Dialectical Behavior Therapy (DBT) is a structured, evidence-based treatment that requires clear, measurable goals to guide clinical work. When therapists establish well-defined DBT goals with clients, they create a roadmap for reducing harmful behaviors, building coping skills, and improving overall quality of life.

Key Takeaways

• DBT goals follow a hierarchy that prioritizes life-threatening behaviors first, then therapy-interfering behaviors, and finally quality-of-life concerns. This structure ensures the most urgent clinical issues receive immediate attention.

• Effective DBT goals are measurable, client-centered, and connected to specific skill modules including emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness.

• Using concrete goal examples helps therapists write treatment plans that are both clinically sound and meaningful to clients, increasing engagement and treatment effectiveness.

Core DBT Skill Areas

DBT organizes therapeutic work into four skill modules, each addressing different aspects of emotional and behavioral functioning. Understanding how goals align with these modules helps therapists create comprehensive treatment plans that address clients' most pressing needs.

Emotion Regulation Goals

Emotion regulation skills help clients identify, understand, and modulate their emotional responses. Research indicates that emotion dysregulation is central to borderline personality disorder and other conditions treated with DBT.

Example goals in this area include:

• Client will identify and label emotions using feeling words at least once daily for four consecutive weeks

• Client will implement opposite action skills when experiencing unwanted emotions in three out of four triggering situations

• Client will reduce emotional vulnerability by maintaining consistent sleep schedule for one month

• Client will practice accumulating positive emotions through pleasant activities at least three times weekly

These goals target the underlying mechanisms that contribute to emotional instability. When clients can name their emotions, they gain distance from overwhelming feelings and can choose skillful responses rather than acting impulsively.

Distress Tolerance Goals

Distress tolerance skills focus on surviving crisis situations without making things worse. Clinical evidence demonstrates that improving distress tolerance reduces self-harm, substance use, and other harmful coping mechanisms.

Example goals in this area include:

• Client will use crisis survival skills during distressing situations instead of self-harm behaviors for three consecutive weeks

• Client will implement radical acceptance when facing unchangeable situations in two out of three opportunities

• Client will practice willingness rather than willfulness when uncomfortable emotions arise

• Client will create and utilize a personalized crisis kit containing five specific coping strategies

• Client will increase tolerance for emotional discomfort by delaying urges to engage in problem behaviors by 15 minutes

These goals recognize that some painful situations cannot be immediately changed or solved. Building tolerance for distress prevents clients from engaging in behaviors that provide short-term relief but create long-term problems.

Mindfulness Goals

Mindfulness forms the foundation of all DBT skills. These practices help clients develop present-moment awareness and reduce automatic reactivity to thoughts and feelings.

Example goals in this area include:

• Client will practice observing thoughts without judgment for five minutes daily, five days per week

• Client will engage in one-mindful practice during daily activities at least twice daily

• Client will describe experiences using words rather than evaluative judgments in identified situations

• Client will participate fully in current activities during group therapy sessions

Mindfulness goals often serve as prerequisites for other skill areas. When clients can observe their internal experiences without immediately reacting, they create space to choose skillful responses rather than falling into habitual patterns.

Interpersonal Effectiveness Goals

Interpersonal effectiveness skills help clients maintain relationships, set boundaries, and communicate needs effectively. These skills address the relational difficulties that frequently bring clients to treatment.

Example goals in this area include:

• Client will use skills to make requests in two interpersonal situations weekly

• Client will maintain self-respect in relationships by saying no to unreasonable requests in three out of four opportunities

• Client will practice relationship-strengthening skills during weekly interactions with important people

• Client will balance priorities when interpersonal conflicts arise

• Client will validate others' emotions before problem-solving in conversations where others express distress

These goals target the interpersonal chaos that often characterizes clients' lives before treatment. Effective communication reduces conflict and helps clients build the supportive relationships necessary for long-term stability.

Writing Measurable DBT Goals

DBT treatment plans require goals that are specific enough to track progress objectively. The SMART framework provides structure for writing goals that both therapists and clients can evaluate clearly.

Specific: Goals should identify exactly what behavior will change. Instead of "improve emotional regulation," write "identify and label emotions using diary card three times daily."

Measurable: Include concrete criteria for success. Rather than "use more coping skills," specify "implement distress tolerance skills in four out of five crisis situations."

Achievable: Set goals that challenge clients without overwhelming them. A client who has never practiced mindfulness shouldn't aim for 30-minute daily meditation immediately, starting with three minutes twice weekly creates a realistic foundation.

Relevant: Connect goals to the client's treatment priorities. If a client entered therapy primarily for relationship difficulties, early goals should emphasize interpersonal effectiveness rather than focusing exclusively on other skill areas.

Time-bound: Establish clear timeframes for achieving goals. "Within six weeks" or "by the end of the skills group module" provides structure and allows for regular progress evaluation.

When therapists involve clients in goal-setting using this framework, treatment plans become collaborative documents that reflect client values and priorities rather than therapist-imposed objectives.

Sample DBT Treatment Plan

Understanding how goals work together in actual treatment plans helps therapists create comprehensive, hierarchical approaches to client care.

Example short-term goals:

• Client will reduce self-harm behaviors from five times weekly to zero instances for four consecutive weeks by implementing distress tolerance skills during urges

• Client will attend all scheduled therapy sessions, arriving on time and completing diary cards before each session

• Client will identify primary emotions using emotion regulation materials at least once daily

Example long-term goals:

• Client will maintain stable housing and employment for six consecutive months by using interpersonal effectiveness skills to manage workplace conflicts

• Client will develop and maintain two supportive friendships characterized by mutual respect

• Client will reduce symptoms as measured by standardized assessment, utilizing emotion regulation skills to accumulate positive experiences

These examples illustrate how DBT treatment progresses from crisis stabilization toward building a life worth living. Short-term goals address immediate safety concerns and establish treatment engagement, while long-term goals focus on quality-of-life improvements.

Short-Term vs. Long-Term DBT Goals

DBT's hierarchical approach requires therapists to understand when to emphasize different types of goals throughout treatment.

Short-term goals typically address:

• Life-threatening behaviors that pose immediate danger

• Therapy-interfering behaviors that prevent effective treatment

• Initial skill acquisition from each module

Long-term goals typically address:

• Quality-of-life concerns like relationship satisfaction and career development

• Skill generalization across multiple contexts

• Values-based living that represents the ultimate aim of DBT

The transition between goal types shouldn't be rigid. Clients often move back and forth as life circumstances change. A client working on quality-of-life goals might need to refocus on life-threatening behaviors if crisis situations emerge.

Effective therapists regularly reassess goal priorities with clients, adjusting treatment plans to reflect current needs while maintaining the hierarchical structure that makes DBT effective.

Frequently Asked Questions

How many DBT goals should a client have at one time?

Most effective DBT treatment plans include three to five active goals that span the treatment hierarchy. Having one goal addressing life-threatening behaviors (if present), one or two targeting therapy-interfering behaviors, and one or two focusing on quality of life creates manageable focus.

Therapists should prioritize depth over breadth, ensuring clients can actually work toward their identified goals rather than creating lengthy lists that function more as aspirations than actionable plans.

Can DBT goals be adjusted mid-treatment?

DBT goals absolutely should be adjusted as treatment progresses and client needs change. The collaborative nature of DBT requires regular goal review during individual therapy sessions. When clients achieve goals, new goals should be established to maintain treatment momentum.

When clients struggle despite consistent effort, therapists should reassess whether the goal is appropriately calibrated or if underlying barriers need addressing first. This flexibility prevents treatment from becoming rigid while maintaining the structure that makes DBT effective.

Takeaway

Establishing clear, measurable DBT goals creates the foundation for effective treatment that reduces harmful behaviors while building clients' capacity for life satisfaction. When therapists understand how to write goals across the four skill modules, they create treatment plans that address both immediate crises and long-term quality of life.

The hierarchical structure of DBT ensures that life-threatening behaviors receive appropriate attention before moving to broader concerns. Using the SMART framework to develop specific, measurable, achievable, relevant, and time-bound goals transforms abstract therapeutic intentions into concrete roadmaps.

Tools like Berries AI can support this clinical work by streamlining documentation, allowing therapists to spend more time on the actual therapeutic relationship and goal development rather than administrative tasks.

Professional Disclaimer: This article is for informational purposes only and is not a substitute for professional clinical judgment, supervision, or continuing education. Therapists should consult current clinical guidelines, receive appropriate DBT training, and use their professional discretion when applying this information to individual client cases.

Sources

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Chapman, A. L. (2006). Dialectical behavior therapy: Current indications and unique elements. Psychiatry (Edgmont), 3(9), 62-68. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/

Substance Abuse and Mental Health Services Administration. (n.d.). Evidence-Based Practices Resource Center. https://www.samhsa.gov/

American Psychological Association. (n.d.). Clinical Practice Guideline for the Treatment of PTSD. https://www.apa.org/ptsd-guideline

Robins, C. J., & Chapman, A. L. (2004). Dialectical behavior therapy: Current status, recent developments, and future directions. Journal of Personality Disorders, 18(1), 73-89. https://pubmed.ncbi.nlm.nih.gov/15061345/