Effectiveness

Definition

Effectiveness in DBT refers to acting skillfully to get what you want and need, while maintaining relationships and self-respect. It means choosing behaviors that work toward your goals instead of getting caught up in emotion-driven reactions.

This is often taught using the DEAR MAN acronym for assertive communication.

Purpose

Used to:

• Increase the chances of getting your needs met.
• Maintain healthy relationships.
• Preserve your self-respect.
• Reduce interpersonal conflicts.
• Communicate assertively rather than passively or aggressively.

When to Use

Use Effectiveness skills when:

• You want to ask for something.
• You need to say “no.”
• You need to negotiate or problem-solve.
• You’re in conflict with someone.
• You feel the urge to explode or shut down.

When Not to Use

Avoid using Effectiveness if:

• Safety is at risk and immediate action is needed.
• The other person is unable or unwilling to engage (e.g., intoxicated, violent).
• You are too dysregulated to communicate calmly (in which case, use distress tolerance first).

How-To

1. Define Your Goal: What do you want from this interaction?

2. Use DEAR MAN:

   • D – Describe the situation factually.
   • E – Express your feelings and opinions.
   • A – Assert by asking clearly or saying no.
   • R – Reinforce by explaining benefits of your request.
   • M – Mindful: Stay focused, don’t be distracted.
   • A – Appear Confident: Use a steady voice and body language.
   • N – Negotiate: Be willing to give and take.

3. Maintain Self-Respect: Stick to your values.

4. Balance Relationship Needs: Be fair and considerate.

Tips & Variations

• Rehearse ahead of time to build confidence.
• Use a calm tone even if you feel upset.
• Be concise and clear.
• Watch out for: passive-aggression, blaming, or threats.
• Pair with FAST skills to preserve self-respect.

Example

Jamal needed his roommate to clean up shared spaces. He practiced DEAR MAN:

• Describe: “I’ve noticed dishes are left in the sink overnight.”
• Express: “I feel frustrated because I can’t use the kitchen in the morning.”
• Assert: “I’d like you to please clean up by the end of the day.”
• Reinforce: “That way, it’s more comfortable for both of us.”

He stayed calm and confident, repeating his request when his roommate tried to change the topic.

Inventor / Origin

Effectiveness skills are part of Interpersonal Effectiveness in DBT, developed by Marsha M. Linehan, PhD, combining assertiveness training, cognitive-behavioral therapy, and principles from dialectics.

Related Skills

• DEAR MAN: For assertiveness.
• GIVE: To maintain relationships.
• FAST: To maintain self-respect.
• Mindfulness: To stay present during interactions.

Limitations

May not be effective if:

• The other person is abusive or dangerous.
• You cannot access your skills due to intense emotion.
• The situation requires immediate action over discussion.

Evidence Base

Research shows that Effectiveness skills:

• Improve interpersonal functioning.
• Reduce conflict and resentment.
• Increase self-confidence.
• Are associated with better outcomes in BPD and mood disorders.

Further Reading

• DBT Skills Training Handouts and Worksheets by Marsha Linehan
• DEAR MAN Skill (Therapistaid)
• Interpersonal Effectiveness Overview

References

• Linehan, M.M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press.
• Linehan, M.M. (2015). DBT Skills Training Manual, Second Edition. New York: Guilford Press.