The Decider: A Skills Manual

The Decider: A Skills Manual contains 32 CBT & DBT based skills for individuals and groups with mental health problems.

The Decider: A Skills Manual is suitable for those who work with adults and young people with mental health problems, including child/adolescent mental health services, primary and secondary care mental health services. The manual and workshops are for all mental health professionals, including nurses, nursing and health care assistants, social workers, psychologists and psychological therapists, occupational therapists, psychiatrists.

The Decider: A Skills Manual is a 105-page ring bound book containing 32 CBT/DBT-informed healthy and effective coping and change skills using the 4 core skill sets of Distress Tolerance, Mindfulness, Emotion Regulation & Interpersonal Effectiveness.

Each of the skills has its own photocopy-able Client Handout page and Clinician page which provides a detailed explanation for the clinician on how to teach and present the skill in ways that the client will really understand and want to start putting into practice (see example page below).

The skills can be used as a comprehensive course of 32 skills, or used flexibly for shorter courses to fit your client group.

Each skill has a specific visual reminder which is depicted on ‘The Decider’.

The skills are:

  • Effective
  • Fun
  • User-friendly
  • Memorable

The Decider: A Skills Manual is most effective when used with groups, when clinicians have the opportunity to be as creative as they like for the best possible effects! The manual is also designed to be used with individuals, and the client handouts pages can also be used for self help.

This website hosts a resources section where manual owners can access and download further printable resources including a course session plan, copies of The Decider, A4-sized visual prompts for all 32 skills, measures, list of props required etc.

The group is designed to be delivered in a highly original and innovative way. It is future focussed and presented in a fun, creative and interactive style using demonstration, music and visuals to aid learning. The skills can also be used individually with clients.

We have found that we are now using the skills in our own personal lives - and they really do work!

All the skills come together in a laminated A4 sheet: 'The Decider'.

The Decider* is a pictorial reference card which summarises the 32 skills and is used by the client to help remind them of the skills they have learned.

The Decider

The Decider: A Skills Manual is designed to be fun, creative, bright, positive, affirming, validating, effective, and potentially life-changing. See some of the feedback.

Whilst a comprehensive DBT service is recognised as the ideal, it is expensive and impractical for small or isolated services like ours to provide. ‘The Decider’ has enabled our service to fill that gap to some degree and may be a valuable initiative for other services.

‘The Decider and Skills Manual’ have the potential to be adapted for a range of service settings and in various formats.

Staff who have been trained to use ‘The Decider’ also report an increase in their own clinical knowledge, skills and confidence.

Example page with client handout on left, and clinician's page on right

Example Page


* It is not possible to use The Decider independently of the manual. The Decider is a pictorial reference card which summarises the 32 skills and is used by the client to help remind them of the skills they learn when attending The Decider Skills Group. The manual explains all the skills with client handouts and clinicians' guides on how to teach the skills. Some of the names of skills and pictures on The Decider will have little or no meaning without the backup of the manual. In that case it would then be left to individuals to interpret those skills in their own way, which will inevitably be much less effective. The Decider can only maintain its effectiveness and integrity when accompanied by the manual.

Feedback for The Decider

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