Free Therapist Training›Free DBT Toolkit›Validation Levels
Last updated: November 11, 2026
Marsha Linehan describes six levels of validation in DBT, from staying awake to radical genuineness. The quick reference lists each level, what the therapist does at that level and a sample response to one invented client statement, then gives three new statements for writing your own response at a level you choose.
The reference comes from the free DBT toolkit of the Sentio MFT program, which trains therapists with deliberate practice. The level names and definitions follow Linehan's 1997 chapter as summarized in later DBT research, and every client statement is new and invented.
This is an optional template from the Sentio MFT program's free DBT toolkit, an original design for you to adapt.
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The six levels of validation
Client statement: Marco, 34, a line cook in his third month of DBT, was often left out of family plans growing up. "My sister had her engagement dinner Saturday. I found out from Instagram. Fine. I'm used to being the one nobody wants around."
| Level | What the therapist does | Sample response to Marco |
|---|---|---|
| 1. Staying awake | Listens to and observes the client's words, feelings and behavior with full attention and evident interest, making an active, nonjudgmental effort to understand. | (Sets the diary card aside and turns toward him.) "Tell me about Saturday. What did you see?" |
| 2. Accurate reflection | Reflects back the client's feelings, thoughts and assumptions in language close to the client's own, adding organization but no interpretation. | "Your sister had her engagement dinner on Saturday, and you found out about it on Instagram." |
| 3. Articulating the unverbalized | Accurately puts into words the client's unspoken thoughts, feelings or patterns of behavior. | "I'm guessing 'fine' is covering a lot of hurt. Maybe some anger, too." |
| 4. Validating in terms of past learning or biology | Conveys that the response makes sense given its causes, such as the client's learning history or biology. | "You were left out of family plans for years growing up. Of course this one lands as more proof that nobody wants you around." |
| 5. Validating in terms of the present | Conveys that the client's emotions, thoughts or actions are reasonable or meaningful given the current situation and normal human functioning. | "Finding out about your sister's engagement dinner from Instagram would hurt almost anyone." |
| 6. Radical genuineness | Responds as a genuine equal, without treating the client as fragile or as only a person with a disorder, and responds to the client's strengths and capacities. | "Ouch. If I found out that way, I'd be hurt too, and angry. You care about her, and you're someone who can tell her how this landed." |
Practice statements
1. Ivy, 26, a graduate student, at the start of a session that began eleven minutes late: "Eleven minutes. I counted. I sat out there thinking you'd finally had enough of me."
| Level | Your response at that level |
|---|---|
2. Walt, 47, a bus mechanic, explaining a blank diary card: "I left the card in my truck all week. I didn't want to look at seven days of zeros in the skills column."
| Level | Your response at that level |
|---|---|
3. Jonah, 19, who lives with his parents and works at a grocery store: "My mom went through my phone again, so I screamed at her and slammed my door. Now everyone in the house acts like I'm the problem."
| Level | Your response at that level |
|---|---|
What Does Each Validation Level Sound Like in Session?
Client statement: Priya, 41, an accountant who was often mocked for speaking up at school, starts the skills group next week. "I can't do the group. Eight strangers staring at me while I talk about my feelings? I'll freeze, say something stupid, and they'll all see what a mess I am."
| Level | What the therapist does | Response to Priya |
|---|---|---|
| 1. Staying awake | Puts down the pen, faces Priya and asks, with evident interest, what she pictures. | "Walk me through it. What do you picture when you walk into that room?" |
| 2. Accurate reflection | Reflects the fear in words close to Priya's own, with no interpretation. | "You're picturing eight strangers looking at you, and you're afraid you'll freeze and say something stupid." |
| 3. Articulating the unverbalized | Names the shame under the fear, which Priya has not said. | "I wonder if the worst part is the thought of people seeing you struggle. That sounds like shame as much as fear." |
| 4. Validating in terms of past learning or biology | Links the fear to being mocked for speaking up at school. | "You were mocked when you spoke up at school. After that, it makes sense that a room of strangers feels dangerous." |
| 5. Validating in terms of the present | Conveys that nerves before a first group are how most people react. | "Most people feel nervous walking into a room of strangers, and more so when they expect to talk about something personal." |
| 6. Radical genuineness | Speaks as an equal and points to a strength Priya has shown. | "I'd be nervous too. And you've pushed back on me in here when you disagreed, so I've seen you speak up when it matters." |
Which levels fit best here, and why. Levels 5 and 6. Priya's nerves fit the situation: a first meeting with a group of strangers makes most people nervous. That makes Level 5 available, and therapists are taught to prefer Level 5 to Level 4 whenever possible because it is thought to be more present-focused and less pathologizing. Level 6 follows Linehan's advice to validate at the highest level the therapist can, and it treats Priya as a capable equal. Her prediction that the group will see "what a mess I am" goes beyond the facts, so no response agrees with it. Once she feels understood, the therapist can turn to change by orienting her to how the group runs: like a class, with homework review in the first half and new skills in the second.
What Is Validation in DBT?
In Linehan's 1993 treatment manual, validation and problem solving are the two core strategies of DBT. Her 1997 chapter "Validation and Psychotherapy" defines validation and describes six levels and five functions of it. The levels run from attention and accurate reflection (Levels 1 and 2), to naming what the client has not said (Level 3), to conveying that a response makes sense given its causes or the present situation (Levels 4 and 5), to responding as a genuine equal (Level 6).
Problem solving brings in change: it pairs chain analysis with solution analysis, supported by orienting and commitment strategies, and its solutions draw on skills training, stimulus control, exposure, cognitive modification and contingency management. Each practice statement holds something to validate and something a change strategy could address. Write the validating response first; the change step can follow in your next sentence.
How Do You Choose a Validation Level?
Choose the highest level that is accurate for this client in this moment. Linehan recommends validating at the highest level the therapist can, and therapists are taught to use Level 5 rather than Level 4 whenever possible, because Level 5 is thought to be more present-focused and less pathologizing than Level 4.
Level 5 needs a response that is reasonable given the current situation and normal human functioning. When the client's response fits the present, say so at Level 5. When it makes sense only in light of the client's history or biology, Level 4 is the accurate choice. Levels 1 and 2 are available in almost any moment: full attention and an accurate reflection. Level 3 is available when you can accurately put into words what is unsaid. At Level 6 you speak as a genuine equal, without treating the client as fragile, and you respond to the client's strengths and capacities.
For each practice statement, choose a level, write the response and say it aloud. Then try the next level up and compare the two.
Which Parts of a Response Should You Validate?
Validate the parts of a client's response that are accurate or make sense, and leave the rest for change strategies. Levels 2 to 5 depend on accuracy: an accurate reflection at Level 2, an accurate account of what is unsaid at Level 3, the response's real causes at Level 4, and what is reasonable in the current situation at Level 5. A feeling can fit the situation while the conclusion the client draws from it goes beyond the facts. Marco's hurt fits learning about his sister's engagement dinner from Instagram, and his belief that nobody wants him around goes further than one dinner, so the sample responses validate the hurt and why the belief makes sense given his history and leave the belief itself alone.
Two responses sound supportive and still miss the levels. Reassurance ("I'm sure she didn't mean anything by it") neither reflects what the client said nor conveys why the response makes sense, and it quietly argues with the hurt. Agreement with a belief that does not fit the facts ("You're right, nobody in that family wants you") fails the accuracy that Levels 2 to 5 depend on. Both can feel kind in the moment; the practice statements give you room to find the accurate response before you need it.
Practice the Skill
Choose one practice statement, say your response aloud at the level you picked, then try the next level up. Sentio's free DBT deliberate practice training includes a full webinar with Tali Boritz and Shelley McMain, in dialogue with Tony Rousmaniere and Alexandre Vaz, whose skill targets include delivering validation at the right level. The webinar accompanies the APA book Deliberate Practice in Dialectical Behavior Therapy, which contains the full set of exercises it demonstrates.
Keep reading
DBT Target Hierarchy Quick Reference, the stage 1 targets in order, with what each means for the session agenda and a completed example
DBT Role Play Scenarios and Recording Review Form, new client statements for rehearsing DBT skills, with a form for reviewing a short segment of a recorded session
DBT Progress Note Template, a session note organized by the target hierarchy, with a completed example
Free DBT Toolkit, every template in one place, each with a PDF and a completed example
Frequently Asked Questions
What are the six levels of validation in DBT?
Marsha Linehan describes six levels in her 1997 chapter "Validation and Psychotherapy": (1) staying awake, listening with full attention and evident interest; (2) accurate reflection; (3) articulating the unverbalized; (4) validating in terms of past learning or biology; (5) validating in terms of the present, meaning the current situation and normal human functioning; and (6) radical genuineness, responding as a genuine equal who sees the client's strengths.
What is Level 5 validation in DBT?
Level 5 validation conveys that the client's emotions, thoughts or actions are reasonable or meaningful given the current situation and normal human functioning. Therapists are taught to use Level 5 rather than Level 4 whenever possible, because Level 5 is thought to be more present-focused and less pathologizing than Level 4. A Level 5 response sounds like this: "Most people feel nervous walking into a room of strangers."
Which level of validation should a therapist use?
Use the highest level that is accurate for the client in that moment. Linehan recommends validating at the highest level the therapist can, and therapists are taught to prefer Level 5 to Level 4 whenever possible. Levels 1 and 2 (full attention and accurate reflection) fit almost any moment, Level 3 fits when you can accurately name what the client has not said, and Level 6 fits whenever you can respond as a genuine equal.
Does validation mean agreeing with the client?
Only with what is accurate. Level 5 conveys that a response is reasonable given the current situation, so it fits the parts of a response that match the facts. Level 4 conveys that a response makes sense given its causes, such as the client's learning history, which lets a therapist validate an old fear without calling it accurate today.
How do validation and change strategies fit together in DBT?
Validation and problem solving are the two core strategies of DBT, and change runs through problem solving: chain analysis paired with solution analysis, with solutions drawn from skills training, stimulus control, exposure, cognitive modification and contingency management. A therapist might validate a client's fear of a new skills group, for example, and then orient her to how the group runs.
Do clients learn validation as a DBT skill?
Yes. Walking the Middle Path, a skills module developed for adolescents and their families, teaches validation along with dialectics and the principles of behavior change (Rathus, Campbell, Miller and Smith, 2015), and the second edition of Linehan's skills handouts and worksheets (2015) teaches Walking the Middle Path skills, validation among them, in its interpersonal effectiveness module. Linehan's skills handouts and worksheets are published by Guilford Press.
References
Boritz, T. Z., McMain, S., Vaz, A., & Rousmaniere, T. (2023). Deliberate practice in dialectical behavior therapy. American Psychological Association. ISBN 978-1-4338-3789-0. https://www.apa.org/pubs/books/deliberate-practice-dialectical-behavior-therapy
Carson-Wong, A. (2016). The effect of therapist use of validation strategies on change in client emotion in an individual DBT treatment session [Doctoral dissertation, Rutgers, The State University of New Jersey]. https://doi.org/10.7282/T3MP55JQ
Koerner, K. (2012). Doing dialectical behavior therapy: A practical guide. Guilford Press. ISBN 978-1-4625-0232-5. https://www.guilford.com/books/Doing-Dialectical-Behavior-Therapy/Kelly-Koerner/9781462502325
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press. ISBN 978-0-89862-183-9. https://www.guilford.com/books/Cognitive-Behavioral-Treatment-of-Borderline-Personality-Disorder/Marsha-Linehan/9780898621839
Linehan, M. M. (1997). Validation and psychotherapy. In A. C. Bohart & L. S. Greenberg (Eds.), Empathy reconsidered: New directions in psychotherapy (pp. 353-392). American Psychological Association. https://doi.org/10.1037/10226-016
Linehan, M. M. (2015). DBT skills training handouts and worksheets (2nd ed.). Guilford Press. ISBN 978-1-57230-781-0. https://www.guilford.com/books/DBT-Skills-Training-Handouts-and-Worksheets/Marsha-Linehan/9781462556342/prior-editions
Linehan, M. M. (2025). DBT skills training handouts and worksheets (Rev. ed.). Guilford Press. ISBN 978-1-4625-5634-2. https://www.guilford.com/books/DBT-Skills-Training-Handouts-and-Worksheets/Marsha-Linehan/9781462556342
Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007). Dialectical behavior therapy with suicidal adolescents. Guilford Press. ISBN 978-1-4625-3205-6. https://www.guilford.com/books/Dialectical-Behavior-Therapy-with-Suicidal-Adolescents/Miller-Rathus-Linehan/9781462532056
Rathus, J., Campbell, B., Miller, A., & Smith, H. (2015). Treatment acceptability study of Walking the Middle Path, a new DBT skills module for adolescents and their families. American Journal of Psychotherapy, 69(2), 163-178. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.163
About This Template
Corrections and suggestions: mabundez@sentio.org.
