, “What will be effective right now?” and guide behavior based on outcome rather than principle.

13) Pros and Cons

Pros and Cons is a distress tolerance skill that strengthens decision-making during crises.

What It Is:
A crisis survival skill used to evaluate the short- and long-term consequences of acting on urges.

How It Helps Clients:
Increases pause time and reduces impulsive behavior.

How To Do It:
Have clients write out pros and cons of acting on an urge versus using skills.

14) Distract with ACCEPTS

ACCEPTS skill provides structured distraction during acute distress.

What It Is:
A crisis survival strategy that uses short-term distraction techniques.

How It Helps Clients:
Reduces emotional intensity in the moment.

How To Do It:
Guide clients through Activities, Contributing, Comparisons, Emotions, Pushing away, Thoughts, and Sensations.

15) IMPROVE the Moment

The IMPROVE the Moment skill helps clients tolerate distress without avoidance.

What It Is:
A distress tolerance technique focused on enhancing the present moment.

How It Helps Clients:
Increases resilience during painful situations.

How To Do It:
Use Imagery, Meaning, Prayer, Relaxation, One thing at a time, brief Vacation, and Encouragement.

16) Turning the Mind

This acceptance skill reinforces commitment to reality as it is.

What It Is:
A reality acceptance strategy involving repeated conscious choice to accept.

How It Helps Clients:
Reduces secondary suffering caused by resistance.

How To Do It:
When non-acceptance arises, guide clients to intentionally “turn the mind” back toward acceptance.

17) Willingness vs. Willfulness

The DBT Willingness vs. Willfulness skill clarifies the difference between openness and resistance.

What It Is:
A reality acceptance practice distinguishing cooperative behavior from stubborn refusal.

How It Helps Clients:
Improves adaptability and reduces conflict.

How To Do It:
Help clients identify willfulness and practice shifting toward willingness.

18) Half-Smiling & Willing Hands

This skill uses posture and facial expression to influence emotion.

What It Is:
A body-based acceptance practice within distress tolerance.

How It Helps Clients:
Supports emotional regulation through behavioral activation.

How To Do It:
Encourage a slight half-smile and relaxed, open palms while practicing acceptance statements.

19) Check the Facts

The DBT Check the Facts emotion regulation skill evaluates whether emotional intensity matches reality.

What It Is:
A structured method for assessing whether emotions fit the facts.

How It Helps Clients:
Reduces unjustified emotional escalation.

How To Do It:
Guide clients to examine interpretations, assumptions, and objective evidence.

20) Problem Solving

The DBT Problem Solving skill addresses situations that require change.

What It Is:
An emotion regulation strategy used when emotions fit the facts and action is needed.

How It Helps Clients:
Promotes effective coping and agency.

How To Do It:
Define the problem, generate solutions, evaluate options, implement a plan.

21) ABC PLEASE

The DBT ABC PLEASE skill reduces vulnerability to intense emotions.

What It Is:
An emotion regulation framework targeting lifestyle and biological vulnerabilities.

How It Helps Clients:
Builds emotional stability over time.

How To Do It:
Accumulate positive emotions, Build mastery, Cope ahead, and address physical health factors (PLEASE skills).

22) DEAR MAN

The DBT DEAR MAN interpersonal effectiveness skill supports assertiveness.

What It Is:
A structured communication strategy for obtaining objectives.

How It Helps Clients:
Improves clarity and confidence in requests.

How To Do It:
Describe, Express, Assert, Reinforce; stay Mindful, Appear confident, Negotiate.

23) GIVE

The DBT Give skill maintains relationship quality during interactions.

What It Is:
An interpersonal effectiveness strategy focused on relationship effectiveness.

How It Helps Clients:
Strengthens connection and reduces defensiveness.

How To Do It:
Be Gentle, act Interested, Validate, use an Easy manner.

24) FAST

The DBT Fast skill protects self-respect during interpersonal interactions.

What It Is:
An interpersonal effectiveness strategy focused on maintaining integrity.

How It Helps Clients:
Reduces resentment and self-blame.

How To Do It:
Be Fair, no unnecessary Apologies, Stick to values, be Truthful.

9 DBT Interventions to Use in Sessions

DBT interventions are clinical strategies that are led by clinicians. They can help provide structure to sessions, shape behavior, and support skill development. Clinicians can use interventions to guide change in session.

1) Chain Analysis

Chain analysis is a key dialectical behavior therapy intervention used to better understand problem behaviors clients struggle with.

What It Is: For this intervention, you will work collaboratively with your client to map the events that led to the behavior they wish to change.

How It Helps Clients: This intervention can help clients increase awareness of their triggers, enabling them to pinpoint where change can be made.

How To Do It: To begin, you’ll help your client to identify the behavior they want to change. Spend time mapping their vulnerabilities and triggering events. Guide your client as they track their thoughts, emotions, and actions. Spend time highlighting alternative behaviors that they can use. 

2) Solution Analysis

This is a follow-up intervention that helps your client implement replacement behaviors and notice their impact.

What It Is: You’ll help your client identify where they can use DBT skills to interrupt behavioral patterns that cause distress. This could include emotion regulation, distress tolerance, interpersonal effectiveness, or mindfulness practices.

How It Helps Clients: This can help decrease relapses and help create realistic strategies for using effective coping skills.

How To Do It: Begin by spending time creating a chain analysis. Review missed opportunities and skills that could have been used. Identify and review specific DBT skills that can be used, and practice this new response.

3) Validation Strategies

Clinicians can implement validation strategies to strengthen the therapeutic alliance.

What It Is: You will validate your clients’ thoughts, emotions, and the legitimacy of their internal experiences.

How It Helps Clients: Validation can reduce shame, increase session engagement, and promote emotional regulation.

How To Do It: You can validate your client in many ways. You may reflect on their emotional experience, normalize their response, and avoid immediate problem-solving with active listening while balancing introducing change strategies. 

4) Behavioral Rehearsal

This intervention strengthens skill acquisition through in-session practice.

What It Is:
A clinician-led strategy involving structured role-play of new skills.

How It Helps Clients:
Improves confidence and generalization of skills.

How To Do It:
Conduct role-plays using interpersonal effectiveness or emotion regulation skills.

5) Contingency Management

This intervention shapes behavior through reinforcement principles.

What It Is:
A behavioral strategy that systematically reinforces adaptive behaviors.

How It Helps Clients:
Increases likelihood of skillful behavior.

How To Do It:
Provide consistent reinforcement for effective behaviors and reduce reinforcement of maladaptive behaviors.

6) Commitment Strategies

This intervention enhances motivation for change.

What It Is:
A set of strategies used to increase commitment to treatment goals.

How It Helps Clients:
Strengthens adherence and follow-through.

How To Do It:
Use pros and cons for change, devil’s advocate, foot-in-the-door, and door-in-the-face techniques.

7) Dialectical Strategies

This intervention addresses rigid or polarized thinking.

What It Is:
A clinician-led strategy that promotes synthesis between acceptance and change.

How It Helps Clients:
Encourages cognitive flexibility.

How To Do It:
Use paradox, reframing, or extending to move toward balanced thinking.

8) Irreverent Communication

This stylistic intervention interrupts maladaptive patterns.

What It Is:
A strategic communication style used carefully within the therapeutic relationship.

How It Helps Clients:
Disrupts stuck behavioral cycles.

How To Do It:
Use unexpected, strategic responses to shift ineffective interaction patterns.

9) Consultation Team

This structural intervention supports therapist adherence and effectiveness.

What It Is:
A formal DBT team meeting focused on therapist support and fidelity.

How It Helps Clinicians:
Reduces burnout and maintains treatment integrity.

How To Do It:
Participate in regular DBT consultation meetings focused on case conceptualization and adherence.

Other Helpful DBT Therapy Resources

DBT is a commonly used therapeutic approach for clients struggling with borderline personality disorder, self-harm behaviors, suicidal behaviors, Post-Traumatic Stress Disorder (PTSD), substance use disorders, eating disorders, depression, and anxiety. This approach introduces practical, effective skills that can help clients manage the stressors and challenges they face in their daily lives. 

TherapyByPro is a reliable and popular professional resource for clinicians. With customizable, evidence-based worksheets, notes, and other documents. Examples of available DBT resources include: 

Final Thoughts on Using DBT in Sessions

DBT allows you to provide structured sessions in a compassionate and supportive way that can help clients make meaningful change in their lives. They may find that their relationships are healthier and that they’re better able to manage the difficulties they experience in life. Accepting their reality while making healthy changes can help those stuck in cycles of emotional reactivity move forward.

If you would like to learn more about incorporating DBT into your clinical work, we encourage you to explore available CEUs and training opportunities within your niche.

View all of our DBT Therapy Worksheets

References:
Dialectical behavior therapy (DBT): What it is & purpose. Cleveland Clinic. (2025b, September 17).