In this article you will read about:
Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan, is a comprehensive cognitive-behavioral treatment that emphasizes both acceptance and change, with a particular focus on the psychosocial context of emotional suffering. Originally designed for chronically suicidal individuals with Borderline Personality Disorder (BPD), DBT has since been adapted for a range of conditions involving emotion dysregulation, impulsivity, and interpersonal instability (Linehan, 1993, 2015).
At the heart of DBT are skills-training modules that teach clients how to navigate intense emotions and build a life experienced as worth living: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness (Linehan, 2015; McKay et al., 2019).
Mindfulness is considered the “core” module, because it underpins all other skills. In DBT, mindfulness is organized into “What” skills (what you do to be mindful: observe, describe, participate) and “How” skills (how you do those actions: nonjudgmentally, one-mindfully, and effectively).
The “What” skills describe the content of mindfulness, whereas the “How” skills describe the attitude and process with which mindfulness is practiced. Together, they allow individuals to bring purposeful, nonjudgmental attention to present-moment experience, in line with broader definitions of mindfulness as “paying attention, on purpose, in the present moment, nonjudgmentally” (Kabat-Zinn, 1990, 1994). This article explores the “How” skills in greater depth, emphasizing their significance, practical application, and impact on both everyday life and therapeutic progress.
Understanding the "How" Skills in DBT
The “How” skills in DBT are essentially process guidelines: they describe the quality of attention and behavior that makes mindfulness genuinely transformative rather than mechanical. They are not separate exercises but ways of doing every mindfulness act—and, eventually, every part of daily life.
When clients first learn mindfulness, they often focus on techniques (e.g., breathing, grounding, noticing thoughts). The “How” skills ensure that these techniques are practiced in a way that reduces shame, reactivity, and impulsive behavior rather than reinforcing them. Linehan (2015) describes the “How” skills as essential for helping clients step out of rigid judgments, automatic multitasking, and ineffective habits, and instead engage with reality as it is in the present moment.
Research on mindfulness-based interventions (MBIs) suggests that cultivating a nonjudgmental, present-centered awareness is associated with improved emotion regulation, reduced anxiety and depression, and better overall psychological functioning (Dunning et al., 2019; Rodrigues et al., 2017).
The DBT “How” skills operationalize this mode of awareness in a simple, teachable format:
Nonjudgmentally – relating to inner and outer experience without labeling it as good or bad.
One-mindfully – doing one thing at a time with full attention.
Effectively – doing what works, guided by goals and context rather than ego, pride, or rigid rules.
These three components work together to help clients exit “emotion mind” and access “wise mind”—DBT’s term for the integration of emotional experience and rational thinking (Linehan, 2015).
The Three "How" Skills Explained
Nonjudgmentally
To practice nonjudgmentally is to observe thoughts, feelings, bodily sensations, and events without evaluating them as good, bad, right, or wrong. Instead of saying “I’m being ridiculous” or “This feeling is stupid,” the person notices, “I am having a thought that I’m overreacting,” or “I notice tightness in my chest and a wave of fear.”
From a DBT perspective, judgments tend to:
Intensify emotional arousal (“I shouldn’t feel this way” often creates shame or anger on top of the original feeling).
Narrow attention so that we only see what confirms our judgment.
Fuel impulsive behaviors aimed at escaping or punishing ourselves or others.
Nonjudgmental awareness shifts the focus to facts and description. For example:
Judgment: “I completely messed up that conversation. I’m a terrible friend.”
Nonjudgmental description: “In that conversation I raised my voice, interrupted twice, and later noticed my friend getting quiet.”
Mindfulness research suggests that nonjudging one’s inner experience is a distinct facet of trait mindfulness linked with lower anxiety and depression (Baer et al., 2006).
Practicing this DBT “How” skill helps clients separate what is happening from the mental story about what it “means” about their worth.
One-mindfully
One-mindfully means doing one thing at a time, fully, with your awareness anchored in the present activity. It is the opposite of habitual multitasking, rumination, and “being elsewhere” while you are doing something.
Examples of one-mindful practice include:
Eating a meal while only eating—notice taste, texture, smell, hunger and fullness cues.
Listening in a conversation while only listening—no phone checking, no planning your reply, no internal argument with yourself.
Walking while only walking—feeling your feet on the ground, your breathing, and the environment around you.
From a cognitive standpoint, chronic multitasking often increases stress and reduces efficiency, while acting with focused awareness improves performance and emotional stability (Dunning et al., 2019; Kabat-Zinn, 1990).
In DBT, one-mindfulness helps to:
Reduce vulnerability to impulsive behavior by keeping attention in the present.
Strengthen wise-mind decisions, because the mind is less scattered.
Enhance the sense of meaning and satisfaction in everyday activities.
Effectively
To act effectively is to do what works in a given situation, in service of your values and goals—even when that means letting go of what you feel like doing, what you think “should” work, or what would prove a point. As Linehan (2015) emphasizes, effectiveness means focusing on reality, not on fairness, ego, or rigid rules.
Examples of acting effectively include:
Choosing to use a calm tone with a partner because your goal is to be heard—not to “win” the argument.
Using a coping skill (like grounding or self-soothing) instead of sending an impulsive text when feeling abandoned.
Agreeing to take a brief break from a heated conversation to prevent escalation, even if part of you wants to “finish it right now.”
Effectiveness asks:
“Given my current goals and the actual situation, what action is most likely to move things in a helpful direction?”
This skill is crucial for individuals who struggle with intense emotions, because in high arousal states, behavior often becomes reactive rather than goal-directed. Acting effectively bridges the gap between inner experience and outward behavior, aligning actions with long-term well-being instead of short-term emotional relief (McKay et al., 2019).
"Mindfulness skills are central to DBT; they are the foundation for all the other skills taught in therapy, including the capabilities for emotion regulation, distress tolerance, and interpersonal effectiveness."
The Importance of "How" Skills in DBT
The “How” skills are crucial in DBT because they provide a practical framework for applying mindfulness moment-to-moment. Without them, mindfulness risks becoming a purely cognitive exercise (“I know I should be present”) rather than a lived experience that actually reduces suffering.
Through the “How” skills, clients learn to:
Act with Awareness
Nonjudgmentally and one-mindfully attending to the present enhances acting with awareness, a facet of mindfulness strongly associated with reduced automatic behavior and improved emotion regulation (Baer et al., 2006). Instead of reacting on autopilot, individuals can:
Notice urges to self-harm, lash out, or withdraw.
Create a brief pause between emotion and action.
Choose more skillful responses that reflect wise mind.
Reduce Suffering
Effectiveness emphasizes doing what works, which is especially vital for individuals whose lives have been shaped by repeated crises, conflict, or invalidation. When people act effectively, they:
Prioritize long-term goals over short-term emotional relief.
Use DBT skills strategically (e.g., STOP skill, opposite action, DEAR MAN).
Reduce the frequency of behaviors that sabotage relationships, employment, and self-respect.
In DBT, mindfulness—and especially the “How” skills—are repeatedly framed as foundational: they support emotion regulation, distress tolerance, and interpersonal effectiveness by making it possible to notice internal experience clearly and choose a response rather than react automatically (Linehan, 2015).
Achieve Goals More Effectively
Effectiveness emphasizes doing what works, which is especially vital for individuals whose lives have been shaped by repeated crises, conflict, or invalidation. When people act effectively, they:
Prioritize long-term goals over short-term emotional relief.
Use DBT skills strategically (e.g., STOP skill, opposite action, DEAR MAN).
Reduce the frequency of behaviors that sabotage relationships, employment, and self-respect.
In DBT, mindfulness—and especially the “How” skills—are repeatedly framed as foundational: they support emotion regulation, distress tolerance, and interpersonal effectiveness by making it possible to notice internal experience clearly and choose a response rather than react automatically (Linehan, 2015).
Applying the "How" Skills in Everyday Life
Incorporating the “How” skills into daily life involves a deliberate shift in how you approach ordinary activities and interactions. Rather than something practiced only in formal meditation, DBT encourages weaving mindfulness into real-world situations where emotions tend to flare.
Practice Nonjudgmental Stance
Notice judgmental thoughts: “I’m such an idiot,” “They’re so selfish,” “This is unbearable.”
Name them as judgments: “That’s a judgment,” or “I’m having the thought that…”
Shift to describing facts: “My heart is racing, my fists are clenched, and I raised my voice.”
Over time, this practice weakens automatic self-criticism and hostility toward others, creating more emotional space and flexibility.
Focus on One Task at a Time
When working, close unnecessary tabs, mute notifications, and bring your attention back each time your mind wanders.
When talking to someone, put your phone out of reach and look directly at the person.
When resting, let yourself only rest—no self-judging thoughts about productivity while you do it.
Even short bursts (e.g., 3–5 minutes of one-mindful activity) can train the brain toward greater presence.
Act Effectively
Ask yourself: “What is my goal in this situation?”
Compare your urges with your goals: “Does yelling serve my goal of feeling close to this person?”
Choose the behavior that is most likely to move the situation in a helpful direction, even if it means temporarily tolerating discomfort.
This may include using other DBT skills such as wise mind checks, opposite action, or self-soothing to support effective choices.
Practical Activity: One-Week "How" Skills Practice
Use this structured activity to actively apply the three “How” skills across a full week. You can repeat or adapt it as needed.
Pick a Daily Anchor Activity
Choose one everyday activity you do every day (e.g., brushing your teeth, making coffee, commuting, doing dishes). This will be your mindfulness anchor for the week.
Set an Intention Each Morning
Before starting your day, take 30–60 seconds to say (silently or out loud):
“Today I will practice Nonjudgmentally, One-mindfully, and Effectively during [chosen activity] and one emotionally challenging moment.”
Practice Nonjudgmentally During the Anchor Activity
While doing your chosen activity:
Notice any judgments about yourself, the task, or the day ahead (“This is pointless,” “I look awful,” etc.).
Label them as judgments (“That’s a judgment”).
Redirect attention to sensory details: what you see, hear, feel, smell, or taste.
Add One-Mindfulness
During the same activity, gently commit to:
Doing only that one thing.
Bringing your mind back each time it wanders (which it will).
Letting go of multitasking (no phone, no email, no planning the whole week).
Even if attention drifts 100 times, each return is a successful repetition of the “attention muscle.”
Choose One Emotionally Charged Moment Per Day
At some point each day, when you notice a spike in emotion (annoyance, shame, anxiety, anger):
Pause for 3 slow breaths.
Silently name the emotion: “Anger is here,” or “I notice anxiety.”
Remind yourself: “Nonjudgmentally. One-mindfully. Effectively.”
Apply the Three “How” Skills to That Moment
Nonjudgmentally: Drop labels like “overreacting,” “pathetic,” or “stupid.” Shift to describing what is happening (bodily sensations, thoughts, urges).
One-mindfully: Focus on this moment only—what is actually being said, what you are feeling now, not past or future arguments.
Effectively: Ask, “Given my goals (e.g., staying safe, preserving this relationship, respecting myself), what is the most effective action right now?”
Choose one small effective behavior (e.g., softening your tone, using “I” statements, taking a 5-minute break, using a distress-tolerance skill).
Brief Evening Reflection (3–5 Minutes)
At the end of each day, jot down:
One example of when you noticed a judgment and shifted to description.
One example of one-mindful attention (even if brief).
One example where you acted more effectively than you might have in the past.
This reflection consolidates learning and builds self-efficacy—an important factor in DBT outcomes (Linehan, 2015; McKay et al., 2019).
Weekly Check-In
After seven days, ask yourself:
“What changed in how I relate to my thoughts and emotions?”
“Did I notice even small shifts in reactivity, clarity, or self-judgment?”
“Which of the three ‘How’ skills felt easiest? Which felt hardest?”
Use these observations to guide where you focus future practice.
The "How" Skills and Coping Strategies
In DBT, the “How” skills are not isolated—they directly support distress tolerance, emotion regulation, and interpersonal effectiveness strategies.
When practicing distress tolerance (e.g., TIPP, self-soothing, radical acceptance), doing so nonjudgmentally reduces the extra layer of shame or self-blame that can undermine coping efforts.
Using emotion regulation skills one-mindfully helps clients stay with one step at a time (e.g., checking vulnerabilities, naming emotions, choosing opposite action), rather than becoming overwhelmed.
Acting effectively is essential in interpersonal effectiveness skills (e.g., DEAR MAN, GIVE, FAST), where the goal is to balance self-respect, relationship needs, and objectives.
Rather than trying to “get rid of” distressing emotions, the “How” skills help individuals relate differently to those emotions—observing them as transient experiences that can be navigated skillfully, rather than as commands that must be obeyed. This shift is consistent with broader mindfulness-based approaches that aim to change one’s relationship with internal experience rather than its mere content (Kabat-Zinn, 1990; Rodrigues et al., 2017).
Challenges in Practicing the "How" Skills
For many people—especially those used to multitasking, self-criticism, or chronic crisis—practicing the “How” skills can initially feel unnatural or even threatening. Common challenges include:
Automatic judgments (“If I stop judging myself, I’ll become lazy or selfish”).
Restlessness with one-mindfulness (“Doing one thing at a time feels boring or inefficient”).
Resistance to effectiveness (“If I compromise or act skillfully, I’m letting others win or giving up on fairness”).
It is important to normalize these reactions. DBT conceptualizes many of them as learned survival strategies in invalidating or chaotic environments (Linehan, 1993).
Over time, the “How” skills can actually increase internal safety and stability by:
Reducing self-attack and internalized criticism.
Creating predictability in how one responds to stress.
Expanding the range of possible responses to difficult situations.
Therapists often coach clients to start with short, manageable practices and emphasize that every moment of noticing and gently redirecting attention is practice—there is no “perfect mindfulness.”
The Impact of the "How" Skills on Therapy
Integrating the “How” skills into therapy sessions strengthens the overall impact of DBT. Clinicians may:
Begin sessions with brief, one-mindful exercises to ground both the therapist and the client.
Use nonjudgmental language consistently, modeling the stance they invite clients to adopt.
Ask effectiveness-oriented questions (“Given your goals, what would be the most effective response here?”).
Mindfulness-based interventions, including DBT-informed approaches, have been linked with improvements in emotional symptoms, cognitive functioning, and overall mental health across various populations (Dunning et al., 2019; Dawson et al., 2019).
In DBT specifically, mindfulness training is a core mechanism thought to facilitate the reduction of self-harm, suicidal behavior, and other high-risk patterns in individuals with BPD and related conditions (Linehan, 2015).
By emphasizing “How” skills, therapists help clients:
Translate mindfulness from a theoretical concept into a moment-to-moment practice.
Build a coherent, compassionate inner stance toward their own experiences.
Generalize skills beyond the therapy setting into home, work, and relationships.
Expert Opinions on the "How" Skills
DBT experts consistently highlight mindfulness as the foundation of the treatment. Linehan notes that mindfulness skills provide the platform on which all other DBT skills rest; emotion regulation, distress tolerance, and interpersonal effectiveness are much more complex to apply without the capacity to observe and accept experiences as they are (Linehan, 2015).
Similarly, authors of DBT skills workbooks emphasize that practicing mindful awareness—particularly nonjudgmentally, one-mindfully, and effectively—helps clients reduce emotional “tsunamis” and respond with greater balance and flexibility (McKay et al., 2019).
These professional perspectives align with the growing evidence base, which shows that cultivating mindfulness processes is associated with improved outcomes across various mental health conditions (Rodrigues et al., 2017; Dunning et al., 2019).
Conclusion
The “How” skills in DBT—Nonjudgmentally, One-mindfully, and Effectively—offer a practical, accessible framework for bringing mindfulness into everyday life. They guide not only what clients do to be mindful but how they relate to themselves, others, and the world in each moment.
For individuals struggling with emotional regulation, impulsive behavior, or chronic self-criticism, the “How” skills can:
Decrease secondary suffering created by harsh judgments and resistance to reality.
Increase present-moment awareness and intentional, wise-mind choices.
Support the effective use of other DBT skills in distress tolerance, emotion regulation, and interpersonal effectiveness.
Mindfulness skills are central to DBT; they truly are the foundation for all other skills taught in therapy, including the capacities for emotion regulation, distress tolerance, and interpersonal effectiveness (Linehan, 2015).
By learning to move through life nonjudgmentally, one-mindfully, and effectively, individuals can build a more grounded, compassionate, and purposeful relationship with themselves and their environment—one moment at a time.
FAQ
Most frequent questions and answers about the "HOW" Skills in DBT
The “How” skills are three guidelines for how to practice mindfulness so that it becomes truly effective and transformative. In DBT, they are:
Nonjudgmentally – noticing thoughts, feelings, and events without labeling them as good/bad or right/wrong.
One-mindfully – doing one thing at a time with full attention in the present moment.
Effectively – doing what works in a situation, based on your goals and reality, rather than on pride, ego, or “shoulds.”
They’re meant to shape the quality of your attention during any activity, not just formal meditation.
In DBT mindfulness:
The “What” skills describe what you do to be mindful:
Observe
Describe
Participate
The “How” skills describe how you do those things:
Nonjudgmentally
One-mindfully
Effectively
You can think of it like this: What skills are the actions; How skills are the attitude and approach you bring to those actions.
No. Formal meditation can be helpful, but it’s not required. The “How” skills are designed to be used in everyday life, including:
Eating a meal
Walking, showering, or commuting
Having a conversation
Working, studying, or doing chores
Any activity can become a mindfulness practice if you bring nonjudgmental, one-mindful, and effective awareness to it.
Yes, you can absolutely start practicing the “How” skills on your own. Many people work with DBT skills workbooks, online resources, and self-guided exercises to integrate these skills into daily life.
That said, if you’re dealing with intense emotions, self-harm, suicidal thoughts, or complex mental health concerns, working with a trained mental health professional can provide:
Safety and structure
Personalized guidance
Support in applying skills in high-risk situations
The “How” skills are powerful tools, but they are not a full replacement for professional treatment when that is needed.
No. Although DBT was originally developed for people with BPD and chronic suicidality, the skills are now used with:
Anxiety and mood disorders
PTSD and trauma-related symptoms
Substance use difficulties
Emotional dysregulation in general
People without a diagnosis who want better emotion regulation and presence
The “How” skills are essentially foundational mindfulness skills, and they can support anyone who wants to relate to their thoughts and emotions more skillfully.
"How" Skills Book Recommendations
Here is a collection of the best books on the market related to “how” skills:
Our commitment to you
Our team takes pride in crafting informative and well-researched articles and resources for our readers.
We believe in making academic writing accessible and engaging for everyone, which is why we take great care in curating only the most reliable and verifiable sources of knowledge. By presenting complex concepts in a simplified and concise manner, we hope to make learning an enjoyable experience that can leave a lasting impact on our readers.
Additionally, we strive to make our articles visually appealing and aesthetically pleasing, using different design elements and techniques to enhance the reader’s experience. We firmly believe that the way in which information is presented can have a significant impact on how well it is understood and retained, and we take this responsibility seriously.
Click on the icon to see all your thoughts in the Dashboard.
Your Thoughts about the "How" Skills
It’s highly recommended that you jot down any ideas or reflections that come to mind regarding “how” skills, including related behaviours, emotions, situations, or other associations you may make. This way, you can refer back to them on your Dashboard or Reflect pop-ups, compare them with your current behaviours, and make any necessary adjustments to keep evolving. Learn more about this feature and how it can benefit you.
References
- Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.
- Baer, R. A., Carmody, J., & Hunsinger, M. (2012). Weekly change in mindfulness and perceived stress in a mindfulness-based stress reduction program. Journal of Clinical Psychology, 68(7), 755–765.
- Dawson, A. F., Brown, W. W., Anderson, J., Datta, B., Donald, J. N., Hong, K., Allan, S., Mole, T. B., Jones, P. B., Galante, J., & Kuyken, W. (2019). Mindfulness-based interventions for university students: A systematic review and meta-analysis of randomised controlled trials. Clinical Psychology Review, 78, 101–859.
- Dunning, D. L., Griffiths, K., Kuyken, W., Crane, C., Foulkes, L., Parker, J., & Dalgleish, T. (2019). Research review: The effects of mindfulness-based interventions on cognition and mental health in children and adolescents – A meta-analysis of randomized controlled trials. Journal of Child Psychology and Psychiatry, 60(3), 244–258.
- Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delacorte.
- Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
- Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.
- McKay, M., Wood, J. C., & Brantley, J. (2019). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance (2nd ed.). New Harbinger Publications.
- Rodrigues, M. F., Nardi, A. E., & Levitan, M. (2017). Mindfulness in mood and anxiety disorders: A review of the literature. Trends in Psychiatry and Psychotherapy, 39(3), 207–215.
