Dialectical Behavior Therapy (DBT) is a groundbreaking treatment based on cognitive-behavioral techniques, mindfulness, and dialectical strategies. DBT helps us better regulate emotions and improve our interpersonal skills. DBT worksheets for youth are supplemental materials that support the work in therapy and enable teens to put their skills into practice; they are an essential piece to the healing puzzle. 

How DBT Worksheets Fit Into Treatment for Teens

DBT’s benefits became apparent when it was first used to treat Borderline Personality Disorder (BPD) in adults, and it was soon expanded for teenagers with emotion dysregulation. The reason for its success, in part, is its focus on skill building. DBT skills provide alternative tools for teenagers to manage intense feelings. In DBT, therapists focus on skills acquisition, skill strengthening, and skills generalization.

DBT worksheets for youth fit into the skills generalization phase of therapy. Teens learn to apply these lessons in their daily lives, and they use worksheets to keep a record. Each DBT skill teens learn will have its own worksheet.

The sections below include a summary breakdown for each skill discussed as well as a sample worksheet for one, however, it should be noted that each skill discussed in our program typically includes a total of 10 worksheets that discuss different aspects of employing that skill.

 

Distress Tolerance Worksheet

Distress tolerance DBT worksheets for youth are tricky because this skill is designed to address particularly challenging situations. Emotions are intense, and the urge to engage in unhealthy coping mechanisms, like self-harm or suicidal ideation, is high. Worksheets addressing this should be clear and concise and offer practical tips to help the teen manage this emotional intensity. One way patients learn to do this in DBT is with the “TIPP” skill: 

Temperature

Temperature-related methods, specifically cold stimuli, can quickly divert attention from emotional distress and elicit tangible physical sensations. For example, “ice diving” – submerging one’s face in ice water – can distract a teenager who typically turns to self-harm, providing a strong stimulus that can help divert their focus from the urge. 

Intense exercise

Vigorous physical activities can trigger the release of mood-enhancing endorphins and help channel emotional energy. For example, a stressed teenager might find relief from a short burst of vigorous exercise, like running in place for a few minutes. 

Paced breathing

Deep breathing involves inhaling slowly through the nose, pausing briefly, and then exhaling gradually through the mouth. This practice helps center the mind and stabilize emotions. It’s also an exercise that can be done in virtually any setting.   

Paired muscle relaxation 

Paired muscle relaxation is another method that can be done anywhere. By tensing muscle groups and gradually relaxing them, the teenager becomes aware of the tension they’re holding and can let it go. 

Distress tolerance worksheets are practical tools for managing immediate distress and can function as valuable historical records. Over time, as a teenager consistently uses these worksheets to develop and refine their distress tolerance skills, they create a documented journey of personal growth.

 

Mindfulness Worksheet

An effective mindfulness DBT worksheet for youth will teach them how to make mindfulness a daily practice. Worksheets in this area guide the teen through different exercises and encourage them to reflect on their results. After each exercise, the teen should reflect on their feelings so they can see how it worked.

 

Emotion Regulation Worksheet

Emotion regulation DBT worksheets for youth offer several ways for teens to face an emotional trigger, depending on which one (there are usually around 10 in a program) they use. These worksheets guide them through:

• Identifying the specific emotion they are experiencing.
• Describing the situation that triggered the emotion.
• Recognizing and labeling any negative thoughts
  or interpretations.
• Assessing the intensity of the emotion on a scale.
• Reframing thoughts about the situation.
• Choosing and implementing appropriate emotion regulation strategies to manage their immediate emotional reaction.
• Reflecting on the effectiveness of the chosen strategies and any changes in their emotional state.

The benefit of having the teen cover these phases in a DBT worksheet is ongoing. The teen may run into similar scenarios and complete the exercise again. Then, they can compare those results to the earliest ones and gauge real-time progress.

 

Interpersonal Effectiveness Worksheet

Interpersonal effectiveness worksheets help teens develop practical interpersonal skills relevant to their everyday experiences and challenges. They can also be adapted for different situations, allowing teens to generalize this skill further. The worksheet walks them through:

• Identifying their emotions and reactions to specific social situations.
• Encouraging them to reflect on whether they’ve experienced similar situations before.
• Offering strategies for approaching the situation.
• Providing space for them to plan and practice assertive communication skills if they decide to address the issue.
• Encouraging them to consider the potential outcomes and consequences of their chosen approach.

Build Lifelong Coping Skills With Compass

DBT worksheets for youth are critical in helping your teen generalize the skills they learn in therapy. It allows them to apply this information and adapt it to different situations. At Compass Behavioral Health, our DBT-Linehan Board-certified™  clinicians help your teen acquire, strengthen, and generalize these skills through proven techniques and engaging supplemental materials.

Our residential program is designed to support adolescents with individualized treatment plans based on a DBT curriculum. This curriculum helps young individuals learn essential skills to manage emotions and overcome self-destructive behaviors.

If you’re interested in understanding how DBT can be effective for youth and how it can benefit your teenager, please reach out for a consultation.