DBT Next Steps Clinician's Manual: Building a Life Worth Living

Developed over 25 years by preeminent experts, DBT Next Steps is a groundbreaking expansion of standard Dialectical Behavior Therapy (DBT) for clients who have moved beyond crisis behaviors--yet haven't achieved their goals in such areas as employment, school, and relationships. Combining skills training with exposure, contingency management, cognitive modification, and didactic strategies, DBT Next Steps fills a gap by systematically targeting quality-of-life-interfering behavior. In a convenient large-size format, this authoritative clinician's manual provides detailed lesson plans for six brand-new DBT skills modules: Perfectionism versus Reinforcement, Establishing and Re-Evaluating Relationships, Time Management, Managing Emotions Effectively, Succeeding after DBT, and Applications of Mindfulness. It shows how Next Steps can be incorporated into an existing DBT program or used as a follow-up treatment. Reproducible skills training handouts and assignments are provided in the related client resource, available separately: DBT Next Steps Skills Handouts.

Katherine Anne Comtois, PhD, MPH, is Professor in the Department of Psychiatry and Behavioral Sciences and Adjunct Professor in the Department of Psychology at the University of Washington. She was a research therapist and co-investigator with Marsha M. Linehan on her clinical trials from 1994 to 2006 and Director of the DBT program at Harborview Mental Health and Addiction Services from 1996 to 2019. She now leads the DBT standard and training programs at the University of Washington Medical Center Outpatient Psychiatry Clinic. Dr. Comtois provides training and consultation on DBT Next Steps and the DBT-ACES program through the University of Washington. In addition, Dr. Comtois provides training and consultation in standard DBT internationally as an independent contractor with Treatment Implementation Collaborative LLC.

Adam Carmel, PhD, is Clinical Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington. He is Codirector of the Annual Comprehensive DBT Training program in the Department of Psychiatry and Behavioral Sciences at the University of Washington. He was previously Director of the Massachusetts Mental Health Center’s DBT program operated by the Massachusetts Department of Mental Health. Dr. Carmel was previously Clinical Assistant Professor in the Department of Psychology at the University of Washington, where he taught DBT in the Behavioral Research and Therapy Clinics under the direction of Marsha Linehan.

Marsha M. Linehan, PhD, ABPP, the developer of Dialectical Behavior Therapy (DBT), is Professor Emeritus of Psychology and Director Emeritus of the Behavioral Research and Therapy Clinics at the University of Washington. Before retiring in 2019, she devoted her career to developing and evaluating evidence-based treatments for populations with high suicide risk and multiple, severe mental disorders. Dr. Linehan is the 2025 recipient of the Lifetime Achievement Award from the American Foundation for Suicide Prevention. Her contributions to suicide research and clinical psychology research have also been recognized with the University of Louisville Grawemeyer Award for Psychology, the Career/Lifetime Achievement Award from the Association for Behavioral and Cognitive Therapies, the Gold Medal Award for Life Achievement in the Application of Psychology from the American Psychological Foundation, and the James McKeen Cattell Award from the Association for Psychological Science. In her honor, the American Association of Suicidology created the Marsha Linehan Award for Outstanding Research in the Treatment of Suicidal Behavior. Dr. Linehan was featured in TIME Great Scientists: The Geniuses and Visionaries Who Transformed Our World. She is founder of the Linehan Institute and is a Zen master.