DBT Next Steps Clinician's Manual
Building a Life Worth Living
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Developed over 25 years by preeminent experts, DBT Next Steps is a groundbreaking expansion of standard Dialectical Behavior Therapy (DBT) for clients who have moved beyond crisis behaviors—yet haven't achieved their goals in such areas as employment, school, and relationships. Combining skills training with exposure, contingency management, cognitive modification, and didactic strategies, DBT Next Steps fills a gap by systematically targeting quality-of-life–interfering behavior. In a convenient large-size format, this authoritative clinician's manual provides detailed lesson plans for six brand-new DBT skills modules: Perfectionism versus Reinforcement, Establishing and Reevaluating Relationships, Time Management, Managing Emotions Effectively, Succeeding after DBT, and Applications of Mindfulness. It shows how Next Steps can be incorporated into an existing DBT program or used as a follow-up treatment. Reproducible skills training handouts and assignments are provided in the related client resource, available separately:
DBT Next Steps Skills Handouts.
“As a DBT clinician, supervisor, and trainer, I find
DBT Next Steps Clinician's Manual to be one of the most immediately applicable treatment manuals I have read in years. There are numerous tools that I can instantly use with my clients. Differentially applying GIVE skills in work and social situations, improving time management on daily tasks, challenging perfectionistic thinking and behaviors, and integrating more positive reinforcement are just a few of the critical components of DBT Next Steps. The manual has clear lesson plans and examples, in-session practice exercises, and assignments to help clients practice and generalize their skills. I will highly recommend this manual and the companion client resource to everyone I train and supervise. Next Steps can be woven into a current DBT program or applied as a freestanding treatment, depending on the client's level of functioning and the skills already acquired.”
—Alec L. Miller, PsyD, Cofounder, Cognitive and Behavioral Consultants, White Plains and New York City
“This is what DBT therapists have been clamoring for!
DBT Next Steps Clinician's Manual provides invaluable insights and practical tools for therapists to help clients overcome barriers to building full and satisfying lives once the crises have stopped. Whether you treat psychiatrically and financially disadvantaged persons or those who struggle with other barriers to self-sufficiency, this is the manual for you.”
—Kathryn E. Korslund, PhD, ABPP, Director of Clinical Care, Two Chairs
“Together,
DBT Next Steps Clinician's Manual and
DBT Next Steps Skills Handouts are a labor of love that is designed to help build up lives. The beautifully clear, in-depth manual expertly guides clinicians through key teaching points, and includes abundant case examples that bring the teachings to life. The client handouts and assignments break down complicated concepts in a user-friendly style that fosters everyday application of the Next Steps skills.”
—Janice R. Kuo, PhD, Department of Psychology, Palo Alto University
“The focus of DBT Next Steps on getting me out of the mental health system has been a complete success. I pay my own bills, live by myself in my own apartment, and have been for two years! I went from not knowing whether I’d see my next birthday to looking forward to every week as an opportunity to connect with people and live a life I’m proud of.”
—Francis C.
“DBT Next Steps was revolutionary for me. Although being in DBT helped bring me out of crisis, I knew it was DBT Next Steps that would help me gain the traction I needed to build a life worth living. The program taught me so much about finding and respecting my own limits while also pushing me to live a full and effective life. Years out of the program, I continue to visit the skills from it daily. I am so grateful for the growth and stability DBT Next Steps has brought into my life.”
—Lou D.
“I was lucky enough to do a year of Next Steps after a first year of DBT. It helped me refine my ambitions, accomplish the goals that were most important to me, and feel like I was living a worthwhile life. Because of this program I was able to finish grad school after a lengthy medical leave—there's no way I would have had the skills to do that without Next Steps. Several years later, I still refer back to the materials. I recommend DBT Next Steps to anyone who is surviving their life but not thriving yet.”
—Alice Z.
About the Authors
Katherine Anne Comtois, PhD, MPH, is Professor in the Department of Psychiatry and Behavioral Sciences and Adjunct Professor in the Department of Psychology at the University of Washington. She was a research therapist and co-investigator with Marsha M. Linehan on her clinical trials from 1994 to 2006 and Director of the DBT program at Harborview Mental Health and Addiction Services from 1996 to 2019. Dr. Comtois now leads the DBT standard and training programs at the University of Washington Medical Center Outpatient Psychiatry Clinic. She is the recipient of the Research Award from the American Foundation for Suicide Prevention and the Distinguished Psychologist Award from the Washington State Psychological Association, among other honors. In addition to leading the development of DBT Next Steps and the DBT-ACES program, she provides training and consultation in DBT internationally.
Adam Carmel, PhD, is Clinical Professor in the Department of Psychiatry and Behavioral Sciences and co-director of the Annual Comprehensive DBT Training program at the University of Washington (UW). Dr. Carmel was previously Clinical Assistant Professor in the Department of Psychology, where he taught DBT in the Behavioral Research and Therapy Clinics under the direction of Marsha M. Linehan. Prior to that, he served as Director of the DBT program at the Massachusetts Mental Health Center while on the faculty of Harvard Medical School. Dr. Carmel is a recipient of teaching and mentoring awards from the UW Psychology Internship Program and the Beth Israel Deaconess Medical Center, Department of Psychiatry.
Marsha M. Linehan, PhD, ABPP, the developer of Dialectical Behavior Therapy (DBT), is Professor Emeritus of Psychology and Director Emeritus of the Behavioral Research and Therapy Clinics at the University of Washington. Before retiring in 2019, she devoted her career to developing and evaluating evidence-based treatments for populations with high suicide risk and multiple, severe mental disorders. Dr. Linehan is the 2025 recipient of the Lifetime Achievement Award from the American Foundation for Suicide Prevention. Her contributions to suicide research and clinical psychology research have also been recognized with the University of Louisville Grawemeyer Award for Psychology, the Career/Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapies, the Gold Medal Award for Life Achievement in the Application of Psychology from the American Psychological Foundation, and the James McKeen Cattell Award from the Association for Psychological Science. In her honor, the American Association of Suicidology created the Marsha Linehan Award for Outstanding Research in the Treatment of Suicidal Behavior. Dr. Linehan was featured in
TIME Great Scientists: The Geniuses and Visionaries Who Transformed Our World. She is founder of the Linehan Institute and is a Zen master.
Audience
Clinical psychologists, psychiatrists, clinical social workers, mental health counselors, and psychiatric nurses.