DBT Glossary

Dialectical Behavior Therapy has its own vocabulary. If you are new to DBT or just starting treatment, this glossary explains the terms, skills and acronyms your therapist and skills group use.

Core acronyms

DBT Dialectical Behavior Therapy: A comprehensive, evidence-based treatment developed by Dr. Marsha Linehan that combines cognitive-behavioral techniques with mindfulness-based approaches. It balances acceptance and change strategies to help people build a life worth living.
BPD Borderline Personality Disorder: A mental health condition characterized by patterns of emotional instability, intense interpersonal relationships, distorted self-image, and impulsive behavior. DBT was originally developed to treat BPD but is now used for many conditions.
CBT Cognitive Behavioral Therapy: A widely used family of therapies that work on emotions, thoughts, and behaviors together, with protocols matched to specific conditions. DBT grew out of CBT and shares many of its principles while adding acceptance-based strategies and skills training.
DBT-A DBT for Adolescents: The adaptation of DBT for teens and their families. It keeps all four parts of comprehensive DBT, adds parents or caregivers to a multifamily skills group, and adds a module, Walking the Middle Path, to address the polarized thinking and extreme positions that commonly drive conflict between teens and parents.
RO-DBT Radically Open Dialectical Behavior Therapy: A separate treatment developed by Dr. Thomas Lynch, intended to target issues of overcontrol: rigid, inhibited, perfectionistic patterns such as chronic depression or anorexia. It shares DBT's name and some of its structure, but it takes a different approach and has its own skills.

The four skill modules

Mindfulness

The practice of paying attention to the present moment without judgment. In DBT, mindfulness is considered a core skill that supports all other modules. It includes "What" skills (observe, describe, participate) and "How" skills (non-judgmentally, one-mindfully, effectively).

Distress Tolerance

Skills for surviving crisis moments without making things worse. These skills help you tolerate painful emotions and situations when you cannot immediately change them.

Emotion Regulation

Skills for understanding, managing, and changing intense emotions. This module teaches you how emotions work, how to reduce vulnerability to negative emotions, and how to increase positive emotional experiences.

Interpersonal Effectiveness

Skills for navigating relationships, asking for what you need, saying no, and maintaining self-respect. This module draws on assertiveness training and teaches specific strategies for different interpersonal goals.

DBT skills, A to Z

ABC PLEASE Emotion Regulation: A skill for reducing vulnerability to negative emotions. Accumulate positive experiences, Build mastery, Cope ahead of time, treat PhysicaL illness, balance Eating, avoid mood-Altering substances, balance Sleep, get Exercise.
ACCEPTS Distress Tolerance: A skill for distracting yourself during a crisis. Activities, Contributing, Comparisons, Emotions (opposite), Pushing away, Thoughts (other), Sensations.
Accumulate Positive Experiences Emotion Regulation: The "A" in ABC PLEASE. Doing pleasant things on purpose, every day, while also building toward a life that fits your values, so painful emotions have less impact.
Build Mastery Emotion Regulation: The "B" in ABC PLEASE. Doing one thing each day that is hard but doable, so that you get better over time, resulting in an increased sense of competence and control.
Check the Facts Emotion Regulation: Asking whether an emotion, and how intense it is, fits what actually happened rather than your interpretation of it. If it fits, you work on the problem; if it doesn't, Opposite Action is often the next step.
Cope Ahead Emotion Regulation: The "C" in ABC PLEASE. Preparing for a difficult situation ahead of time by deciding which skills you'll use, rehearsing it vividly in your mind beforehand, and considering how you'll handle it if things go poorly.
DEAR MAN Interpersonal Effectiveness: An acronym for asking for something or saying no effectively. Describe the situation, Express your feelings, Assert what you want, Reinforce the other person, stay Mindful, Appear confident, Negotiate when needed.
Describe Mindfulness: A mindfulness "What" skill: putting words to what you observe, sticking to the facts. "My chest is tight and I'm thinking she's angry" describes; "she hates me" is a judgment.
Dialectics Interpersonal Effectiveness: The idea that two things that seem opposite can both be true, and that the way forward is usually a synthesis rather than picking a side. The "D" in DBT. The primary dialectic is between acceptance and change: accepting reality as it is while working towards change.
Effectively Mindfulness: A mindfulness "How" skill: doing what works in the situation you're actually in, with your real goals in mind, instead of what feels right or fair in the moment.
FAST Interpersonal Effectiveness: A skill for maintaining self-respect. Be Fair, no Apologies (when unnecessary), Stick to your values, be Truthful.
GIVE Interpersonal Effectiveness: A skill for maintaining relationships. Be Gentle, act Interested, Validate the other person, use an Easy manner.
Half-Smiling and Willing Hands Distress Tolerance: Using the body to support acceptance: relaxing the face into a slight upturn of the lips, and unclenching the hands, palms up. The body's posture nudges the mind toward accepting rather than fighting.
"How" skills Mindfulness: The three mindfulness skills for how you practice: non-judgmentally, one-mindfully and effectively. They go with the "What" skills.
IMPROVE the Moment Distress Tolerance: A skill for making a crisis moment more bearable. Imagery, Meaning, Prayer, Relaxation, One thing in the moment, Vacation (brief), Encouragement.
Loving-Kindness Mindfulness: A mindfulness practice of silently offering warm wishes to yourself and to others, including people you find difficult. It builds compassion and reduces anger towards the other person, allowing you to be more effective in your responses.
Mindfulness of Current Emotion Emotion Regulation: Noticing an emotion in your body, observing it rise and fall like a wave, without pushing it away or holding on to it. You are not your emotion, and you don't have to act on it.
Mindfulness of Current Thoughts Distress Tolerance: Watching thoughts come and go as events in the mind rather than facts about the world. You notice a thought, label it as a thought, and let it pass without arguing with it or having to act on it.
Non-Judgmentally Mindfulness: A mindfulness "How" skill: sticking to facts and observations instead of sticky labels like good, bad or should. Judgments tend to make emotions bigger, and reduce your range of possible responses.
Observe Mindfulness: A mindfulness "What" skill: noticing what is happening, inside you or around you, without putting words to it or reacting to it.
One-Mindfully Mindfulness: A mindfulness "How" skill: doing one thing at a time with full attention, bringing your mind back each time it wanders.
Opposite Action Emotion Regulation: An emotion regulation skill that involves doing the opposite of what an unhelpful emotion is urging you to do. For example, if anxiety urges you to avoid a situation, opposite action would involve approaching it instead.
Participate Mindfulness: A mindfulness "What" skill: throwing yourself fully into what you're doing such that, in the moment, you are doing nothing else.
PLEASE Emotion Regulation: Taking care of the body to prevent these common vulnerability factors: treat PhysicaL illness, balance Eating, avoid mood-Altering substances, balance Sleep, get Exercise.
Problem Solving Emotion Regulation: Used when an emotion fits the facts and the situation can be changed: describe the problem, check the facts, set a realistic goal, brainstorm options, pick one, act, and see how it went.
Pros and Cons Distress Tolerance: Weighing the pros and cons of acting on a crisis urge against the pros and cons of resisting it, ideally written down before the crisis, so the long-term costs stay in view when the urge is strong.
Radical Acceptance Distress Tolerance: Fully acknowledging reality as it is in this moment, without trying to fight it, deny it, or judge it. Radical acceptance does not mean approval — it means choosing to stop suffering over things you cannot change right now.
Recovering from Invalidation Interpersonal Effectiveness: Steps for when someone dismisses your experience: check whether any part of their response is accurate, acknowledge what is, validate the rest of your experience yourself, and remember that being invalidated doesn't mean your response was invalid.
Self-Soothe Distress Tolerance: Comforting yourself through the five senses (sight, sound, smell, taste and touch) to get through a difficult moment without making it worse.
Self-Validation Interpersonal Effectiveness: Accurately acknowledging your own emotional state, while recognizing that your emotional responses make sense given your history and the situation, even when you'd like to change them.
STOP Distress Tolerance: A skill for pausing before reacting impulsively. Stop, Take a step back, Observe what is happening, Proceed mindfully.
TIPP Distress Tolerance: A skill for quickly changing your body chemistry during a crisis. Temperature (cold water on face), Intense exercise, Paced breathing, Paired muscle relaxation.
Turning the Mind Distress Tolerance: Choosing acceptance again each time you notice yourself fighting reality. Acceptance is rarely a single decision; turning the mind is the repeated choice to come back to it.
Urge Surfing Distress Tolerance: Noticing an urge in the body and riding it out like a wave, watching it build, peak and pass, without acting on it or fighting it.
Validation Interpersonal Effectiveness: Communicating that another person's emotions, thoughts or actions make sense given their situation. Validating is not agreeing or approving; it is showing you understand.
Walking the Middle Path Interpersonal Effectiveness: Skills for finding the balance between extremes, such as too strict and too lenient, or self-denial and self-indulgence. They combine dialectics, validation and behavior-change strategies, and are central to DBT for teens and families.
"What" skills Mindfulness: The three mindfulness skills for what you do when you practice: observe, describe and participate. They go with the "How" skills.
Willingness Distress Tolerance: Doing what the situation needs, wholeheartedly, without dragging your feet. Its opposite, willfulness, is refusing to accept the moment: sitting on your hands, trying to fix what can't be fixed, or giving up.
Wise Mind Mindfulness: The integration of your emotional mind and your reasonable mind. Wise mind is the place where logic and emotion overlap, allowing you to make decisions that honor both your feelings and the facts of a situation.

Key ideas

Biosocial Theory: DBT's explanation of how severe emotion dysregulation develops: a person born emotionally sensitive and reactive, slow to return to baseline, grows up in an environment that often invalidates their emotions. Each makes the other worse over time.
Emotion Mind: The state of mind where feelings are automatically acted on and facts and consequences fade from view. One of the three states of mind in DBT, with reasonable mind and wise mind.
Invalidating Environment: Surroundings that dismiss, punish or oversimplify a person's emotional experience, such as being told you're overreacting or that you should just snap out of it. Half of DBT's biosocial theory.
Levels of Validation: Six increasingly deep ways to validate: paying attention, reflecting back accurately, naming what hasn't been said, making sense of it from the person's history, making sense of it from the present situation, and treating the person as an equal (radical genuineness).
Life Worth Living: The overall goal of DBT: not only reducing crises, but building a life the person experiences as worth living, by their own values. Treatment goals are set with that life in view.
Reasonable Mind: The state of mind where logic and facts are in charge and emotions are set aside. Useful for planning, but on its own it misses what matters to you. One of the three states of mind in DBT.
Willfulness: Refusing to tolerate or accept the moment: insisting on control, trying to fix what can't be fixed, or giving up entirely. DBT's answer is willingness.

How DBT treatment works

Behavioral Tech: The training institute founded by Dr. Marsha Linehan to train clinicians in DBT. Its Foundational and Intensive trainings are among the primary routes into DBT practice.
Chain Analysis: A structured method for understanding a problematic behavior by examining the entire sequence of events, thoughts, emotions, and actions that led to it. It helps you and your therapist identify where to intervene with skills next time.
Comprehensive DBT: DBT delivered with all four of its parts: weekly individual therapy, a weekly skills group, phone coaching between sessions, and a therapist consultation team. This is the form of DBT tested in research trials.
Consultation Team: A weekly meeting of DBT therapists where they support each other in providing effective treatment. The consultation team is a required component of comprehensive DBT and exists to help therapists stay motivated, skilled, and balanced.
DBT-Informed: Therapy that borrows DBT skills or ideas without delivering all four parts of comprehensive DBT. It is not the treatment that was tested in DBT research trials.
DBT-Linehan Board of Certification: An independent organization that certifies DBT programs and clinicians who meet the standards set by Dr. Marsha Linehan. Front Range Treatment Center is a DBT-Linehan Board Certified program.
Diary Card: A daily tracking tool used in DBT to monitor emotions, urges, behaviors, and skill use throughout the week. Your therapist reviews it at the start of each individual session to guide the conversation.
Four-Miss Rule: A standard DBT program rule: missing four scheduled sessions of the same kind in a row, individual or group, ends that round of treatment. It is agreed up front so attendance problems get addressed early.
Multifamily Skills Group: The skills group format in DBT for teens, where teens and their parents or caregivers learn the skills together, so the whole family shares the same language.
Phone Coaching: Brief contact with your DBT therapist between sessions to get help using a skill in the moment the problem is happening. It is coaching, not a therapy session by phone.
Prompting Event: In a chain analysis, the event that set the chain off: what happened, inside or outside you, just before the problem started.
Skills Group: The weekly class in comprehensive DBT where the skills are taught, practiced and assigned as homework. It works more like a class than group therapy: the focus is learning skills, not processing personal stories.
Target Hierarchy: The order in which DBT addresses problems: life-threatening behaviors first, then anything that interferes with therapy, then problems that get in the way of quality of life, while building skills throughout.
Therapy-Interfering Behavior: Anything, by client or therapist, that gets in the way of treatment working, such as missed sessions, unfinished diary cards, or a therapist running late. DBT treats it as a problem to solve, not a character flaw.
Vulnerability Factors: In a chain analysis, the things that made you more reactive that day, such as poor sleep, illness, hunger or stress, so the prompting event hit harder than it otherwise would.

Put the skills to work

Knowing what an acronym stands for is the easy half. These free tools turn the skills into something you can use:

DBT Skills Finder — answer a few questions, get a skill for the situation you're in right now.
DEAR MAN worksheet — fill in four boxes and it builds a script for asking for something or saying no.
Opposite action worksheet — pick the emotion, check whether it fits the facts, get a specific plan.

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