The 5 DBT Modules

Emotions can be overwhelming, but learning to manage them during difficult times can be empowering. Crippling anxiety or sudden panic doesn’t have to get the best of us—that’s where DBT modules come in handy.

The core modules of DBT equip us to become more productive and live a happier life. They are helpful for individuals with depression, anxiety, eating disorders, and other diagnosed mental illnesses and can be practiced alone or with a therapist [*].

Discover how the modules of DBT can help you achieve far-reaching health benefits and put you on a path toward success!

What is DBT?

Dialectical behavior therapy is a type of talk therapy or psychotherapy based on cognitive behavioral therapy [*]. However, DBT is more applicable to individuals who feel emotions more intensely than others.

The word “dialectical” pertains to marrying two opposing concepts and is a core principle of DBT. Ultimately, DBT aims to encourage individuals to achieve two positive goals that may not appear to be achievable together.

It also aims to help individuals identify and understand difficult emotions, learn to manage them, and make positive changes. You can apply DBT modules for kids and also effectively practice DBT with teens, as success isn’t measured by age but, rather, through practice.

DBT was originally developed to treat people with borderline personality disorder but now applies to various conditions like attention deficit hyperactivity disorder, substance use, anxiety, depression, and post-traumatic stress disorder, among other health concerns [*].

Its modules have been proven effective, with DBT helping to reduce suicidal tendencies and improve coping mechanisms [*].

The 5 DBT Modules Explained

DBT comprises five modules that help individuals better manage their behaviors, emotions, and thoughts. These DBT modules are typically regarded as “acceptance” or “change” skills.

Module 1: Mindfulness

Mindfulness, which dates back to the ancient Buddhist period, is a foundational DBT skill that focuses on observing one’s thoughts and feelings without judgment [*]. Therapists often break mindfulness down into two skills:

• WHAT Skills. These skills refer to what to do when you practice mindfulness. For instance, you might observe your present experience through a mind-body scan. Then, you’ll describe your emotions and immerse yourself in a DBT mindfulness exercise.
• HOW Skills. These skills refer to how you apply mindfulness. WHAT skills emphasize practicing one activity at a time and choosing one that is best for the current situation. They also highlight performing activities nonjudgmentally, without adding labels like “good” or “bad.”

With these skills, you can balance emotion and reason and achieve a wise mind. In DBT, a wise mind is a balanced mind that integrates emotion with rationality and reason. Individuals can become better decision-makers and problem-solvers as they spend more time developing their wise minds. They also become less impulsive, as they can consider the potential consequences of their actions, and are more resilient in the face of adversity.

Some exercises you can practice to achieve a wise mind include:

• Mindful meditation
• Self-assessment
• Relaxation techniques
• Self-soothing

Module 2: Distress Tolerance

Individuals who practice distress tolerance learn to experience difficult or painful emotions without succumbing to negative impulses or harmful coping mechanisms. Distress tolerance is beneficial in situations where these challenging emotions are unavoidable.

One way to exercise distress tolerance is to work on your ACCEPTS skills, which focus on healthy distractions to help keep you grounded. For example, if you are feeling overwhelmed, you might try an activity (the “A” part of ACCEPTS) like taking a short walk around the block and focusing on positive thoughts (the “T” part of ACCEPTS).

On the other hand, TIPP skills focus on quickly altering your body chemistry to reduce the effects of distress or panic. For instance, you might splash cold water on your face (the “T” part of TIPP pertaining to temperature) or practice paced breathing (the “P” part of TIPP).

Module 3: Emotion Regulation

Life is unpredictable, and things won’t always turn out the way you expect. You could start the day on a high, only to encounter a difficult situation later. You might become overwhelmed by emotions, but you don’t have to “fall victim” to them.

Emotion regulation skills help you recognize and accept complicated feelings when things go awry. However, unlike distress tolerance, emotion regulation focuses more on how you manage your day-to-day emotions.

You can practice emotion regulation skills by using emotion regulation worksheets. These worksheets structure your exercises and offer a tangible way to engage with therapy concepts. Some exercises include:

• Riding the wave of a problematic situation
• Busting myths about emotion regulation
• Practicing opposite actions to reduce intensity
• Accumulating positive emotions

Module 4: Interpersonal Effectiveness

Interpersonal effectiveness determines how you interact with others and form relationships. It asks you to reflect on whether you communicate effectively, practice empathy with others, are emotionally intelligent, and can assert yourself respectfully.

As a DBT module, here are a few skills you can practice to shape your interpersonal effectiveness:

• DEAR MAN. This interpersonal effectiveness skill breaks down the process of having a productive and respectful conversation with another person. It focuses on expressing oneself without judgment or assuming the other person knows how you feel. It encourages you to assert yourself respectfully and be mindful of your goals.
• GIVE skill. Much like DEAR MAN, the GIVE skill focuses on effective communication and good relationship outcomes. It encourages individuals to practice how they speak with others, such as speaking gently (the “G” part of GIVE) and acting interested (the “I” part of GIVE).
• FAST skill. In relationships, it’s important to practice respect for everyone—including yourself. With FAST skills, you can learn how to nurture a mutually beneficial relationship that considers everyone’s needs. Suppose you want to lead a group project but feel anxious about being judged. The FAST skill would help you make fair suggestions while sticking to your values and being truthful to your groupmates.

Mastering interpersonal effectiveness makes us better communicators and promotes healthy relationships.

Module 5: Walking The Middle Path

Finally, walking the middle path is the fifth DBT module, bringing the former four modules together. Walking the middle path entails working to achieve a balanced mindset.

Walking the middle path encourages individuals to find the middle ground between two opposites, known as “dialectics.” Dialectics are terms, concepts, or ideas that seem contradictory but can work well together [*]. When individuals learn to walk the middle path, they broaden their horizons and see certain situations from different perspectives.

When we walk the middle path, we embrace acceptance and change. For example, you might accept that you have a mental condition, such as bipolar or borderline personality disorder (BPD), but work toward changing certain habits that may be detrimental to your health.

Use our worksheet on walking the middle path to learn how to bring these dialectics together to expand your point of view.

The Bottom Line

Life can occasionally get the best of us, but it doesn’t always have to. By practicing the five core DBT modules and using DBT worksheets, you can face challenges head-on and achieve more positive outcomes.

Sources:

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4. B. O'Connell, Dowling M. “Dialectical behaviour therapy (DBT) in the treatment of borderline personality disorder.” Journal of Psychiatric and Mental Health Nursing, 2013.
5. Eeles J, Walker D. “Mindfulness as taught in Dialectical Behaviour Therapy: A scoping review.” Clinical Psychology & Psychotherapy, 2022.
6. Castorina JA. “Dialectics.” Springer eBooks, 2022.