Interpersonal Effectiveness in Dialectical Behavior Therapy

Clients who have completed the mindfulness training module in dialectical behavior therapy (DBT) then move on to the second core skills module, interpersonal effectiveness. These skills are extremely important because the way we communicate with others has a significant impact on the quality of our relationships and on the outcome of our interactions. In order to communicate more effectively, DBT clients are taught skills that help them approach conversations in a more thoughtful and deliberate manner rather than acting and reacting impulsively due to stress or intense emotions. Two key components of interpersonal effectiveness are the ability to ask for things and to say no to requests, when appropriate.

In the Skills Training Manual for Treating Borderline Personality Disorder, DBT founder Marsha Linehan identifies three types of effectiveness that must be addressed in interpersonal exchanges:

1. Objective effectiveness
2. Relationship effectiveness
3. Self-respect effectiveness

For any given situation, these three factors must be considered and prioritized. The individual is likely to be more satisfied with the interaction and outcome if his or her highest priority has been addressed.

The term objective effectiveness refers to the goal or purpose of the interaction, which often is a tangible outcome. For instance, a woman might want her husband to call her when he will be working late. Relationship effectiveness represents the goal of a conflict-free relationship. In this example, the wife might rank emotional closeness and harmony as her highest priority. Alternately, self-respect effectiveness might be the top priority if this woman feels that his failure to call is disrespectful to her.

Dialectical behavior therapy utilizes acronyms to help clients remember the skills that are tied to each type of effectiveness. For objective effectiveness, the acronym is DEAR MAN, and the skills are as follows:

D – Describe: Describe the situation in concrete terms and without judgment.

E – Express: Express feelings, conveying to the other party how the situation makes you feel.

A – Assert: Assert your wishes, i.e. clearly state what you do or do not want.

R – Reinforce: Reinforce why the desired outcome is desirable, and reward people who respond positively to the request.

M – Mindful: Be mindful and present in the moment, focused on the current goal.

A – Appear: Appear confident, adopting a confident posture and tone, and maintain eye contact.

N – Negotiate: Be willing to negotiate and give in order to get, with the understanding that both parties have valid needs and feelings

Moving on to relationship effectiveness, the DBT acronym is GIVE:

G – Gentle: Approach the other party in a gentle and nonthreatening manner, avoiding attacks and judgmental statements.

 I – Interested: Act interested by listening to the other person and not interrupting.

V – Validate: Validate and acknowledge the other person’s wishes, feelings, and opinions.

E – Easy: Assume an easy manner by smiling and using a light-hearted, humorous tone.

Finally, the DBT acronym for self-respect effectiveness is FAST:

F – Fair: Be fair to yourself and to the other party, to avoid resentment on both sides.

A – Apologize: Apologize less, taking responsibility only when appropriate.

S – Stick: Stick to your values and don’t compromise your integrity to gain an outcome.

T – Truthful: Be truthful and avoid exaggerating or acting helpless to manipulate others.

The interpersonal skills taught in DBT can increase the likelihood of positive outcomes, regardless of how the client prioritizes objective, relationship, and self-respect effectiveness for that particular interaction. When used effectively, the DEAR MAN-GIVE-FAST skills help the individual convey his or her needs and wishes clearly, without the other party having to “read their mind.” It enables the person to ask for what he or she wants respectfully and with integrity, while considering the other person’s feelings and preserving the relationship.

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