Download PDF activities for your DBT sessions, homework, and skills groups.
Can you ever have enough DBT (dialectical behavioral therapy) worksheets and other activities? After all, DBT is a therapy built upon effective, memorable skills to cope with overwhelming emotions. DBT leaders are always looking for new and effective ways to teach them.
Formal DBT includes both individual sessions and skills groups each week. It's offered for teens and adults, and youth groups include parents as well. However more and more therapists are also providing DBT-informed therapy, incorporating some elements of the popular treatment into everyday therapy.
Whether you're a DBT therapist, an eclectic counselor, or a person seeking new skills, here are some DBT worksheets and other activities to help you teach or learn important concepts.
1. DBT DEARMAN Skill Worksheet
DEARMAN is a beloved DBT skill that helps you learn how to ask for something in an effective way. Many people struggle with not asking for what they want, or the opposite – becoming threatening or aggressive when they’re upset.
The DEARMAN skill provides an outline of how to ask what you want in a calm and assertive way. It’s important not to let others walk all over your boundaries.
It’s also important to ask for what you need in a clear and calm way. Here’s a list of what the acronym stands for.
Describe the situation or request
Express your thoughts and feelings about it
Assert what you need kindly but firmly
Reinforce that this issue is important
Mindfully stay calm and aware in the moment
Appear confident and believe in yourself
Negotiate by compromising if needed
Describe
Start with outlining the request or problem. Here are some example topics to use DEARMAN for:
Request a raise at work
Ask your roommate to stop playing loud music in the morning
Talk to a friend who keeps violating your boundaries
Ask your significant other to help more around the house
Request an extension on a school assignment
Ask that your landlord take care of a problem in your apartment
When you talk to the other person, be clear with yourself and with them what you want. Be willing to compromise somewhat (that’s what the negotiate phase is for). But, don’t give away what you really need in the situation.
Spell out the problem, situation, or request clearly so that there’s no confusion about it.
Express
During the express phase, you might express your feelings about what’s going on. For example, you might say to a roommate, “I’ve been feeling overwhelmed and frustrated lately having to take care of all the cleaning myself.”
If you’re in a professional setting, perhaps it’s more like, “I’ve taken on more and more responsibilities and I feel my contribution should be recognized.”
If you’re asking a friend to give you some space, you could say, “I really enjoy spending time with you and I want to keep doing that. But I feel pressured and ignored when you keep asking me after I’ve said no to something you want to do.”
Assert
Being assertive is all about being firm but calm. You don’t give in, but you also don’t get aggressive. And you definitely don’t get loud, pushy, or violent.
Here are some example phrases that might show assertiveness.
I’m not okay with you pressuring me to do this activity. This can’t happen again.
I’ve made this business more and more money over the past few years, and I believe my request for a raise should be considered.
I’m not going to continue to do your half of the chores. Since we agreed to split the responsibilities, I’d like you to keep up your side of it.
Reinforce
Reinforce is all about not backing down. While there can be some room for compromise, your request shouldn’t be dismissed outright. A response of, “Oh yeah, I’ll get to that sometime,” may reflect that the other person didn’t hear you or isn’t taking you seriously.
Return to your assertive stance and make it clear, without getting loud or inappropriate, that you are serious.
Be Mindful
Staying mindful is an internal process. It’s not something you express to the other person. But it can help you keep the situation in perspective. Plus, it can help you deal with any anxiety, which is normal when you’re asking for something important to you.
Ways to stay mindful include slowing your breathing, learning medication, and using grounding techniques.
Appear Confident
Appearing confident is really just a reflection of feeling confident. You have a right to ask for what you need and want. You might not always get it, but many people feel better simply because they stood up for themselves.
Physical signs of confidence include standing up straight, holding your head up, and not slinking off when you aren’t taken seriously at first. Internally, you can self-coach. Think, “I’m doing what’s right,” or “It’s perfectly normal and okay to set a boundary.”
Negotiate
Finally, be willing to compromise if needed. But don’t give in entirely. Maybe your roommate says they hate doing dishes, so you agree to trade them for cleaning the bathroom. Create a clear plan for how the chores will be done, and what you should both do if they start slipping again.
If you’re dealing with a more serious issue such as a friend pressuring you to do something you aren’t comfortable with, negotiating may not be appropriate. Instead, it’s your job to stand your ground going forward. In most cases if you’re firm the pressuring will stop.
However, if someone is abusing, threatening or coercing you it goes beyond DEARMAN. Ask for help from a person of authority or a therapist to help.
The DEARMAN worksheet provides an outline to practice with. It’s obviously not as simple as a 1-2-3 process, but thinking about your request ahead of time can make all the difference.
The worksheet also has a poster-type page you can put up or take a picture of. Plus, it has a form you can use to organize your thoughts and share with the other person if appropriate.
2. Wise Mind Worksheet
Wise mind is another popular DBT skill that crosses many areas of therapy and self-help. You might think of it as part Buddhist mindfulness and part practical decision making. The idea goes like this.
Part of our brain is instinctual. It’s sometimes called the lizard brain, because it’s all about immediate reactions. You might respond in fear or in impulse.
If you want a piece of candy you take it, no questions ask. See a new car you like? Why not buy it on the spot! Want to go on a date that’s obviously not a good idea. The heck with it.
We sometimes need this part of our brain to overcome fears, ruts, or anxieties. And we need it – it’s the part of us that survives and has fun in the world.
However, if lizard brain is in control all of the time, life tends to take on more stress than fun. You’ll face the consequences of constant rash decisions.
On the other hand, we have the responsible brain. Think of this as your parents at their strictest, or the mean teacher you had in kindergarten. Get your work done! No play before dinner! Arriving on time is arriving late.
We need this part of our brain to stay out of jail, out of trouble with the IRS, and in our boss’s good graces. But if it’s in control all of the time life may become stifling and overwhelming.
Now, there’s wise mind. Wise mind knows that the lizard brain and responsible brain are an important part of self. Their needs are valid, and should be taken into account. But it operates in a calmer, wiser place, in the middle.
Wise mind might say it’s okay to blow off homework for one night, but you’ll need to make up for it the next. It might calm lizard brain when it’s about to tell someone off, instead setting firm but peaceful boundaries.
It doesn’t forget responsible mind either. Paying bills on time and having a savings account makes more room for lizard brain to have fun. The whole idea is to find the balance in the calm, somewhat Zenfull center.
Your wise mind would be the first to tell you that no one is perfect at this. There may always be a shifting or counterbalancing act to keep things roughly even. But in the most important and difficult decisions, it’s the one you want running the show.
3. Radical Acceptance Worksheet
Finally we have radical acceptance. This one doesn’t work as well in acronym or homework form. That’s because it’s less about reasoning and more about … you know … acceptance.
Radical acceptance is when you finally let go of a relationship that’s not worth it. When you say to the he** with it when your dream vacation is falling apart. When you accept yourself as you are, with full love and without reservation.
Sometimes you need to stay in problem-solving mode, reframing a situation or using your new DEARMAN skill. At other times there’s no amount of reasoning, trying to fix things, or saying sorry that’s going to change the situation.
That’s when it’s time for radical acceptance. It’s saying to yourself, “This is how it is. There’s nothing more I can do about it. Life goes on.”
Understandably, it can feel invalidating. It’s definitely not something you want to say to someone else. And often it’s inappropriate to say to yourself too. For many it’s a last resort, to use when you’ve been spinning your wheels so long that it’s making you miserable.
In those moments, radical acceptance can be liberating, healing, and just the step you need to move on with a happier life.
Radical acceptance isn’t exactly something you can do homework on. It’s more a state of mind or a spiritual experience in the moment. But it can help to reflect on the idea and consider for areas of your life that just aren’t worth it.
4. The Greatest DBT Board Game on Earth
I’m honored to offer the Greatest DBT Board Game on Earth. That might sound like an arrogant title, but since it’s the only DBT board game I know of, I’m radically accepting it as is.
The board game is really a way to make discussing and reviewing DBT a lighter experience. It’s complete with prompts covering the four key areas of DBT, including:
Mindfulness
Interpersonal Effectiveness
Distress Tolerance
Emotional Regulation
You might notice that it overlaps with the worksheets above. You can travel the board which is set in a carnival theme, complete with a mindfulness tent and emotional roller coaster. Discuss scenarios where you might use skills, or review the skills themselves.
There’s also a beta telelehealth version available, so you can play the DBT game remotely. It’s set up to offer a more realistic feel to playing a real board game, rather than a watered down version. Check it out to see what you think!
Play to complete as many discussion points as you can, or simply as a fun way to make DBT group more interactive.
5. DBT Jenga and Dice Prompts
Looking for something more tactile? Our DBT Jenga stickers and printable DBT dice offer prompts as well.
You can make up your own game, such as naming a problem and then rolling the dice until an appropriate skill comes up to help with it.
Or, use pre-made scenarios on the dice and see if you can match them with skills. Roll one dice with a problem described and another with a list of skills.
It can be a bit of a creative challenge if two prompts don’t easily go together. How do you use DEARMAN to cope with a headache, for example? Maybe you can’t but it could be pretty interesting to try!
It might seem silly, but at the least it will help you clarify what skills work well in specific situations, and what may not do the trick.
The Jenga stickers also include scenarios focused on the four areas mentioned of mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Discuss and practice skills within each core area of DBT.
These game options are easy and light. And if you don’t want to deal with actual dice or Jenga, just cut out the prompts and put them in a little box or bag. Draw and discuss the topic or skill that comes up.
All five worksheets and activities are available in the DBT Activity Kit. Or, you can purchase them as part of the Giant Therapy Activity Bundle, full of dozens of games, worksheets and activities that overlap with DBT.
Resource:
DBT Skills Training Manual, Second Edition, by Marsha M. Linehan, 2014, available on Amazon.