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The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance

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A Clear and Effective Approach to Learning DBT Skills

First developed for treating borderline personality disorder, dialectical behavior therapy (DBT) has proven effective as treatment for a range of other mental health problems, especially for those characterized by overwhelming emotions. Research shows that DBT can improve your ability to handle distress without losing control and acting destructively. In order to make use of these techniques, you need to build skills in four key areas-distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness.

The Dialectical Behavior Therapy Skills Workbook, a collaborative effort from three esteemed authors, offers straightforward, step-by-step exercises for learning these concepts and putting them to work for real and lasting change. Start by working on the introductory exercises and, after making progress, move on to the advanced-skills chapters. Whether you are a professional or a general reader, whether you use this book to support work done in therapy or as the basis for self-help, you'll benefit from this clear and practical guide to better managing your emotions.

This book has been awarded The Association for Behavioral and Cognitive Therapies Self-Help Seal of Merit — an award bestowed on outstanding self-help books that are consistent with cognitive behavioral therapy (CBT) principles and that incorporate scientifically tested strategies for overcoming mental health difficulties. Used alone or in conjunction with therapy, our books offer powerful tools readers can use to jump-start changes in their lives.

241 pages, Paperback

First published January 1, 2007

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9892 people want to read

About the author

Matthew McKay

156 books297 followers
Matthew McKay, PhD, is a professor of psychology at the Wright Institute in Berkeley, and author of more than 30 professional psychology and self-help books which have sold a combined total of more than 3 million copies. He is co-founder of independent self-help publisher, New Harbinger Publications. He was the clinical director of Haight Ashbury Psychological Services in San Francisco for twenty five years. He is current director of the Berkeley CBT Clinic. An accomplished novelist and poet, his poetry has appeared in two volumes from Plum Branch Press and in more than sixty literary magazines. His most recent novel, Wawona Hotel, was
published by Boaz Press in 2008.

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Displaying 1 - 30 of 211 reviews
Profile Image for Amanda.
11 reviews1 follower
January 1, 2020
If I only had read the first chapter of the book, I would have given it more stars. The second chapter is very reliant on religion / spirituality, which is incredibly unhelpful for those of us who are not religious and actually have trauma from religion. Also, as a scientist, I found the misinformation and conflation of scientific information to make is seem magical and divine to be extremely dishonest and disturbing. Upon googling the authors of the book, I discovered that one runs a Christian Leadership program. Religious beliefs should be kept far away from medicine, including Psychiatry and psychology. If this man were my psychiatrist, I would complain to the Department oh Health.
Profile Image for Songs and Sonnets.
11 reviews5 followers
October 8, 2011
I've tried out three DBT self-help books, and this one is by far the best. It's well laid out, easy to understand and very user-friendly. It teaches you mindfulness techniques as well as skills for getting through a crisis, improving mood, and getting your needs met in relationships. I've found these particularly useful for coping with stress.

One of the things I like about this book is it doesn't make any assumptions about the reader, or target a particular mental health problem. DBT was originally developed to treat borderline personality disorder, but this book is equally suitable for people who want to learn DBT skills to tackle other issues.

The other DBT books I've read were Don't Let Your Emotions Run Your Life by Scott Spradlin and Depressed and Anxious by Thomas Marra. The former is very much aimed at people with BPD, and I couldn't relate to a lot of it. It also goes into a lot of detail on some aspects of DBT, but is sketchy about others. Depressed & Anxious was a very difficult book to understand, and I gave up after one and a half chapters.

So if you're interested in DBT, whatever your diagnosis, in my opinion The Dialectical Behavior Therapy Skills Workbook is the one to try!
Profile Image for Michelle.
269 reviews23 followers
January 25, 2013
As a therapist, I'm always on the lookout for self-help books that I can recommend to clients. In the process, I'm often lucky enough to benefit from the material as well. That absolutely happened with this workbook. The authors do a great job laying out the principles of DBT in clear language accessible to any lay person. The pacing of the book makes it practical. Explanations are interspersed with exercises to put new ideas/behaviors into practice. Examples are given throughout to illustrate the ideas. In particular, I appreciated the explanations and exercises targeting distress tolerance. If you or someone you are close to has a hard time getting over unpleasant emotions OR shuts down whenever emotions show up, this is a great book to explore. The Interpersonal Effectiveness skills might be a little harder to implement on your own but would be a wonderful adjunct to therapy.
Profile Image for Marisa Bennett.
111 reviews32 followers
April 13, 2012
It seems that many people do NOT want to use great books like this to effect change in their lives that ensure a much higher quality of life. This is not the simplest workbook, but doing it, and then asking your therapist to work on sections where you see you struggle is a heck of a lot better than doing nothing! This workbook is excellent! It works if you work!
Profile Image for Matteo Ressa.
2 reviews
July 9, 2018
Life changing

I wish I would have read this 20 years ago. To read again and again, practicing every day the worksheets. Enlightening.
Profile Image for Paula.
157 reviews5 followers
August 28, 2022
Someone told me about Dialectical Behaviour Therapy as I was talking about Cognitive Behavioural Therapy and the limitations I felt CBT had. I took out this book from the library as I wanted to learn more about the framework of DBT and wanted to see if there were any practices that could help me in terms of personal growth.

I was rather uncomfortable reading this book. The authors do not say if their clients had severe childhood trauma, however, based on the stories they shared, their clients definitely sound like they had a traumatic childhood. This book is better suited for people with serious emotional problems as there were frequent references of people with cutting tendencies or those who threatened their loved ones by saying they will kill themselves if the loved one didn't meet their demand.

Some people here have commented how the authors reference the concept of spirituality. I do agree that I think the word spirituality has no place in therapy. We need to keep therapy secular. At the end of this book, the authors have an excerpt from their book, "The New Happiness: Practices for Spiritual Growth and Living with Intention." Here they define spirituality as, "living a life based on choices and actions that make you feel more connected with your deepest values." They go on to say that this book, The New Happiness, "defines spirituality as a process of doing rather than a process of believing." I think most people would be ok with this definition, however, we just don't even need to use that word. I mean, if that's what it means to you, sure but for me, living my life according to my values is just that - me living my life. I don't need to call it my spirituality or give it any other label. In Chapter 2 - Advanced Distress Tolerance Skills, they do talk about using a higher power, which is basically having faith in something bigger and more powerful than yourself. They claim that doing so can "make you feel empowered, safe, and calm." They do say a higher power doesn't have to be a god and they suggest on page 45 that you can have a higher power that is someone who can make you feel stronger and more confident, however, I do not think making a human a higher power is a good choice. I can see someone like a cult leader who takes advantage of people and manipulates them. Also I doubt that there is any science backing this claim that we need a higher power. 

This book seems geared for people who have serious trouble with practicing self-restraint and emotional regulation so most of the content just didn't seem relevant for me. I did think Chapter 10 - Advanced Interpersonal Effectiveness Skills had some useful concepts. I thought the section on page 244 "Coping With Resistance and Conflict" was informative. They list 5 conflict management skills and they are:
1. Mutual validation. The authors claim that when people aren't listening to you, one of the common reasons is that they feel invalidated. Validating acknowledging their needs, feelings, and motivations. Depending on the context, some situations are not resolved even if you validate the other person. Humans are complex and many are driven by unconscious feelings that we most likely can never understand or help. All the validation in the world sometimes just doesn't work. It would be nice if the authors acknowledged the limitations of validating others.
2. Broken Record. This is basically repeating yourself and not giving someone ammunition. Examples the authors give are, "I just prefer it" or "That's just how I feel."
3. Probing. This is basically using questions to understand people. The key phrase the authors reference is, "What is it about (name the situation) that bothers you?" I can see this being usful in helping to understand the psychology of others as well since you are making an effort to understand what drives them in life. It seems like it would be useful to use in regular conversation as well as a way to deepen a friendship.
4. Clouding . This involves agreeing to some part of what they say and ignore the rest of the argument. One way is to agree or modify words of exaggeration such as "always" and "never." For example person says, "You never support me when I need something." You can respond by saying, "Yes there have been times when I couldn't completely support what you were asking."
5. Assertive Delay . Involves saying that you need time to think before you make a decision.

Chapter 1 - Basic Distress Tolerance Skills talks about using radical self-acceptance as a way to minimize self-destructive behaviours and to increase your distress tolerance skills. They have a list of pleasurable activities that people can engage in such as joining a public speaking group or take photographs. They advise using distraction, which I think is a good point since typically we think being distracted is a bad thing, however, we can use it constructively, especially in times when we are feeling volatile. For example, we can distract ourselves by leaving the situation or by doing tasks and chores. They end with talking about how to self-soothe and they reference the 5 senses as ways we can soothe ourselves such as looking at pictures we find comforting or by touching our pets. In Chapter 2 - Advanced Distress Tolerance Skills, they continue to discuss other techniques for managing stress and that includes visualizing a safe place or having a cue word. When they referenced having a cue word, I couldn't help but think of Frank Costanza's use of the phrase, "Serenity Now!" for when he was experiencing anger. 

My only problem with this book is that I don't think they understand that people with these types of severe emotional problems probably have bodies that are highly stressed and in a constant state of vigilance. They just don't know how to relax on a physical level and so that impacts their daily interactions with people. They can become this way due to various traumas such as abuse in childhood, being in an accident, etc. I've done reading on trauma and read that our nervous system needs to relax and that the behaviours people engage in because they think are relaxing, are actually not relaxing for their body and continues to keep their nervous system on high alert. I found the books "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma," and "Overcoming Depression" by Paul Gilbert to be helpful in understanding this idea. It's like the authors aren't asking themselves what is the cause that drives their clients to be so volatile and that to me is what is lacking in this book. I don't know if it's a lack in the book or a lack in the framework of DBT. They do reference a technique in chapter 2 page 59 called Feelings-Threat Balance (FTB-Cope) where you assess the level of the threat versus the strength of your feelings. They also reference using self-compassion and mindfulness, however, I just think they don't get the biology aspect.

Overall I thought this book was ok. I think it's probably best suited for those who are working with a psychiatrist on their issues and have serious emotional issues. 
Profile Image for Murgatroyd.
63 reviews3 followers
June 10, 2017
This one was a lot of work! I feel like I should get some college credits for this. But it was also very helpful. I feel like I have gotten better at practicing mindfulness to calm myself from panic attacks and other scary situations. And I have learned better to remember to be mindful in the first place. Very helpful book!
Profile Image for Strawberry Witch.
283 reviews6 followers
June 4, 2021
Wow. This was terrible. This might be helpful for someone very young, or...or...someone who doesn’t read? I don’t know. Everything in here is just super basic. The “mindfulness” crap is ridiculous. I should take deep breaths? No shit, for reals?

I think, at this point in my life, I’ve done so much inner work on my own that books like this just make me roll my eyes. I’ve apparently been doing DBT for years; I was just thinking of it as, like, journaling a lot, doing yoga, and trying to be less of a bitch in general. So, you know, maybe try that before trying this stupid book.
Profile Image for ✨Bean's Books✨.
648 reviews5 followers
January 9, 2018
Amazing workbook! Everything is well laid out and arranged. Subjects are very well explained. The exercises are easy to follow but really make you dive into yourself. The book has helped me be more present in the "now" and to be much more mindful of my actions, my surroundings and my emotions and reactions. I would definitely recommend this workbook to anyone needing DBT (Dialectical Behavior Therapy) help.
Profile Image for Carlton Brown.
Author 2 books41 followers
March 25, 2015
Well worth the read for those wishing to develop their emotional intelligence, and learn news skills to help you cope with difficult interactions and relationships. Whether you have low emotional intelligence (EQ), borderline autistic tendencies, or suffer from anger, anxiety-depression, or other difficult emotions; you will find value in this book.

The book is divided into four main sections that initially introduce you to, then further explore skills for; distress tolerance, mindfulness, emotional regulation and interpersonal effectiveness. This is a “how to manual” full of great insight, knowledge, and practical skills exercises which really do make a difference – if you do the work!

This is an information dense book, and if you are serious then you will likely need to keep reading it for it to more fully sink in (or is that just my limitation!!?). This is a lifelong journey and this book your companion if you need to rebalance your IQ : EQ balance and work on your interpersonal effectiveness skills. There’s no easy way out, and the work needs to be done! This is a very helpful book in my view - and a one which sat on my bookshelf for many years until the time was right.
Profile Image for meghana.
87 reviews7 followers
May 12, 2022
Read this on Suman's recommendation. Important to note that I did these exercises outside the context of therapy. I found them to be really valuable - while the content was not earth-shattering, working through them one by one was more challenging than expected, and I plan to return to this workbook regularly as I work to improve my mindfulness, emotional regulation, and relationships. I'd recommend that anyone give it a try.
Profile Image for Erica Filer.
75 reviews2 followers
July 11, 2022
Amazing clinical resource! Filled with a great amount of interventions and research to support the DBT theory (particularly with trauma).
Profile Image for A..
41 reviews
May 19, 2019
So, I tend to be wary of self-help books, because although comforting to read, the information rarely sticks in my mind. For that to happen, you need to incorporate it into your daily routine or actively change your behaviour. Too many self-help books merely try changing your mindset, which isn't enough. Anyway, when I first discovered this book, I'd never heard of DBT before. I was intrigued and curious about it, especially when it seemed like something that could potentially be highly beneficial for me. I thought that even if it wouldn't be, it'd still be interesting to learn about since psychology as a topic interests me. The fact that this is a workbook also gave me some hope that it might be easier to implement its ideas into my life.

I quickly learned DBT was originally designed to treat or help people with BPD cope. I'm not personally diagnosed with BPD but I do suffer from a series of other mental health issues including anxiety, depression and autism, although I occasionally have BPD tendencies. This book hardly speaks of BPD though, but instead uses the term "overwhelming emotions". I found that very inclusive because after having read it, I definitely see how DBT, or at least parts of it, could be beneficial to a much wider range of people.

My immediate opinion is that I really, really enjoyed the experience of this workbook. Is it perfect? Definitely not. I even considered giving it 3 stars, but thought, after all, it deserved more because of how helpful it is and I'd strongly recommend it to anyone considering buying it. However, my three main issues with it were 1. the writing (which was too dry, repetitive and tedious for my liking), 2. how heavily it relied on exercises instead of explaining the concepts more thoroughly and how to use them in your day-to-day life, and 3. the layout. It jumped around a lot and the order was confusing and irritating. Personally, I also think mindfulness should have been the first chapter. But oh well...

On the upside, this book is full of positive insight, practical ways to cope with distress short-termed and long-termed, how to be more mindful in terms of your thoughts and emotions, and lastly, how to deal with pain and conflict in relationships. Everything it preaches comes from a pretty empathetic place, both in regards to yourself and others, which urges the reader to ideally become more "emotionally intelligent". Also, the terms "wise mind" and "radical acceptance" were both new to me, and I found them incredibly enlightening, so I'll hopefully keep remembering and using them.

I'll probably have to take re-skim the entirety of it and create notes for myself in order to not forget everything it taught me but that's okay. I'd imagine that ideally, it's more effective to use in a therapy setting, but if you for whatever reason can't attend therapy, this is for sure better than nothing!

Also worth noting: When I began reading this book and doing the exercises (not all but shh), which is only a few weeks ago, I was in an extremely bad place. I feel a lot better already and I'll give this book credit for helping me out quite a bit!
Profile Image for Jess Bae.
42 reviews1 follower
February 16, 2022
Marsha Linehan created DBT from the perspective of a person who has struggled with mental illness and found ways to heal herself. Although DBT can be rigorous and even rigid, I've always appreciated how Marsha firmly indicates that the standard American family situation exacerbates temperamental sensitivity and trauma responses. In other words, she decreases the blame and stigma placed on individuals with BPD (who inherit the legacy of hysterical women!). DBT is at its best, IMHO, when it is For Us, By Us, to cite the iconic Black-owned hip hop clothing company. I know that DBT is For Everybody, however, I am honestly suspicious of a book on DBT written by three men. Do they have BPD? What brought them to this work? I only trust DBT providers who use their own experiences; this does not happen in this book and for that reason there are times that this book can be condescending.
Profile Image for Jill.
107 reviews1 follower
January 7, 2016
If it's DBT (Dialectical Behavioral Therapy) and you suffer from anxiety, depression, bipolar, addiction etc Get this books. If you learn your coping skills, and emotion regulation, distress tolerance, mindfulness, and interpersonal relation....

This book and DBT which is a form of cognitive behavioral therapy WILL help you.
238 reviews
October 8, 2020
Lots of exercises, but nothing new fundamentally. It offers hardly any explanation or theory.

---

I read the whole book again. It's more like a comprehensive therapy system, the core of it is mindfulness, with some additional communication techniques, Not very different from ACT.

In terms of mindfulness, better to learn mindfulness directly from other sources.
Profile Image for Josephine.
142 reviews
March 24, 2023
This was a slog. I read it hoping to have an introduction to DBT. I came away with strategy overload and feeling bored and frustrated. 2 stars because I suspect it’s meant to be used as part of therapy and that likely would have made it easier to stick to and follow.
Profile Image for Karen Lukens.
5 reviews1 follower
May 4, 2014
Fantastic book on how to get mindful, communicate better and get out of your head and the victim mentality.
Profile Image for Khalil.
19 reviews1 follower
June 16, 2020
C'est un bon livre facile à lire et bien organisé. Il représente une bonne initiation à la thérapie comportementale et dialectique.
Profile Image for Josie.
9 reviews
September 16, 2025
I never thought I would love a book like this so much. My new favourite psychology book ❤️
Profile Image for Joshua Lawson.
Author 2 books19 followers
April 11, 2019
Lately I’ve been studying the principles and practices of Dialectical Behavioral Therapy. DBT is an innovative new approach that is proving itself to be one of the most effective forms of therapy for people with emotion regulation issues and even extreme personality disorders.

One thing I’ve noticed about DBT is that it teaches all the psychological tools most of us failed to receive as children, such as mindfulness, radical acceptance, and various conflict resolution skills. In effect, therapists are attempting to provide as a corrective measure what was lacking as a preventative measure when their clients were young.

Of course there is always more to the story when it comes to individual cases, so don’t take this reductionist observation too far. In general, however, I think it holds true. It supports my conviction about the all-importance of a healthy, nurturing childhood, and how society forces itself to play catch-up later on with many destructive patterns of human behavior all because we dropped the ball when our kids were young.

So my hat goes off to the creators and practitioners of DBT, CBT, and every other form of cognitive and behavioral therapy that is helping people find relief from their troubles. Whole-hearted living is hard work at any stage of life. But it’s so much harder on the back end than the front. We parents need to step up our game, first by dealing with our own issues and then by providing our kids with the tools they need to cope with the unavoidable stress of life in healthy, transformative ways.

At any rate, this is an excellent workbook for people of any age. I’ll be using it myself and getting a few copies to share with friends.
Profile Image for Blue.
63 reviews3 followers
June 8, 2015
Very easy to follow book with helpful skills and exercises based on DBT. I have recently been researching Dialectical Behavior Therapy as a treatment for Borderline Personality Disorder for a friend and really enjoyed learning about mindfulness. I found that the mindfulness skills could be used in my own life and wanted to delve a bit deeper into all of DBT. In reading this book though I realized that while most would consider me sensitive and my emotions even I would admit can sometimes be overactive this book is more than I needed. I think this book would work best for someone who suffers from extreme emotions and reactions who wants to control those, especially in the moment. For me my emotions/thoughts seem to plague me most when I am by myself so I predict I would find mindfulness more helpful by itself. I found the book a good read and while it specifically doesn't mention Borderline Personality Disorder by name I think it would be very helpful for someone suffering from symptoms of that disorder. If someone cannot find DBT skills training near them finding a do-it-yourself guide such as this one would be a great start to sorting out your emotions and working towards regulating them more successfully. I wonder how it compares to the DBT workbook by Marsha Linehan specifically for Borderline Personality Disorder.
Profile Image for Christine.
449 reviews16 followers
December 20, 2019
I'm a social worker who has struggled to get on board with DBT for a number of years. It was always explained in a way that felt confusing, overly complicated for clients, and that would require memorization of too many acronyms. I've known that DBT is a popular treatment modality and that certain clients respond well to it, but I was about to give up trying to understand it.

This is the first book that has presented DBT in a way that I can get on board with. I don't know how well the workbook goes without participating in group or individual therapy because it still seems a bit complicated, but in the proper setting I think this book can be a good tool, especially for those who like lists, homework, and concrete things to take away from therapy.

What I liked about the book:
1) It's direct, nothing is sugar coated and people need to hear this stuff
2) It touches on the main points for people who are really struggling (distress tolerance, mindfulness/acceptance/understanding, and interpersonal effectiveness/social skills).
3) The examples used in the book are diverse making it easy for many people to relate

What I don't like about the book:
1) It's not a stand alone book to be used on your own - a therapist is needed to work through many of these things such as suicidal behaviors
2) The mindfulness chapters are too drawn out and repetitive
Profile Image for Kaela McNeil.
Author 2 books
August 22, 2018
This book was recommended to me because I have complex PTSD. I found that the ideas behind the chapters -- about mindfulness and emotional regulation, etc. -- to be helpful, but in practice the book was difficult to follow. For instance, chapter 1 talks about distress tolerance, showing readers how destructive behaviors lead to feeling better temporarily but long term have detrimental effects towards feeling "better." The workbook has a few worksheets in this chapter to come up with coping strategies that are healthy. So, when I started reading the second chapter, I assumed that the workbook would follow up with some sort of guideline about how to put this into practice. However, within the first few paragraphs of the second chapter, the workbook states something along the lines of "now that you've been practicing these coping strategies for a while." The book gave no indication as to when or how to implement these practices or how long I should practice before moving on to the next chapter.

TL;DR Good info, but as a workbook it was confusing.
Profile Image for Angel Graham.
Author 1 book33 followers
December 5, 2016
I'm working with this book, slowly but surely. I read it first, then reread it, noting which things I wanted to work on first. Now, I'm reading it a third time, and slowly working through the exercises. I was part of a Marsha Lineham DBT group for nearly 2 years, and this follows much of the same principles, but puts it into easy to read and understand language for a person to work with alone.

You don't have to have done a DBT group for this to be useful. If you simply want to become more mindful, and present, this book is well worth the price, and the read.
Profile Image for Sarah ♡ (let’s interact!).
716 reviews351 followers
July 26, 2022
The skills I have learnt and practiced from this workbook over this past year have, quite literally, changed and saved my life. I would recommend DBT to anybody who needs help managing and controlling their emotions. 🖤
This type of therapy is particularly good for individuals who are autistic and/or have BPD like myself. I personally struggled with connecting with it in group therapy, but practicing again on my own really helped me.
Profile Image for Allie.
1,425 reviews38 followers
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November 4, 2019
I recently did a DBT intensive outpatient program (IOP), but I actually started in a CBT group so I didn't do the entire course of the DBT program. The book has a lot of worksheets, which is basically what I wanted and one of the things I liked most about the IOP, so I'm slowly going to work through the old skills again and the new ones I missed.
37 reviews
October 22, 2019
An incredibly worthwhile tool to manage existing in the world, especially if you've developed unhelpful coping mechanisms from trauma. My copy is full of sticky notes and highlighted sections, the skills taught are life-long practices that work if you work them.
Profile Image for Frrobins.
423 reviews33 followers
January 23, 2019
I'm a therapist, and I loved so many of the activities and ideas in this book and have been integrating them into the work with my clients, who have been responding well to them. Highly recommend!
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