The Four Modules of DBT
DBT, or dialectical-behavioral therapy, is an evidenced-based treatment originally created by Marsha Linehan, Ph.D., for use in the treatment of patients diagnosed with borderline personality disorder (BPD). Those with BPD often experience intense mood swings, have challenging relationships, and engage in self-injurious behaviors. Thus, the core modules of DBT were developed to center on skills to increase awareness to emotional experiences, cope with overwhelming emotions, tolerate unpleasant feelings and situations, and communicate with others in an effective way.
Although DBT was originally used for treating BPD, these skills are truly applicable to anyone, as all humans, at some point, feel uncomfortable feelings, encounter challenging situations, and struggle in communicating with others.
The first module of DBT, mindfulness, centers on increasing awareness to the present moment. Mindfulness skills aim to increase the ability to be aware of what is going on in the present moment. This means awareness of not only what is going on in the moment externally (what is happening around you), but also what is going on in the moment internally (what is happening inside of you). Through being mindful of internal experiences, like thoughts, feelings, and physical sensations, we can gain awareness as to how these things effect our mood, behavior, and interactions. Mindfulness skills are the foundation for the rest of the DBT modules. Skills taught in the core mindfulness module include:
The second DBT module, distress tolerance, focuses on skills to increase resilience and manage emotions during stressful times. So many of us (consciously or subconsciously) seek to “numb out” during difficult times, turning to substances or other unhealthy behaviors. While these ways of “coping” may feel good in the moment, they are ultimately unhelpful. Distress tolerance skills, sometimes referred to as “crisis survival skills” aren’t necessarily about taking away the feelings or the stressful situation, but more about increasing the capacity to navigate these experiences in an effective way. Skills taught in the distress tolerance module include:
The third module of DBT, emotion regulation, teaches skills to promote increased understanding of the function of emotions, as well as the action urges that often accompany these emotions. This module also provides ways to decrease the intensity of strong emotions, and approaches to “ride” an emotional wave, without having to take action. Skills taught in the emotion regulation module include:
The final DBT module, interpersonal effectiveness incorporates skills that look similar to those taught in some assertiveness or interpersonal problem-solving trainings. These skills focus on identifying needs in relationships, learning when (and how) to say “no”, and dealing with interpersonal conflict. Each skill taught in this module shares a goal of maintaining respect, for oneself and for others. The skills taught in the interpersonal effectiveness module include:
Jenna Jarrold, MS, LAC, NCC