The DBT 4 Modules: The Fundamentals of Dialectical Behavior Therapy

In Dialectical Behavior Therapy (DBT), there are four DBT modules that make up the core fundamentals of this therapy style.

Before we go into these DBT 4 modules, let us first break down what dialectics are.

Dialectics means that two opposites can be true at the same time. When this happens, you create a new way of looking at the situation.

When it comes to the four modules of DBT they fall under acceptance skills or change skills.

Acceptance Skills include Mindfulness (module one) and Distress Tolerance (module four).

Change Skills include Emotion Regulation (module two) and Interpersonal Effectiveness (module three).

Read on to learn more about these four DBT modules that consist of skills to help you cope with difficult emotions and live a more fulfilling life.

DBT 4 Modules: #1 Core Mindfulness Skills

The first module is Mindfulness which is a state of mind about being in the moment and the core component to regulate emotions. Additionally, it is the foundation for all the other skills that are taught in DBT Therapy. Mindfulness helps you to slow things down, remove any judgments, and accept things as they are. It is quite common for people to find themselves dwelling on the past or worrying about the future. By practicing mindfulness, you can create a sense of balance and not act on impulse or urges.

Misconceptions About Mindfulness

A common misconception about mindfulness is that it is about clearing your mind, not thinking at all, or changing your thoughts. However, that is not the case. It is to build awareness and nonjudgmental observations about your thoughts and feelings and not wander to the past or future to the point you get lost in them. Additionally, it is important to know that mindfulness and meditation, guided imagery, and/or relaxation are not equally the same thing. While those areas can be a component of mindfulness practice or exercise, there are numerous ways to practice mindfulness that does not incorporate them that can be applicable to your life and your needs.

DBT Mindfulness vs. Traditional Mindfulness

What separates DBT Mindfulness from traditional mindfulness is the importance of nonjudgmental self-awareness of your thoughts, feelings, emotions, and physical sensations in the present moment. DBT is grounded in the ability to practice mindfulness, therefore, every session incorporates a mindfulness practice to help you build and strengthen the skill. Continuous practice of the skill is key because it is a challenging skill to learn, therefore, it is practiced at the beginning and end of each session as well as between each core module. We are human and our minds are hardwired to create stories and judgments. You know that you are building that skill when you can redirect your mind the moment you notice that you are not in the present moment. The more that you practice mindfulness, the stronger you get at recognizing when you are in control versus your thoughts and emotions controlling you.

The Seven DBT Mindfulness Skills:

Within DBT there are seven mindfulness skills which include the following:

DBT Wise Mind:

1. The wise mind combines the emotional mind and the rational mind but goes beyond that to incorporate intuition. This is a deep sense of knowing which is the power of intuition that can make the wise mind difficult to put into words. This is the aim of DBT.

DBT What Skills

2. Observing: This is when you simply observe and become aware of your thoughts, feelings, and behaviors without trying to change them or judge them.

3. Describing: Once you are aware, then you can describe your thoughts, feelings, behaviors, and experience. Through understanding that feelings and thoughts are not facts you have the power to build empathy and self-control.

4. Participating: When you’re participating, you’re living in the present moment.

DBT How Skills

5. Nonjudgmentally: In this skill, you’re learning how to not identify anything as good or bad, black or white. Rather than judging thoughts or events, you are looking at the consequences instead.

6. One-Mindfully: The premise of this is to focus on one thing in the present moment. It is to focus on one thing, the task at hand. We remain mindful to not allow worry or judgment to take over and influence your emotional response.

7. Effectively: This is when you act according to your goals. It is empowering because it allows you to focus on your objectives and not get stuck in judgment. It helps you act on a specific goal instead of getting stuck in thinking about it.

Benefits of Practicing DBT Mindfulness

There are endless benefits to practicing and strengthening mindfulness skills. Some of the benefits include:

  • Increased emotional regulation (ability to manage and regulate emotions)
  • Increased awareness and focus
  • Improved communication
  • Healthier interpersonal relationships
  • Decreased symptoms of anxiety or depression
  • Improved ability to handle stressful situations
  • Increased cognitive recollection and focus

DBT 4 Modules: #2 Interpersonal Effectiveness Skills

In this module, you will learn how to navigate relationships with yourself as well as others. There is a strong emphasis on the patterns of dysfunctional or chaotic relationships. You will learn how to become more aware of how your emotions and behavior can affect your relationships and how you can make positive changes. By gaining interpersonal effectiveness skills you will become aware of your effect on others. There is also a strong emphasis on learning boundaries and clearly identifying your values.

The 3 Core Techniques

1. Objective:

How to get what you want by expressing your wants and needs respectfully.

Exercise: DEAR MAN

The acronym DEAR MAN outlines a strategy that helps you communicate effectively.

Describe: This is where you clearly and concisely describe the situation focusing on facts without judgment. You leave out any opinions or interpretations in this step.

Express: You focus on “I” statements in order to express your feelings and emotions.

Assert: You’ll express what you want or need clearly and effectively.

Reinforce: Here you will focus on how you’ll reward the other person by them responding well to you. Often a simple “thank you” goes a long way.

Mindfulness: Be mindful of your goal with the interaction without getting distracted.

Appear confident: Even if you don’t feel confident, use body language that expresses confidence.

Negotiate: It’s important to know what your limits are and what you’re willing to accept. However, it’s equally important to be willing to compromise.

2. Relationship:

How to maintain healthy relationships.

Exercise: GIVE

The acronym GIVE helps with relationship effectiveness with healthy and positive interactions.

Gentle: It’s important to not attack or threaten.

Interested: Actively listening shows that you’re interested and helps the other person feel heard.

Validate: To validate someone means that you acknowledge their feelings and that you’re mindful of how you are interacting.

E: Be easy going with a light hearted attitude.


3. Self-Respect Effectiveness:

How to keep your own self-respect.

Exercise: F.A.S.T.

The acronym FAST is about being loyal to your values and beliefs and still getting what you desire.

Fair: Be fair to both yourself and others.

Apologies: Unless it is necessary, do not apologize. You don’t have to apologize for a disagreement, a request, or even an opinion.

Stick to Your Values: Your values are essential. It’s vital not to neglect them just to be liked.

Truthful: Honesty is the best policy.

DBT 4 Modules: #3 Emotional Regulation Skills

Suppressing emotions is never a good idea as they will continue to get bigger internally and result in unhealthy outbursts. That is why learning skills to regulate overwhelming emotions is extremely important with DBT. In this module you will learn about emotions and their purpose so that you can better identify and regulate them when they surface.

Learning Emotion Regulation Skills help you to address emotional vulnerability and manage your emotional reactions in healthy ways and offers you specific techniques to help manage emotions. One of the goals is to be able to identify and label your feelings and change the feelings that you want to change. You learn immediate tools that will help you cope when overwhelm surfaces.

How Emotional Dysregulation Manifests

  • Explosive anger outbursts
  • Excessive or crippling anxiety
  • Panic attacks
  • Intense mood swings
  • Crying in response to your frustrations

Emotion Regulation Coping Techniques

  • Take care of your mind by taking care of your body.
    • Sleep hygiene
    • A balanced diet
    • Avoiding drugs and alcohol
    • Regular exercise
  • Opposite action skill
    • This is about taking an action that is the opposite of what you usually would do. When we behave in a particular way then our emotions will follow suit.
  • Checking the facts skill
    • Asking yourself questions and investigating your emotions will help you to reduce the intensity of those extreme emotional highs and lows.
  • Focus on positive events
    • Practicing paying attention to what is good and positive in your life helps to avoid emotional dysregulation.


DBT 4 Modules: #4 Distress Tolerance Skills

The fourth module is distress tolerance skills which teach you methods on how to reduce distress and manage it in healthy ways. We are often faced with situations that we are unable to control, and this skill is beneficial for managing your response to an uncontrollable situation or crisis. With the foundation of mindfulness, you will learn distress tolerance skills that will teach you how to tolerate uncomfortable experiences. DBT Distress Tolerance Skills empower you to accept the reality of the situation and not make it worse.

Examples of Unhealthy Ways of Dealing with Stress and Discomfort

      • Isolation
      • Self-Harm
      • Self-Medicating
      • Avoidance
      • Impulsive Overreactions
      • Risky Behavior
      • Emotional Outbursts
      • Self-Destructive Actions
      • Distress Tolerance Techniques

During this module, you will learn healthy ways to work through distress and crisis situations as opposed to past self-destructive behaviors.

There are four survival strategies that include:

  1. Distracting yourself until the emotions pass
  2. Radical acceptance of the reality of the situation
  3. Self-soothing through your five senses
  4. Mindfully list the pros and cons of not acting out urges

How to Benefit from the DBT 4 Modules

Hopefully, you have insight into each of the DBT 4 modules to understand what they are and how you can benefit. We encourage you to attend a DBT Skills Group and talk to a Licensed Therapist who is skilled in Dialectical Behavior Therapy for individual therapy if you are interested in learning these skills and applying them to your life.

Join Our Upcoming Online DBT Basic Skills Group for Adults

We have a few spots remaining.
?Dates: February 8th – May 3rd (Open to Adults 18+)
⏰Time: Every Tuesday from 6:00-7:30PMCT
?Where: Online via Zoom

To register, contact us at 217-398-9066 or email us at [email protected]

This group is for you if you want to learn how to:
✅ Improve your interpersonal relationships
✅ Manage emotional reactions
✅ Manage unwanted behaviors
✅ Stop or reduce drug and alcohol use
✅ Use DBT skills to live a more fulfilling life
✅ Find peace or stability during moments of crisis or heightened emotions
✅ +and more

These skills fall into categories, including core mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills. Each week we will focus on teaching new skills and assist you in integrating them into your day-to-day life.

We do not know when we will be offering it again, so we encourage you to take advantage of the opportunity. The group will be facilitated by two of our Illinois Licensed Therapists who are trained and skilled in Dialectical Behavior Therapy.

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