Creative DBT Activities Using Music! Interventions for Enhancing Engagement and Effectiveness in Therapy 

Let me introduce you to the idea of utilizing music activities that have been specially created and chosen by board certified music therapists to teach, strengthen, practice, and enrich the learning of DBT's practical life skills in the areas of mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and walking the middle path.  

Dialectical Behavioral Therapy (DBT) is a cutting edge evidence based therapy model created by Dr. Marsha Linehan, that has been shown to be extremely effective. DBT skills aim to “change behavioral, emotional, thinking, and interpersonal patterns associated with problems in living”. (Linehan 2015) 

Creative DBT Activities Using Music- Interventions for Enhancing Engagement and Effectiveness in Therapy is a new book by Deborah Spiegel MT-BC with Lauren Bonavitacola PsyD, MT-BC and Suzanne Makary MT-BC. It is published by Jessica Kingsley 2020.  

This book presents you with a variety of ways to instill a skill and practical ways for generalization, for use with groups and individual clients. It offers tangible assignments that the client can take home and do on their own. No musical background is required to successfully use the activities. 

"You do not need to be a musician or a psychologist to find these therapeutic activities immediately applicable to your patients, students, and colleagues practicing DBT. Spiegel, Makary, and Bonavitacola outline many effective and practical ways to creatively weave music into DBT!" Alec L. Miller, Psy D, Co-Founder and Clinical Director of CBC, and Clinical Professor of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine.

Click here to purchase the book.
  If you already have it, click here to be put on the waiting list for a supplemental webinar to the book.

"Music is so much more engaging for the adolescents, and when kids are engaged, that's half the battle for teaching them skills. Especially at a program like mine where group participation is expected as part of treatment." 

Libby Aresenault, Dialectical Behavior Therapy Skills Group Leader, Mental Health Counselor at an inpatient DBT program, and non-musician

"I've been providing adherent DBT for adolescents and adults for 14 years and am ready for some new ideas. I'm excited to learn music activities to complement my skills training groups!"

Angela Klein PhD, licensed clinical psychologist in the greater San Diego area 

"My adolescent daughter was in a crisis last week and she wouldn't let me teach her any skills. She loves music, so I was thrilled to have this self-help program to give her."

Anonymous (parent who wishes not to be named)

There are two sections to the book.  

 The group activities section shows specific ideas for how to present a particular group activity to focus on one DBT skill vs another. Detailed instructions and suggestions are included. The second section provides music activities/handouts for teaching and reinforcing every DBT skill, presented in a self- help format, in the order the skills are typically taught.  

The handouts can be used:  

  • as homework to reinforce skills clients have learned or are learning
  • as a resource for a specific client who needs to learn that skill
  • for discharging clients providing a creative way to encourage continuity 
  • for therapists seeking creative ideas to use in skills groups or individual sessions
  • for anyone seeking personal growth to use in a self-help format

Who are these DBT informed music activities for?  

  • Clinicians who work within the structure of DBT and want some new ideas to reinforce, practice, & enrich the learning of Dialectical Behavior Therapy skills and/or to have something engaging that your clients can use on their own in-between to practice and strengthen skills 

  • Music therapists who want quick grab and go DBT informed interventions you can modify for your work with clients in your practice, and a resource to refer clients to who want to continue their learning and practicing of the skills through music activities upon discharge. 

  • Clients of any age. Therapists can pass these out as handouts for homework, to followup on skills you taught them, to provide continuity, to offer something upon discharge for practicing emplementation of skills.

  • Teens who have been through a lot. Love your music? These music activities and skills lessons are written in a self-help format especially for you. 

  • Parents who are feeling overwhelmed or stressed. You can enjoy these activities and lessons as well. Do them with your child and/or do them for yourself. The skills are beneficial to anyone's life and the activities are a good way to put the skills into practice. 

  • Personal growth seekers. The skills are beneficial to anyone's life and the activities are a good way to put the skills into practice.  

Here is an Example:

The “what” skills are meant to help you find your wise mind. The what skills are to –  

Observe Describe Participate  


Listen to several songs in a row on a radio station so you have a variety of songs. While listening to the music, write down what you observe about the music. What instrument sounds do you hear? Were there violins or guitars? Drums? Was it loud? Fast or slow? Notice what emotion the song evokes in you, and how that emotion feels in your body. Do you have any urges or impulses to act as a result of this song? What thoughts does it bring up? You can even draw to the music.  


Write this down for 3 or 4 songs.  


A Skill you can take away from this:  

In this activity you were mindfully focused on what you observed, (taking in information at the sensory level, without description or labels), including what you heard in the music, your thoughts, emotions, body sensations, and urges, and then you described what you observed by putting it into words and describing it on the paper. If you followed the instructions to completion then you participated.  

The “what” skills are meant to help you find your wise mind. The way these skills work in a moment of distress is that through the act of mindfully observing what you notice in your surroundings, in your body, and in your mind, and in describing these observations, (your senses, thoughts, emotions, body sensations, and urges), you can step back from the urge to act immediately and instead make a wise choice in your behavior that is effective. You then participate in the present moment effectively and skillfully, doing what works.  


Questions to ponder: Have you ever had an experience of acting impulsively, without thinking about it and regretting it later?  

The time to use this skill is then. Before you act, notice the urge to act and get into your wise mind. Ask yourself, “Is this a wise minded choice?” Then choose the wise action and participate mindfully.  

How can you use this skill in your life?  

What situations might come up during your week where using the “what” skills to find your wise mind may be helpful?  


Roller Coaster Song I’m going to give you an example of how I used this skill in my life with the Roller Coaster Song… (this is in the actual lesson)

Action Step for this Week 

This week, practice observing, describing, and participating mindfully, (what to do to get to wise mind) starting out in everyday, low intensity moments. Over time, it will be become much easier to observe, describe, and participate in moments when your emotion intensity is much higher, and you can bring yourself to wise mind!


 Copyright 2017-2019 D. Spiegel All Rights Reserved

(When you purchase this program you are granted the right to make copies for your personal growth &/or professional use.)

*DBT Skills: DBT Skills Training Manual by Marsha M. Linehan (2015 Gilford Press)  

>> Click here to purchase the book and to be put on the waiting list << 

Imagine, over the next year of experiencing the activities in this program, your clients remembering and implementing skills in life, feeling a proud sense of mastery develop for all the wins day after day...using skills, reducing impulsive behaviors, regulating emotions, communicating masterfully, and being mindful and wise.

“Deborah will teach you a wealth of music activities you can use to liven up your DBT skills groups or other therapy groups (if you are a therapist) or to reinforce the skills you are learning in skills groups (if you are a DBT client). I also believe that a person who isn't involved in therapy but seeks personal growth could learn effective life skills by completing these activities. ”  

Sally Bonkrude MA, LPC, MT-BC

Deborah Spiegel MT-BC 

Deborah is a DBT informed Board Certified Music Therpist as well as CEO and director of The Spiegel Academy (Music Therapy Continuing Education). 

Author of the book Music Activities & More for Teaching DBT Skills and Enhancing Any Therapy: Even for the Non-Musician (Authorhouse 2010) Deborah is also a presenter of workshops on this topic nation wide. ->

Ms Spiegel received her DBT skills training from Behavioral Tech, through both live and online classes,and with her treatment team while working in an inpatient DBT milieu at the Colorado Mental Health Institute. She served as the treatment team's music therapist as well as serving as a DBT skills group leader for almost 12 years. She found herself adding music to her skills groups and then again reinforcing the skills the patients learned during her music therapy groups.  

Since 2011 Ms Spiegel has been an approved provider with the Certification Board for Music Therapists, providing continuing education classes on a wide range of topics including DBT informed music therapy, for music therapists and allied health professionals.  

Lauren Bonavitacola Psy.D., MT-BC 

Dr. Lauren Bonavitacola is is an intensively trained DBT licensed psychologist and board certified music therapist at Cognitive & Behavioral Consultants of Westchester & Manhattan. Dr. Bonavitacola is providing consultation for this project and book. She is also the supervising clinician for the DBT related classes offered to music therapists at The Spiegel Academy.  

Suzanne Makary MT-BC 

Suzanne Makary is a DBT informed Board Certified Music Therapist serving as the Music Therapist and Supervisor of the Adult Partial Hospitalization Program for St. Luke’s University Health Network - Bethlehem Pennsylvania. She has been a big support in the final touches of producing this book.