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From DBT Skills Training Handouts and Worksheets, Second Edition  by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan. Permis -
sion to photocopy this worksheet is granted to purchasers of this book for personal use only (see copyright page for details). Purchasers may 
download a larger version of this worksheet from www.guilford.com/dbt-  
worksheets .interpersonal effectiveness WorksHeet 10   (I. E. Handout 13) (p. 1 of 2)
ending r elationships
Due Date:       Name:                   Week Starting:  
Fill out this sheet to outline how to end an unwanted relationship when the relationship is not abu -
sive. if it is abusive, first call a local domestic violence hotline or the n ational Domestic v io-
lence hotline (1-800-799-7233).  Write on the back of this sheet if you need more room.
relationship problem: Describe how the relationship is destructive or interfering with your life.
 
 
list Wise m ind pros and cons for ending the relationship.
Pros:  
 
Cons:  
 
Script i deas for D ear man , Give fa ST to end a r elationship
 1. Describe  the relationship situation, or the problem that is the core reason you want to end the 
relationship.
 2. express  feelings/opinions about why the relationship needs to end for you.
 3. assert  in your decision to end the relationship directly (circle the part you will use later in 
“broken record” to stay mindful if you need it).
 4. reinforcing  comments to make about positive outcomes for both of you once the relationship 
is ended.
(continued on next page )