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Home 2018-06-04T12:22:24+00:00

Regulate Emotion. Maximize Potential.

The Skills System is a DBT™-informed emotion regulation skills training curriculum consisting of nine core skills and three System Tools that help people be effective at all levels of emotion. The original version, The Skills System Instructor’s Guide: An Emotion Regulation Skills Curriculum for All Learning Abilities, was written in 2011. The updated edition, The Emotion Regulation Skills System: A DBT™-informed Approach was published by Guilford Press in 2016.

3-Day Skills System Training in Needham, MA

On October 15-17, 2018, Julie F. Brown, PhD, will be conducting a 3-day Skills System training in Needham, MA, sponsored by Justice Resource Institute. The Skills System is a DBT-Informed emotion regulation skills curriculum that practitioners can teach to (a) individuals with complex learning/behavioral health challenges and (b) the staff/family members that support them. Questions? Email Julie Brown.

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Individuals who experience learning/developmental, and mental health challenges often experience difficulty regulating emotions. There are few evidence-based, and psychologically-based treatments for individuals with co-occurring cognitive and mental health issues. The Skills System is a simplified, user-friendly model that is taught to youths and/or adults with diverse learning profiles. This treatment tool has been used in a myriad of inpatient, outpatient, residential, vocational, school, outreach, and corrections settings in the US and abroad.
Individuals may need supports that help them avoid engaging in destructive behaviors, as well as, needing a vehicle and road map to be able to manage and build a quality of life. In Skills System groups/individual training, the participants learn skills to help them stop demonstrating life threatening/destructive behavior. They gain tools for solving problems, expressing themselves, getting things that they need, and managing relationships with themselves and other people.

Individuals have to be able to deal effectively with:

  • Family members
  • Community access
  • Staff relationship
  • Coordinating support plans
  • Work
  • Friendships
  • Dating and intimacy

Emotion regulation skills training can help people get what they need AND stay on-track.

See Sample Skills System Handouts.

View Sample Handouts PDF
The Skills System is often used as a treatment tool or plug-in within more comprehensive therapeutic models (e.g. DBT, trauma-informed treatment etc); it plays well with others! In more naturalistic or clinically-eclectic settings, the Skills System can function as a primary treatment model. In both of these scenarios, the Skills System helps create a common language and emotion regulation tool kit that equips treatment providers and collateral supports (e.g. staff, family members) to help participants develop core self-management capacities.

Learning Formats for Participants: The Emotion Regulation Skills System book provides practitioners with materials to run therapy groups with individuals who experience learning challenges. These groups are a billable services through most health insurances. The Skills System teaching strategies can be adapted for individual/1:1 skills training, as well. It may be optimal to expose participants to both group skills training and individual therapy to enhance generalization. The participant having access to Skills System skills coaches in the living environments can also improve the integration of new, adaptive behaviors.

Practitioners/Teams: Just as learning formats for clients are tailor-able to meet the needs of diverse participants, there are alternative options for agencies, skills group leaders and skills coaches. All Skills System at JRI implementations are customized, accommodating the goals and resources of the individual/group to maximize skills acquisition, fidelity, and sustainability. For example, individuals/teams may want to dabble in the Skills System materials with the intention of adding a few strategies to their existing bags-of-tricks; other practitioners/teams may choose to fully integrate the model.

When practitioners/teams are contemplating learning the Skills System, it is important to be clear about the realities of treating individuals with long-standing behavioral health and learning challenges. As our pilot data highlights, exposure to a comprehensive treatment model over an extended period of time may be necessary to facilitate significant improvements in emotion/self-regulation functioning. Additionally, support providers likely need to have competency in the Skills System model versus a casual understanding of the concepts. When skills group leaders and skills coaches are fluent in the Skills System model, they are able to customize learning experiences for youths and adult who have complex behavioral health and learning challenges.

Collateral support people, such as staff, teachers, or family members, can learn the Skills System and can function as in-vivo skills coaching in the participant’s natural environment. A Certificate of Specialized Proficiency: Skills Coach is available through the Skills System (see Certificates). Having information about emotion regulation strategies allows the support person to help the individual manage emotions, versus suppress or avoid them. Ineffective supports can exacerbate behavioral dysregulation, resulting in transactions involving co-dysregulation versus co-regulation between people. This type of common language not only facilitates the generalization of emotion regulation strategies, it may also serve to improve attunement in relationships.

When collateral support providers understand the Skills System, they have tools to help them engage in self-regulation strategies. The experience of supporting an individual with complex behavioral health issues can evoke emotional escalation for both the client and the support person. The Skills System can be a helpful framework for collateral support providers to use, not only to help clients directly, but indirectly through using Skills System strategies, potentially minimizing extraneous conflict that can add to volatile situations.

A comprehensive implementation of the Skills System involves developing a Train-the-Trainer (TtT) team that develops the competency to:

  • Lead Skills System groups
  • Integrate the model into individual therapy
  • Train staff as in-vivo skills coaches
  • Anchor the language into programs to facilitate sustainability
The DBT skills concepts were created for individuals who experienced high levels of emotional, cognitive, and behavioral dysregulation. Unfortunately, the Standard DBT skills curricula are not accessible for people with significant learning challenges. Cognitive load demands are too high to allow for learning, free recall, and generalization in the natural environment. Most specifically:

  • Language was too complex
  • Divided into four modules – Difficult to integrate concepts
  • Hundreds of discreet skills
  • No mechanism for people to know what skill to use when
  • No system for linking skills; no connective tissue; lily pads vs. chains
  • No structure that differentiated skills you use at low/high levels of emotion

Skills System Adaptation of DBT:

The goal in creating the Skills System was to use a DBT-based framework that helped people experience a dialectical synthesis (the ability to be in pain AND be effective at the same time) versus polarization during emotional, cognitive, behavioral, relationship, and self-processes in complex life contexts.

Simultaneously, the framework had to be accessible for (1) Individuals diagnosed with moderate/mild ID (who often have limited reading abilities and impaired executive functioning) and (2) simple enough for collateral support providers to learn given the limited time/resources that are often available for training. Both of these groups had to be able to learn essential concepts, be able to recall them under-pressure, assemble adequate skills chains to manage the span of a dysregulation emotion, and generalize these capacities into diverse, real-life contexts.

The De-construction and Re-construction Process:

This process involved de-constructing essential DBT processes, re-labeling, and reorganizing the concepts in a way that (1) provided effective emotions regulation strategies in the re-constructed form and (2) minimized extraneous cognitive load demands. The work of James Gross, PhD (editor of the Emotion Regulation Handbook, 2007, 2014) was integrated to ensure that all aspects of emotion regulation processes were addressed in the Skills System model; Dr. Gross also reviewed and endorsed the Skills System prior to the publication of this model. The work of Sweller (Cognitive Load Theory, 1988, 2010) guided the design of both the Skills System model and teaching strategies.

The Skills System Design

  • Framework breaks complex tasks into component parts – Task Analysis
  • Integrates mindfulness strategies and goal directed thinking that lead the individual to execute goal-directed actions
  • Provides clear, strategic steps (micro-transitions) to create adaptive chains of behavior
  • The tools have to be flexible enough to be able to adapt to internal and external changes in the moment
  • The skills and the “system” function as cognitive scaffolding to help navigation (being present & effective) across the spans of emotions

Approximately one third of adults with intellectual and developmental disabilities have emotion dysregulation and challenging behaviors (CBs). Although research has not yet confirmed that existing treatments adequately reduce CBs in this population, dialectical behavior therapy (DBT) holds promise, as it has been shown to effectively reduce CBs in other emotionally dysregulated populations. This longitudinal single-group pilot study examined whether individuals with impaired intellectual functioning would show reductions in CBs while receiving standard DBT individual therapy used in conjunction with the Skills System (DBT-SS), a DBT emotion regulation skills curriculum adapted for individuals with cognitive impairment. Forty adults with developmental disabilities (most of whom also had intellectual disabilities) and CBs, including histories of aggression, self-injury, sexual offending, or other CBs, participated in this study. Changes in their behaviors were monitored over 4 years while in DBT-SS. Large reductions in CBs were observed during the 4 years. These findings suggest that modified DBT holds promise for effectively treating individuals with intellectual and developmental disabilities.

Download the PDF below to see the full pilot study.

Download Pilot Data PDF


Messages from Julie F. Brown, PhD, developer of the Skills System

Recent Publication: Free PDF Download

Brown, J.B., Hamilton-Mason, J., Maramaldi, P., & Barnhill, L.J. (2018). Beyond the Surface of Consumer-Staff RelationshipsGlobal Journal of Intellectual & Developmental Disabilities, 4(4), 1-6.

Abstract: The perspectives of individuals diagnosed with an intellectual disability and mental illness who demonstrate challenging behaviors are underrepresented in the literature. The goal of this study was to explore the perspectives of consumers with a dual-diagnosis on their relationships with staff. This qualitative constructivist grounded theory study included 30 individuals with mild or moderate intellectual disabilities, at least one co-occurring mental health diagnosis, and a history of challenging behaviors.

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3-Hour NADD Pre-Conference Presentation: DBT Skill Building & Emotion Regulation

On October 31st, 2018 from 9:00 am to 12:15 pm, Dr. Brown will chair a session that will describe how Dialectical Behavior Therapy (DBT) strategies are used to help individuals with dual-diagnosis improve emotional regulation skills. Participants will learn DBT concepts/take-homes that can immediately inform current practices. Additionally, teams from the US and abroad will describe their DBT-based skills programs designed to treat this population.

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Developing Enhanced Teaching Strategies for Individuals with ASD

The Institute on Disability and Human Development at University of Illinois at Chicago (UIC) recently received a grant from the State of Illinois that is supporting the adaptation of Skills System for use with individuals with Autism Spectrum Disorder (ASD). The Autism Awareness Program (AAP) grant aims to increase awareness of issues facing individuals with autism spectrum disorders (ASD) and their families across the life span and to provide education on ASD to providers, families, and people with ASD that translates the latest research into practice. The UIC team is working collaboratively with Dr. Brown to develop enhanced teaching materials/processes for this population.

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Recent Publication: Free PDF Download

Brown, J.B., Hamilton-Mason, J., Maramaldi, P., & Barnhill, L.J. (2017) Communication Crossroads. Global Journal of Intellectual & Developmental Disabilities, 3(4): 555616.

This review examines an emergent analysis in a constructivist grounded theory qualitative study that explored how bi-directional communication patterns were observed impacting the demonstration of cognitive strengths of individuals with intellectual disabilities, mental health issues, and histories of challenging behaviors in a focus group setting.

Download PDF

The Carlat Report-Psychiatry

The literature highlights that individuals with intellectual disabilities experience higher rates of mental illness than non-disabled counter-parts. Despite these increased vulnerabilities, the availability of ID-specific psychiatric and psychological treatments are limited. Please download this edition of The Carlat Report-Psychiatry for an excellent overview of psychiatric services for individuals with dual-diagnosis by Julie Gentile, MD. Additionally, on pages 6-7 there is an introduction to the Skills System that was developed by Julie Brown, PhD.

Download The Carlat Report
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Improving Assess of DBT for Individuals with Cognitive Challenges

Individuals with intellectual disabilities (ID) experience heighten vulnerabilities related to complex biopsychosocial factors, yet have limited access to comprehensive psychologically-based treatments to address these pervasive problems. Dr. Brown, a DBT trainer with Behavioral Tech, LLC- Linehan Institute, was invited to write a book chapter about how to adapt DBT for individuals with ID.

Download Book Chapter PDF

Translating the Skills System Handouts into Other Languages

The Skills system handouts are currently available in English and Swedish. Teams are working on Icelandic and Korean translations.

The following steps we taken by a team in Sweden to translate the Skills System handouts into Swedish. They did an amazing job with this challenging project and kindly shared the steps they took to execute this achievement. If you are interested in facilitating a translation, please feel free to contact me about this process.

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 Jump in With Both Feet!

It has come to my attention that many newcomers to the Skills System and those who have been using the model for years are continuing to utilize the 2011 self-published text (The Skills System Instructor’s Guide: An Emotion Regulation Skills Curriculum for All Learning Abilities). I would recommend everyone invest in the 2016 Guilford Press version (The Emotion Regulation Skills system: A DBT-Informed Approach). While the core elements remained the same in the update, there are a few sub-skill changes that clarify Skills System mechanisms. The new text providers a clearer theoretical framework and …

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A New Article! Free Download!

This article, recently published in the Journal of Mental Health Research in Intellectual Disabilities is entitled Exploring Perspectives of Individuals with Intellectual Disabilities and Histories of Challenging Behaviors about Family Relationships: An Emergent Topic in a Grounded Theory Focus Group Study. This is a unique piece of research because it explores the complex topic of family relationships from the perspective of individuals who are diagnosed with an intellectual disability that have one/more co-occurring mental illnesses and histories of challenging behaviors.

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New Instant Best Seller!

The Emotion Regulation Skills System for the Cognitively Challenged Client: A DBT™-Informed Approach (Brown, 2016) was recently deemed a Guilford Press Instant Best Seller. Click the link below to go to Guilford Press to get your copy. Thank you all for purchasing the revised version of the Skills System!

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Check out the New Blog Posts by Dr. Susan Vaught & Deborah Jackson, LICSW

Dr. Vaught added a post entitled The Competency Vacuum that addresses the difficulties associated with treating individuals with complex mental health and learning challenges. Deborah Jackson’s post discusses using the Skills System with forensic populations.


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The Emotion Regulation Skills System for the Cognitively Challenged Client: A DBT™-Informed Approach (2016) by Julie F. Brown, PhD, is available through Guildford Press and Amazon. This book provides a comprehensive presentation of the Skills System curriculum materials, and allows the purchaser to download an additional 150 pages of supplementary handouts. The Skills System is a highly effective treatment tool that has been used successfully in a multitude of settings with a myriad of individuals who have diverse behavioral and learning profiles.

Available at Guilford Press