Doing Dialectical Behavior Therapy

Doing Dialectical Behavior Therapy: A Practical Guide by Kelly Koerner is an indispensable and hands-on guide for clinicians seeking to understand and apply Dialectical Behavior Therapy (DBT) in real-world practice. Written by one of the field’s most experienced trainers and practitioners, this book translates the complexity of DBT into clear, actionable steps, offering therapists an approachable yet comprehensive framework for working with emotionally dysregulated and high-risk clients.

Overview

DBT, originally developed by Marsha Linehan, is one of the most effective evidence-based treatments for clients with chronic emotion dysregulation, self-harming behaviors, and multiple treatment failures. In this volume, Koerner provides not only a theoretical foundation but also the “how-to” of doing DBT—from assessment and case formulation to session planning, intervention, and therapist self-management.

The book is filled with vivid clinical vignettes, illustrative dialogues, and step-by-step instructions, making it ideal for both DBT beginners and seasoned clinicians looking to refine their skills. Koerner’s compassionate tone and practical orientation make this an accessible, deeply instructive guide that bridges the gap between DBT theory and clinical implementation.

Content Overview

The structure of the book mirrors the therapeutic process, leading readers from understanding DBT’s principles to mastering its techniques:

1. Foundations of DBT and the Biosocial Model
   Koerner begins by breaking down the theoretical core of DBT—the dialectical balance between acceptance and change. She describes how emotional dysregulation often arises from the interplay of biological vulnerability and invalidating environments. This framework sets the stage for understanding why DBT’s multifaceted approach is uniquely effective for complex clients.
2. Case Conceptualization and Treatment Planning
   One of the book’s strengths lies in its detailed guidance on formulating cases and prioritizing treatment goals. Koerner teaches clinicians how to identify target behaviors—such as suicidal ideation, self-injury, or therapy-interfering behaviors—and arrange them in a hierarchical order of intervention, ensuring that the most critical issues are addressed first.
3. Core Therapeutic Strategies
   The heart of the book lies in its demonstration of the three main strategy sets that define DBT:
   • Behavioral Change Strategies: Concrete tools like chain analysis, exposure, and skills coaching to modify maladaptive behaviors.
   • Validation Strategies: Techniques that communicate acceptance and understanding, reinforcing the therapeutic alliance and promoting trust.
   • Dialectical Strategies: Approaches that help clients integrate opposing perspectives, fostering cognitive flexibility and emotional balance.
   Koerner provides numerous sample dialogues showing how to weave these strategies together in-session, helping therapists maintain balance between empathy and challenge.
4. Skills Integration and Flexibility
   Koerner emphasizes that DBT is not a rigid formula but a flexible framework. She shows how therapists can integrate DBT principles—mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness—into various treatment modalities, even for clinicians who are not DBT-certified.
5. Working with Challenging Clients and Avoiding Burnout
   The book concludes with invaluable insights into managing the therapist’s emotional responses. Koerner highlights the importance of consultation teams, mindfulness practices for therapists, and self-reflection to sustain compassion and prevent burnout when working with high-intensity clients.

Key Strengths

• Practical and structured: The book goes beyond theory, offering concrete guidance on how to conduct sessions and apply interventions.
• Engaging clinical examples: Real-world case vignettes bring the therapy to life and demonstrate how to navigate difficult client interactions.
• Clear explanations of complex concepts: Koerner simplifies DBT’s philosophical underpinnings—dialectics, behaviorism, and validation—making them accessible without oversimplifying.
• Therapist-focused insights: Addresses the real challenges therapists face, such as maintaining boundaries, balancing empathy with firmness, and sustaining motivation.

Tone and Readability

Koerner writes with warmth, clarity, and deep respect for both clinicians and clients. Her style strikes a balance between academic rigor and conversational ease, making the book equally useful for graduate students, practicing clinicians, and DBT teams. The inclusion of session scripts, checklists, and decision-making frameworks makes this not just a theoretical manual but a hands-on guidebook for everyday use.

Who Should Read This Book

• Therapists and counselors seeking to implement DBT principles in clinical settings.
• Mental health professionals working with clients who have chronic emotional instability, self-harm tendencies, or multiple diagnoses.
• Students and trainees learning the foundations of evidence-based therapy.
• Practicing clinicians from other modalities (CBT, ACT, trauma therapy) looking to enrich their work with DBT-informed strategies.

Doing Dialectical Behavior Therapy: A Practical Guide stands as one of the most user-friendly and instructive DBT texts available. Kelly Koerner has succeeded in demystifying the complexity of DBT, offering clinicians a roadmap grounded in compassion, precision, and flexibility.

Whether you are new to DBT or an experienced practitioner refining your skills, this book provides the tools, insights, and encouragement needed to help clients move from chaos to balance—and to help therapists stay grounded and effective in the process.

It’s a must-have resource for anyone serious about mastering the art and science of DBT.

Author: Kelly Koerner, PhD

GET YOUR COPY: Doing Dialectical Behavior Therapy