DBT Skills Training Manual, Second Edition
The original edition of this skills training manual was published in 1993. At that time, the only research conducted on Dialectical Behavior Therapy
(DBT) was a 1991 clinical trial comparing DBT to treatment as usual for the treatment of chronically suicidal individuals meeting criteria for borderline personality disorder (BPD). Since then, an enormous amount of research has been conducted on “standard” DBT, which typically consists of DBT individual therapy, group skills training, telephone coaching, and a therapist consultation team.
Research has also been conducted on stand-alone DBT skills training, and on the behavioral practices that together make up the DBT skills. The new skills in this edition are a product of my experience and research using the original skills; the wide-ranging research on emotions, emotion regulation, distress tolerance, and mindfulness, as well as new findings in the social sciences; and new treatment strategies developed within the cognitive-behavioral paradigm.
The major changes in the revised skills package are described below.
From Marsha M. Linehan–the developer of dialectical behavior therapy (DBT)–this comprehensive resource provides vital tools for implementing DBT skills training. The reproducible teaching notes, handouts, and worksheets used for over two decades by hundreds of thousands of practitioners have been significantly revised and expanded to reflect important research and clinical advances. The ebook DBT Skills Training Manual gives complete instructions for orienting clients to DBT, plus teaching notes for the full range of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills. The companion volume is available separately: DBT Skills Training Handouts and Worksheets, Second Edition.
New to This Edition DBT Skills Training Manual
*Each module has been expanded with additional skills.
*Multiple alternative worksheets to tailor treatment to each client.
*More extensive reproducible teaching notes (provided in the book and online), with numerous clinical examples.
*Curricula for running skills training groups of different durations and with specific populations, such as adolescents and clients with substance use problems.
*Linehan provides a concise overview of “How to Use This Book.”
New Skills in This Edition
There are still four primary DBT skills training modules: mindfulness skills, interpersonal effectiveness skills, emotion regulation skills, and distress
tolerance skills. Within these modules, I have added the following new skills.
1. In mindfulness skills (Chapter 7), I have added a section on teaching mindfulness from alternative perspectives, including a spiritual perspective.
2. In interpersonal effectiveness skills (Chapter 8), I have added two new sections. The first focuses on skills for finding and building relationships you want and ending relationships you don’t want. The second focuses on balancing acceptance and change in interpersonal interactions. It closely duplicates the skills Alec Miller, Jill Rathus, and I developed for adolescent multifamily skills training, in which parents of adolescent clients also participate in skills training.
3. The emotion regulation skills (Chapter 9) have been expanded greatly and also reorganized. The number of emotions described in detail has expanded from six to ten (adding disgust, envy, jealously, and guilt). A section on changing emotional responses adds two new skills: check the facts and problem-solving. Also in that section, the opposite action skill has been extensively updated and expanded. Skills for reducing emotional vulnerability have been reorganized into a set of skills called the ABC PLEASE skills. In the section on accumulating positive emotions, I changed the Pleasant Events Schedule (now called the Pleasant Events List) to be appropriate for both adolescent and adult clients. I also added a values and priorities handout that lists several universal values and life priorities. Another new skill, cope ahead, focuses on practicing coping strategies in advance of difficult situations.
Optional nightmare and sleep hygiene protocols are also included. Finally, a new section is added for recognizing extreme emotions (“Identify Your Personal Skills Breakdown Point”), including steps for using crisis survival skills to manage these emotions.
4. The distress tolerance skills (Chapter 10) now start with a new STOP skill—stop, take a step back, observe, and proceed mindfully—adapted from the skill developed by Francheska Perepletchikova, Seth Axelrod, and colleagues. The crisis survival section now includes a new set of skills aimed at changing body chemistry to rapidly regulate extreme emotions (the new TIP skills). A new set of skills focused on reducing addictive behaviors has also been added: dialectical abstinence, a clear mind, community reinforcement, burning bridges, building new ones, alternate rebellion, and adaptive denial.
5. Across modules I have also made a number of changes. Every module now starts with goals for that module along with a goals handout and a corresponding pros and cons worksheet. The worksheet is optional and can be used if the client is unwilling or ambivalent about practicing the skills in the module.
A mindfulness skill has been added to both the interpersonal module (mindfulness of others) and the distress tolerance module (mindfulness of current thoughts). Together with mindfulness of current emotion (emotion regulation), these additions are aimed at keeping the thread of mindfulness alive across time.
Table of Contents:
List of Online Handouts and Worksheets
An Introduction to DBT Skills Training
Chapter 1 Rationale for Dialectical Behavior Therapy Skills Training
Chapter 2 Planning to Conduct DBT Skills Training
Chapter 3 Structuring Skills Training Sessions
Chapter 4 Skills Training Treatment Targets and Procedures
Chapter 5 Application of Fundamental DBT Strategies in Behavioral Skills Training
Part I Appendices
Teaching Notes for DBT Skills Modules
Chapter 6 General Skills: Orientation and Analyzing Behavior
I. The Goals of Skills Training,
II. Overview: Introduction to Skills Training,
III. Orientation to Skills Training,
IV. Biosocial Theory of Emotion Dysregulation,
V. Overview: Analyzing Behavior,
VI. Chain Analysis of Problem Behavior,
VII . Analyzing Missing Links,
VIII . Missing-Links Analysis Combined with a Chain Analysis,
Chapter 7 Mindfulness Skills
I. Goals of This Module,
II. Overview: Core Mindfulness Skills,
III . Wise Mind,
I V. Mindfulness “What” Skills: Observe,
V. Mindfulness “What” Skills: Describe,
VI. Mindfulness “What” Skills: Participate,
VII . Mindfulness “How” Skills: Nonjudgmentally,
VIII . Mindfulness “How” Skills: One-Mindfully,
I X. Mindfulness “How” Skills: Effectively,
X. Summary of the Module,
XI. Overview: Other Perspectives on Mindfulness,
XII . Mindfulness Practice: A Spiritual Perspective,
XIII . Wise Mind: A Spiritual Perspective,
XIV. Practicing Loving Kindness,
XV. Skillful Means: Balancing Doing Mind and Being Mind,
XVI. Wise Mind: Walking the Middle Path,
Chapter 8 Interpersonal Effectiveness Skills
I. Goals of This Module,
II. Factors Reducing Interpersonal Effectiveness,
III. Overview: Core Interpersonal Effectiveness Skills,
I V. Clarifying Goals in Interpersonal Situations,
V. Objectives Effectiveness Skills: DEAR MAN,
VI. Relationship Effectiveness Skills: GIVE,
VII. Self-Respect Effectiveness Skills: FAST,
VIII. E valuating Your Options: How Intensely to Ask or Say No,
I X. Troubleshooting Interpersonal Effectiveness Skills,
X. Overview: Building Relationships and Ending Destructive Ones,
XI. Skills for Finding Potential Friends,
XII . Mindfulness of Others,
XIII . How to End Relationships,
XIV. Overview: Walking the Middle Path Skills,
XVI. Validation Skills,
XVII . Strategies for Changing Behavior,
Chapter 9 Emotion Regulation Skills
I. Goals of This Module,
II. Overview: Understanding and Naming Emotions,
III . What Emotions Do for You,
IV. What Makes It Hard to Regulate Emotions,
V. A Model of Emotions,
VI. Observing, Describing, and Naming Emotions,
VII. Overview: Changing Emotional Responses,
VIII. Check the Facts,
I X. Preparing for Opposite Action and Problem Solving,
X. Acting Opposite to the Current Emotion,
XI. Problem Solving,
XII. Reviewing Opposite Action and Problem Solving,
XIII. Overview: Reducing Vulnerability to Emotion Mind,
XIV. Accumulating Positive Emotions: Short Term,
XV. Accumulating Positive Emotions: Long Term,
XVI. Build Mastery and Cope Ahead Skills for Emotional Situations,
XVII . Taking Care of Your Mind by Taking Care of Your Body,
XVIII. Nightmare Protocol,
XIX. Sleep Hygiene Protocol,
XX. Overview: Managing Really Difficult Emotions,
XXI. Mindfulness of Current Emotions,
XXII. Managing Extreme Emotions,
XXIII. Troubleshooting Emotion Regulation Skills,
XXIV. Review of Skills for Emotion Regulation,
Chapter 10 Distress Tolerance Skills
I. Goals of This Module,
II. Overview: Crisis Survival Skills,
III. Knowing a Crisis When You See One,
IV. STOP Problematic Behavior Immediately,
V. Pros and Cons as a Way to Make Behavioral Decisions,
VI. TIP Skills for Managing Extreme Arousal,
VII . Distracting with Wise Mind ACCEPTS,
VIII . Self-Soothing,
I X. Improving the Moment,
X. Overview: Reality Acceptance Skills,
XI. Radical Acceptance,
XII . Turning the Mind,
XIII . Willingness,
XIV. Half-Smiling and Willing Hands,
XV. Allowing the Mind: Mindfulness of Current Thoughts,
XVI. Overview: When the Crisis Is Addiction,
XVII . Dialectical Abstinence,
XVIII. Clear Mind,
XIX. Community Reinforcement,
XX. Burning Bridges and Building New Ones,
XXI. Alternate Rebellion and Adaptive Denial,
About the author:
Marsha Linehan, Ph.D., ABPP, is a Professor of Psychology and adjunct Professor of Psychiatry and Behavioral Sciences at the University of Washington in Seattle and is Director of the Behavioral Research and Therapy Clinics, a research consortium that develops and evaluates treatments for multi-diagnostic, severely disordered, and suicidal populations. Her primary research is in the application of behavioral models to suicidal behaviors, drug abuse, and borderline personality disorder. She is also working to develop effective models for transferring science-based treatments to the clinical community.
She is the developer of Dialectical Behavior Therapy (DBT), a treatment originally developed for the treatment of suicidal behaviors and since expanded to treatment of borderline personality disorder and other severe and complex mental disorders involving serious emotion dysregulation. In comparison to all other clinical interventions for suicidal behaviors, DBT is the only treatment that has been shown effective in multiple trials across numerous independent research studies. DBT effectively reduces suicidal behavior and is cost-effective compared to both standard treatment and community treatments delivered by expert therapists. It is currently the gold-standard treatment for borderline personality disorder and has demonstrated utility in the treatment of high substance abuse and eating disorders.
Linehan has authored multiple books, including three treatment manuals: Cognitive-Behavioral Treatment for Borderline Personality Disorder, DBT Skills Training Manual (2nd ed.), and Skills Training Manual for Treating Borderline Personality Disorder. She serves on several editorial boards and has published extensively in scientific journals DBT Skills Training Manual.
Linehan is the founder of The Linehan Institute, a non-profit organization that helps advance mental health through support for education, research, and compassionate, scientifically-based treatments. Linehan is also the founder of Behavioral Tech LLC, a DBT training and consulting organization, and the founder of Behavioral Tech Research, Inc., a company that develops innovative online and mobile technologies to disseminate science-based behavioral treatments for mental disorders.
Linehan was trained in spiritual directions under Gerald May and Tilden Edwards and is a Zen master (Roshi) in both the Sanbo-Kyodan-School under Willigis Jaeger Roshi (Germany) as well as in the Diamond Sangha (USA). She teaches mindfulness via workshops and retreats for health care providers.
She has dedicated her life and research to working with people whose lives are at-risk due to crippling and incapacitating psychological problems.
Reviews of the customers about ebook DBT Skills Training Manual:
DBT Skills Training Manual A useful ebook. Religious, in the sense of, set out a life path, or a part of a life path, a way to live, and a momentum; very clearly out of suicidal misery, less clearly toward, ultimately… normal employee-consumer life? Adaptation to the status quo? Sagacious, serene middle-age? Reading it makes me want to make an anti-DBT, to teach (rather than browbeat) sagacious, serene middle-aged (or otherwise privileged) people how to care more about their (social, physical) environment, be more affected by it and less self-regulated, think more in terms of black-and-white (with dialectics? Perhaps a dialectics cast in a different vibe than DBT’s, of urgency rather than skillful acceptance) make the least borderline people somewhat more borderline in some ways — I suppose to bring a good immaturity to people whose maturity is somewhat bad. Again, a useful ebook with valuable skills in it, good vocabulary, well-designed, with a specific, distinctive vibe (through writing style and design of the therapy), a good example of how to make a life path — yet, ultimately, I think, best intended to bring people out of suicidality and then set somewhat to the side while another life path is adopted which relates the client (or some non-client who happens to read the book) to the outside world, as skillful as having been instructed, with as much longing for things to be better as when miserable.
In the DBT Skills Training Manual, Marsha Linehan has added a great wealth of additional skills to the Dialectical Behavior Therapy program – despite the original version has already helped a great number of people suffering from Borderline Personality Disorder. Its huge increase in material and skills can feel overwhelming, but working with a certified DBT team is part and parcel of proper treatment; your therapist and group leaders will be your guides. This manual DBT Skills Training Manual and the accompanying workbook have been invaluable to the therapy team I have had the honor of being a client. My own copies of these ebooks have given me quick access to such important reference materials I continue building my life worth living.