DBT worksheets: Mindfulness

These DBT worksheets (mindfulness-based) describe the core mindfulness skills DBT teaches to help therapy clients regulate their emotions.

Dialectical behavioral therapy (DBT) is a therapeutic modality that can strengthen clients' emotional regulation and distress tolerance skills through mindfulness. 

In this article, we provide an overview of the mindfulness skills DBT has to offer, as well as examples of exercises. 

You can also download free DBT worksheets mindfulness techniques to save to your electronic health record (EHR) and share with clients. 

What are DBT mindfulness skills?

DBT is an evidence-based treatment used to treat a range of physical and mental health conditions, including depression, bipolar disorder, chronic pain, substance use disorders, borderline personality disorder, eating disorders, and attention-deficit hyperactivity disorder. 

DBT can be used with or without medication, depending on the individual’s circumstances. 

Dialectical behavioral therapy may benefit clients struggling with emotional regulation, interpersonal conflicts, distress tolerance, difficulty communicating, and unhelpful behaviors. 

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The main benefits of learning mindfulness skills/DBT techniques are that they can help clients to:

• Increase awareness of present-time experience, including their thoughts, emotions, physical sensations, and behavior—without judgment
• Strengthen tolerance of distressing situations, like feeling painful emotions 
• Decrease reactivity to emotions or stressful situations
• Enhance skills to cope with difficult circumstances
• Build acceptance of the present moment, even if it involves challenging situations or environments
• Improve interpersonal effectiveness skills, such as assertive communication and setting and maintaining boundaries
• Reduce avoidant or impulsive behaviors
• Promote feelings of emotional regulation by better understanding and controlling emotions

Mindfulness is one of the core components of DBT. It involves bringing one's mind into the present moment without judgment. 

There are several types of mindfulness skills DBT uses, including mindful breathing, guided visualizations, meditation, body scans, and conscious activity. 

These techniques aim to describe, observe, and pay attention to the here and now.

Below, you’ll find several DBT mindfulness exercises you can use with clients. 

Examples of mindfulness skills DBT

There are several DBT mindfulness exercises you can use with clients, which are also included in the DBT worksheets: mindfulness.

These mindfulness exercises include:

Wise mind exercises 

The wise mind technique helps individuals make informed decisions by balancing rational thoughts and emotions. 

In DBT, there are three states of mind:

• Emotional mind: Allowing emotions to control behavior and decision-making.
• Rational or reasonable mind: The logical mind considers facts, but discounts emotions when making decisions.
• Wise mind: Balances emotions with reasoned thinking and intuition to reach an informed, healthy decision. 

“What” skill 

This skill involves:

• Observe: Notice your thoughts, feelings, and body sensations without judgment. For example, instead of saying, “I am stressed,” say, “I feel the tension in my chest, and my breathing is a little more shallow.”
• Describe: Use non-judgemental language to describe internal or external experiences. For example, instead of saying, “I am sad,” you might say, “I notice sadness” or “I notice a heavy feeling in my chest.”
• Participate: Engage fully in the present moment and go with the flow, letting go of self-consciousness and immersing yourself in whatever you are doing in the present moment. For instance, enjoy coffee with a friend instead of worrying about your appearance or how they may perceive you.

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“How” tool 

This technique involves using mindfulness to observe facts, be present with one thing at a time, and take meaningful action. 

The steps of this technique involve:

• Non-judgement: Observe and describe experiences without labeling them “good” or “bad.” Instead, collect the facts. For example, instead of saying, “I am terrified about this presentation at work. I am so anxious,” say, “I notice my heartbeat is a little faster before this presentation.”
• One-mindful: Give your full attention to the present moment, putting aside worries about the future and instead engaging in the activity before you. For instance, instead of worrying about your to-do list, you might spend time mindfully having breakfast with your family, noticing the texture and flavor of the food, and feeling a connection with family members.
• Effective: Do what works in the present moment to achieve the outcome you desire instead of focusing on “what’s right,” or rigid or preconceived ideas. For example, focus on active listening and problem-solving in a conflict rather than being right. 

How to use the DBT worksheets for mindfulness

Therapists can download and use the DBT worksheets for mindfulness in several ways.

First, you can use them to demonstrate the mindfulness skills DBT offers in session. You can also provide it as a handout for the client to practice mindfulness activities at home.

You can print the DBT worksheets mindfulness skills to display in your office as a resource. 

If you're a supervisor, the DBT worksheets for mindfulness could be helpful resources for associates that you supervise.

Sources

• Corliss, J. (2024). Dialectical behavior therapy: What is it and who can it help? Harvard Health Publishing. 
• Dialectical Behavior Therapy Tools. (n.d.). Mindfulness tools. 
• McKay, M., Wood, J. C., & Brantley, J. (2019). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance (2nd ed.). New Harbinger Publications
• Yale Medicine. (n.d.). Dialectical behavioral therapy (DBT). 

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