DBT Skills Decision Flowchart: Never Wonder Which Skill to Use Again
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Ever find yourself staring at a DBT worksheet thinking… okay, but which skill am I actually supposed to use right now?!
If you’ve ever learned DBT skills or flipped through a DBT skills workbook, you already know there are a LOT of them.
TIPP, STOP, DEAR MAN, Wise Mind, Opposite Action, Radical Acceptance… they’re all helpful, but when you’re overwhelmed, your brain usually isn’t flipping through a mental list of coping skills. It’s just trying to survive the moment.
I’ve been running DBT skills groups for years, and this is hands down the biggest frustration I’ve seen.
The problem isn’t that the skills don’t work. It’s that people often aren’t sure which one fits their situation.
That’s exactly why I created this DBT Skills Decision Flowchart.
Instead of guessing, you’ll be able to look at what’s happening and work from there.
Feeling completely overwhelmed? There’s a skill for that. Trying to figure out why you reacted so strongly? There’s a place to start. Need to get through a conversation without saying something you’ll regret? Yep, there’s a path for that too.
Let’s start with a quick refresher on what DBT actually is, the four core DBT skill areas, and why figuring out which skill to use can feel so confusing in the first place.
Once you understand that, the flowchart will make a whole lot more sense, and you’ll know exactly where to start the next time your emotions take over.
What is Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy (CBT) developed by psychologist Dr. Marsha Linehan.
It was originally created to help people with borderline personality disorder (BPD), especially those struggling with chronic suicidal thoughts and self-harm.
As DBT continued to be studied, it became clear that these skills could help far beyond BPD.
Now, therapists use them to support people facing anxiety, trauma, relationship issues, emotional stress, and many everyday challenges.
I’ve been using DBT with clients for many years now, and one of the things I love most about it is that it isn’t just something you talk about during therapy. You actually learn skills you can use in real life.
Whether you’re trying not to act on your urges, set boundaries with people, work through people pleasing, or understand why you keep reacting the same way, DBT gives you tools you can come back to again and again.
That’s one of the reasons DBT has helped so many people. The skills are practical, straightforward, and meant to be used outside the therapy office, when life is actually happening.
What Are the Core Skills in DBT?
DBT has four main skill areas, and each one helps with a different kind of problem.
- DBT Mindfulness skills help you slow down and notice what’s happening instead of reacting on autopilot.
- DBT Distress Tolerance skills help you get through really difficult moments without making things worse.
- DBT Emotion Regulation skills help you understand your emotions so they don’t end up making every decision for you.
- DBT Interpersonal Effectiveness skills help you communicate, set boundaries, ask for what you need, and keep your self-respect while doing so.
Here’s what I wish more people knew: you don’t use every DBT skill for every situation.
If you’re in the middle of a crisis, you probably don’t need a communication skill. If you’re about to have a hard conversation, calming your body might only be one piece of the puzzle.
Every skill has a purpose. Once you know when to use each one, DBT starts feeling a whole lot less overwhelming.
Why Choosing a DBT Skill Feels Hard
I can’t tell you how many times I’ve had a client say, “I know I learned this skill… I just couldn’t remember which one to use.”
And honestly? That makes complete sense.
When your emotions are running high, you’re not gonna sit there flipping through every DBT skill you’ve ever learned.
You’re trying to calm down, fix the problem, stop the argument, or simply make it through the next few minutes.
That’s when your mind goes blank.
I’ve seen people know the skills, understand the skills, and still freeze because they weren’t sure which one actually fit what they were feeling.
That’s exactly why I made this flowchart.
Instead of stopping to wonder, “Should I use STOP? Or Wise Mind? Or Radical Acceptance? Or Opposite Action?” you can follow a simple path that points you in the right direction.
Because the easier it is to choose a skill, the more likely you are to actually use it. And that’s when DBT starts making a real difference.
DBT Skills Decision Flowchart
I think we’ve all had those moments where everything feels SO urgent. You don’t want to make things worse, but you also have no idea what to do next.
Below is the DBT Skills Decision Flowchart I created to help you find a clear next step without feeling like you have to remember every skill all at once.
Just take a look, find where you are, and let it point you in the right direction. Sometimes, one clear next step is enough to help you move forward.
DBT Skills Flowchart
If you’re overwhelmed and don’t know which skill to reach for, this flowchart was made for exactly that.
How the DBT Skills Flowchart Works
The first thing you’ll do is check in with yourself and ask, “How intense are my emotions right now?” That’s where the SUDS scale on the left comes in.
SUDS stands for Subjective Units of Distress. It goes from 0 to 100 and gives you a quick way to rate how overwhelmed you’re feeling.
Once you find your SUDS level, it’ll point you toward the DBT module that’s most helpful for that moment.
From there, look for the behavior or struggle that sounds the most like what you’re experiencing. Crying and can’t stop? Stuck replaying the same thought? Having a hard time accepting reality? Trying to ask for what you need or protect your self-respect?
Each one points you to a specific DBT skill with a short explanation of how to use it.
You’ll also notice arrows between some of the modules. That’s because emotions don’t always stay in one place!
You might start with Distress Tolerance skills to get through the immediate crisis, then move into mindfulness DBT skills once you’ve calmed down enough to understand what happened.
Think of this flowchart as your starting point. It helps you choose a direction when your mind feels all over the place.
Then, once you’ve found the skill you need, you can go back to the original DBT skills worksheets or DBT skills workbook for more detailed instructions on how to practice it.
Frequently Asked Questions
1. How do I use the DBT Skills Flowchart when I am feeling overwhelmed?
Start by rating your emotions on the SUDS scale. Then follow the flowchart to the DBT module that matches your distress level.
From there, find the situation that sounds the most like what you’re dealing with and try the skill that’s listed. Think of this flowchart as your very own DBT skills cheat sheet.
2. What if more than one DBT skill seems to fit?
That is completely normal!! You don’t have to get it perfect. Just look at the DBT skills list.
Start with the skill that feels like the best fit, and if your emotions change, you can always just move to another section of the flowchart.
3. What if I don’t know what number to give myself on the SUD scale?
This is also pretty common. I don’t want you worrying about picking the “right” number. A quick estimate is more than enough.
The goal is to notice whether your emotions feel low, moderate, or very intense so you know where to begin.
4. Can I use this flowchart if I’ve never done DBT before?
I recommend using it alongside therapy or a DBT skills group if you can. DBT has A LOT of skills and concepts, so learning the basics first will make this flowchart much easier to understand and use.
This flowchart helps you choose the right skill, and the DBT handouts and therapist teach you HOW to practice it.
5. Can I print this flowchart or use it with my clients?
Yes! This flowchart is intended for both personal and clinical use.
One purchase allows one individual to use it personally, or one therapist or educator to print copies for their own clients and group participants.
Please be sure to read the Terms of Use before purchasing or using this digital product.
Final Thoughts…
I LOVE everything DBT! I know there are a LOT of skills, and at first, they can feel like way too much to remember.
But I’ve been using DBT with clients for years now, and I honestly never get tired of seeing those moments when someone comes back to group and says, “I actually used it!”
They stopped themselves from reacting, asked for what they needed, or rode out an urge instead of acting on it. Those are the moments that remind me why I love teaching these skills so much.
The goal isn’t to remember every DBT skill.
It’s to have something you can turn to when your emotions are loud, and your mind can’t decide what to do next.
And I get it, those moments happen to ALL of us. I’ve watched clients sit there knowing they learned the skills, but completely blank on which one to use. That doesn’t mean DBT isn’t working. It means you’re human.
The more you practice, the faster you’ll start recognizing what your emotions are asking for. Over time, you won’t need to think as hard about which direction to go.
Until then, let this flowchart do some of the thinking for you. One small step, one skill, one moment at a time is enough.
More Posts You’ll Love
- How to Use the DBT Model for Describing Emotions (+Printable)
- How to Stop Emotional Monitoring (When No One Taught You How)
- 50 June Journal Prompts for Exploring the Family Roles You Grew Up With
- If Your Emotions Go From 0 to 100, This DBT STOP Skill Can Help
- Can You Sit With It Instead? 4 Simple Steps to Actually Feel Your Feelings
NEW TO DBT SKILLS? SAVE THIS SO YOU ALWAYS KNOW WHICH SKILL TO USE!
Nisha Patel, LCSW
Founder of Brown Girl Trauma