Dialectical Behavior Therapy

3 Day Certification Training

Katelyn Baxter-Musser, LCSW
Handout Packet

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
1
 Building A Life Worth Living
How do you define a life worth living?

What brings you joy?

List two goals that can you set to build a life worth living?

Set 3 small achievable goals that help you work towards

your goal above?

What are possible behaviors that interfere with you

achieving your goal(s)?

List 3 supports that can help you achieve a life worth living

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
2
 Living Worth Living Goals
What are you goals and priorities in life? What would you like to be
different about your life?
Use the sections below to help you identify goals for different areas of
your life:

Mental/Emotional Health:

Physical Health:

School/Education:

Work:

Finances:

Relationship with Family:

Relationships with Friends:

Hobbies/Interests:

Spirituality:

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
3
Page 1 of 2
 Living Worth Living Goals

Choose two goals to begin to focus on:

How would your life be different once you have

achieved your goal?

How can you start achieving your goal?

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
4

Page 2 of 2
 Assessing for Borderline Personality
Disorder
Use these questions as a guide when assessing for borderline
personality disorder
1. What recent stressors account for the client’s symptoms?
2. Does this appear to be an isolated situation or it is part of a general problem?
3. Is the client’s presenting problem an outcome of conflicted interactions with
significant others? If so is this an isolated situation, or part of a general pattern?
4. Does the client maintain positive relationships with some significant others
(i.e. friends, family and coworkers), or are most relationships conflicted?
5. Does the client appear to be replicating old relationships in the present? (i.e.
those with parents or early caregivers?
6. Does the client’s problem behaviors represent efforts to master old traumas
by repeating them with people I the present?
7. Has the client’s personality changed as the result of a medical condition?
8. Is the client under the influences of any substance that might account for the
symptoms of anxiety and depression?
9. Is the evidence of a history of hypomanic or manic episodes? Of depressive
episodes?
10. If the client is an older adolescent or young adult, are identity concerns
related to a developmental phase?
11. If the client displays manipulative behaviors towards others, including the
social worker, are the related to a desire to elicit nurturance or power or
personal gain?
12. What cultural condition my be affecting the client’s relationship-seeking
behavior?
13. What environmental condition may be affecting the client’s relationship-
seeking behavior?
Questions from Corcoran, J. & Walsh, J. (2016) Clinical Assessment and Diagnosis in Social Work Practice
(3rd ed.). New York, New York: Oxford University Press

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and
for professional use with clients only
5
 Adverse Childhood Experience (ACE)
Questionnaire: Finding your ACE
Score
(ra hbr 10 24 06)

While you were growing up, during your first 18 years of life:
1. Did a parent or other adult in the household often …
Swear at you, insult you, put you down, or humiliate you?
or
Act in a way that made you afraid that you might be physically hurt?
Yes No If yes enter 1 ________
2. Did a parent or other adult in the household often …
Push, grab, slap, or throw something at you?
or
Ever hit you so hard that you had marks or were injured?
Yes No If yes enter 1 ________
3. Did an adult or person at least 5 years older than you ever…
Touch or fondle you or have you touch their body in a sexual way?
or
Try to or actually have oral, anal, or vaginal sex with you?
Yes No If yes enter 1 ________
4. Did you often feel that …
No one in your family loved you or thought you were important or special?
or
Your family didn’t look out for each other, feel close to each other, or support each other?
Yes No If yes enter 1 ________
5. Did you often feel that …
You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
or
Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Yes No If yes enter 1 ________
6. Were your parents ever separated or divorced?
Yes No If yes enter 1 ________
7. Was your mother or stepmother:
Often pushed, grabbed, slapped, or had something thrown at her?
or
Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?
or
Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Yes No If yes enter 1 ________
8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs?
Yes No If yes enter 1 ________
9. Was a household member depressed or mentally ill or did a household member attempt suicide?
Yes No If yes enter 1 ________
10. Did a household member go to prison?
Yes No If yes enter 1 ________
Now add up your “Yes” answers: _______ This is your ACE Score

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
6
RESILIENCE Questionnaire

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and
for professional use with clients only
7
 RESILIENCE Questionnaire continued..

Retrieved from https://www.aap.org/en-us/advocacy-and-policy/aap-

health-initiatives/resilience/Pages/Clinical-Assessment-Tools.aspx

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW
and Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this
training and for professional use with clients only
8
 (Resick, et al., 2012)

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser,
LCSW and Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to 9
participants of this training and for professional use with clients only
 Know Your Vulnerability Factors
Vulnerability factors that might impact our ability to manage
stressful situations:

• Being sick
• Not having a balanced/healthy diet
• Use drugs/substances
• Lack of sleep
• Over sleeping
• Isolation
• Lack of healthy support system
• Sedentary lifestyle

What are your vulnerability factors?

___________________________________________
___________________________________________
___________________________________________

What is one goal that you can set to manage or

improve at least one vulnerability factor?
___________________________________________
___________________________________________
___________________________________________
From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and
for professional use with clients only
10
 being aware of the present moment on
Mindfulness: purpose without judgement, rejection or
attachment

When practicing mindfulness, we want to focus our attention on what we choose

rather than being driven by and having our emotions, thoughts, or experiences
control us.

Some goals of mindfulness include:

- Reducing suffering
- Increasing happiness
- Increasing control of your mind versus emotions controlling you
- Experiencing reality as is

Answer the questions below to help you start on your pathway

to being aware, awake and
attentive.

What is your goal for mindfulness?

___________________________________________________
___________________________________________________
___________________________________________________

How can you begin to put this goal into practice?

___________________________________________________
___________________________________________________
___________________________________________________

Practice mindfulness daily. Be patient with yourself. Develop a practice that

works for you and when you venture away (mindlessness) gently bring
yourself back.

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and
for professional use with clients only
11
Ideas For Mindfulness Practice
Practice: anytime, anywhere, while doing anything!

Ideas for Mindfulness Practice:

- Be mindful of movements
- Pay attention to nature
- Walk
- Create with art
- Breathing in a color and out a color
- Coloring mandalas
- Yoga/stretching
- Deep breathing
- Progress muscle relaxation
- Meditation
- Contemplative prayer

Your idea(s) for mindfulness practice:

___________________________________________
___________________________________________
___________________________________________

Track your daily experiences with mindfulness. Try to

do at least 3 before the next session

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW
and Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this
training and for professional use with clients only
12
 Mindfulness Practice Log
Date:____________

Emotions prior to starting:

___________________________________________________________
___________________________________________

Distress level before starting (0-10 scale 0- none 10 is the most):

_________________

Emotions after:
___________________________________________________________
___________________________________________

Distress level after (0-10 scale 0- none 10 is the most):

_________________

Date:____________

Emotions prior to starting:

___________________________________________________________
___________________________________________

Distress level before starting (0-10 scale 0- none 10 is the most):

_________________

Emotions after:
___________________________________________________________
___________________________________________

Distress level after (0-10 scale 0- none 10 is the most):

_________________

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and
for professional use with clients only
13
 Worksheet retrieved from http://www.new-synapse.com/aps/wordpress/?p=1195

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser,
LCSW and Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants 14
of this training and for professional use with clients only
 Loving Kindness Wishes For
Others & Yourself
List 4-5 Wishes for Others

List 4-5 Wishes for Yourself

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training
and for professional use with clients only
15
Defining Your Values
Your values are the things that you believe are
important in the way you live and work. They (should)
determine your priorities, and, deep down, they're
probably the measures you use to tell if your life is
turning out the way you want it to.

Ask yourself: What are my values? List below:

___________________________________________
___________________________________________
___________________________________________
___________________________________________
___________________________________________

What action step do I need to do ensure that I stick to

my values?
___________________________________________
___________________________________________
___________________________________________
___________________________________________

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser,
LCSW and Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants
of this training and for professional use with clients only

16
 What Are My Goals in
Relationships?
Ask yourself and identify below:
What kind of relationships do I want in my life? What kind do I currently have in my life?

What are the barriers to having What skills can I use to break
the relationships I want? through these barriers?

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
17
 Emotions and Opposite Action

Image source pinterest

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
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 You have a right to all of these.
Highlight the 4 most important and/or the 4 you are struggling to believe in
the most

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
19
 Chain Analysis

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and
Inner Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and
for professional use with clients only
20
 From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for professional
use with clients only
21
 From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for professional
use with clients only
22
From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only

23
From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only

24
From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only

25
From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only

26
From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only

27
From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
28
 This page is intentionally left blank

From DBT 3 Day Certification Training with Katelyn Baxter-Musser, LCSW. Copyright 2019 by Katelyn Baxter-Musser, LCSW and Inner
Awakenings Counseling & Consulting. Permission to photocopy this handout is granted to participants of this training and for
professional use with clients only
29