Dialectical Behavioral Therapy
Dialectical Behavior Therapy (DBT) is an evidence-based form of cognitive-behavioral therapy developed by Dr. Marsha Linehan in the late 1980s to help individuals manage intense emotions, impulsive behaviors, and chronic relationship difficulties. Originally designed to treat borderline personality disorder and chronic suicidality, DBT integrates principles of Cognitive Behavioral Therapy (CBT) with dialectical philosophy—the concept that two seemingly opposite truths can coexist—and Eastern mindfulness practices derived from Zen Buddhism. This therapeutic approach emphasizes balancing acceptance and change, helping clients validate their current emotional experiences while working toward meaningful behavioral transformation. DBT focuses on four core skill areas--Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness—that teach clients how to tolerate distress, manage emotions, and improve relationships. Over time, DBT has become widely recognized as an effective treatment for a range of conditions, including anxiety, depression, PTSD, substance use disorders, and emotional dysregulation, helping individuals build stability, resilience, and a more fulfilling life.
Dialectical Behavior Therapy (DBT) glossary of terms.
Below is a glossary of terms and explanations to become familiar with before using the worksheet below.
DBT Tools for Anxiety Reduction — Glossary
Double Board Certified Counseling Services, Inc. — Mark Zauss, LMHC, LPC, CCMHC, NBCC, BC‑TMC, ADHD‑CCSP, C‑DBT, CCTP
Licensed in Florida, Massachusetts, and Connecticut • Date:
Provider 1
Mark Zauss — Cognitive Behavioral Therapist | Specialties: ADHD, Anxiety, PTSD, OCD, Mood Disorders
This page is an information‑only glossary to help you learn DBT terms before practicing the skills.
This page is an information‑only glossary to help you learn DBT terms before practicing the skills.
Glossary
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Use the controls to expand all sections or open just the ones you need. These definitions are written in clear, client‑friendly language and mirror the skills you’ll use in session.
Mindfulness Skills
▶Observe
Notice thoughts, emotions, and body sensations as they happen—without trying to change or judge them.
Describe
Put your experience into words (e.g., “I’m noticing tightness in my chest”) to create clarity and space.
Participate
Engage fully in the current activity to interrupt worry and rumination.
One‑Mindfully
Focus on one thing at a time instead of multitasking or mentally jumping ahead.
Non‑Judgmental Stance
Replace self‑criticism with neutral observation (“This is what I’m feeling,” not “I shouldn’t feel this”).
Wise Mind Breathing
Centering breaths that integrate emotion and reason into calm awareness.
Mindfulness of Current Emotion
Acknowledge anxiety directly and watch it rise and fall, rather than fighting it.
Mindfulness is the foundation of DBT—practice daily in short moments.
Distress Tolerance (Crisis Tools)
▶TIPP
Rapid body‑based calming: change Temperature (cool water/pack on face), brief Intense exercise, Paced breathing (5–6 breaths/min), and Paired muscle relaxation.
STOP
Stop, Take a step back, Observe, Proceed mindfully—a reset sequence to prevent impulsive reactions.
Self‑Soothing (5 Senses)
Use pleasant sensory input (sound, smell, taste, touch, sight) to calm your nervous system.
IMPROVE the Moment
Use Imagery, Meaning, Prayer/values, Relaxation, One‑thing‑in‑the‑moment, brief “Vacation,” and Encouragement.
ACCEPTS
Healthy distraction: Activities, Contributing, Comparisons, Emotions (opposite), Pushing away, Thoughts, Sensations.
Radical Acceptance
Accept reality fully to reduce suffering that comes from resisting what is.
Grounding 5‑4‑3‑2‑1
Anchor to the present by naming things you can see, feel, hear, smell, and taste.
Use these when distress is high to avoid making things worse.
Emotion Regulation
▶Check the Facts
Test thoughts against the evidence and adjust your emotional response to fit the situation.
Opposite Action
Do the opposite of the emotion’s urge (e.g., approach a task you want to avoid).
PLEASE
Lower vulnerability with Physical health care, balanced Eating, avoid mood‑Altering substances, adequate Sleep, regular Exercise.
Build Positive Experiences
Schedule enjoyable and mastery‑building activities to lift baseline mood.
Values‑Driven Actions
Choose behaviors that align with your core values to reduce inner conflict.
Name It to Tame It
Label emotions to activate the rational brain and reduce overwhelm.
Prevention skills—practice when calm to make anxiety spikes less intense.
Interpersonal Effectiveness
▶DEAR MAN
Describe, Express, Assert, Reinforce; stay Mindful, Appear confident, Negotiate—assertive request formula.
GIVE
Gentle, Interested, Validate, Easy manner—keep relationships positive while addressing issues.
FAST
Be Fair, avoid unnecessary Apologies, Stick to values, be Truthful—protects self‑respect in communication.
Boundary Practice
Set clear, respectful limits to reduce people‑pleasing and conflict‑avoidance anxiety.
Validation
Acknowledge feelings (yours and others’) without necessarily agreeing—builds trust and lowers defensiveness.
These skills reduce social/performance anxiety and improve communication.
Mind–Body Integration
▶Box / Diaphragmatic Breathing
Slow, deep breathing that lowers heart rate and calms the nervous system.
Progressive Muscle Relaxation (PMR)
Tense and release muscle groups to relieve physical tension.
Guided Imagery
Visualize a safe, peaceful place to counteract stress responses.
Urge Surfing
Observe anxious urges like waves—notice them rise, crest, and pass without reacting.
Sensory Mindfulness Walk
Engage all senses during slow, mindful movement.
Self‑Validation Statements
Compassionate self‑talk (“It makes sense that I feel anxious right now”) that reduces shame and fear.
Pair these with daily micro‑practices for steady physiological calm.
DBT Worksheet - please save and send to [email protected]
DBT Tools to Reduce Anxiety
Double Board Certified Counseling Services, Inc. — Mark Zauss, LMHC, LPC, CCMHC, NBCC, BC‑TMC, ADHD‑CCSP, C‑DBT, CCTP
Licensed in Florida, Massachusetts, and Connecticut • Date:
Provider 1
Mark Zauss — Cognitive Behavioral Therapist | Specialties: ADHD, Anxiety, PTSD, OCD, Mood Disorders
NPI / Credentials available upon request • This worksheet is for psychoeducation and skills practice.
NPI / Credentials available upon request • This worksheet is for psychoeducation and skills practice.
Worksheet
Version: 1.0
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Client Information
Mindfulness Skills
Anchor attention in the present and reduce cognitive fusion with anxious thoughts.
Distress Tolerance (Crisis Tools)
Short‑term tools for high arousal or panic to avoid making things worse.
Emotion Regulation
Lower baseline vulnerability and change your relationship with anxiety.
Interpersonal Effectiveness
Reduce social/performance anxiety via confident, values‑based communication.
Mind–Body Integration
Physiological down‑regulation and embodied awareness.
Personalized “Anxiety SOS” Plan
Select 3–5 rapid tools you’ll use first, then list supports and safety steps.
Therapist / Client Notes
Tip: Print this worksheet or save as PDF after completing. Bring to next session.