Dealing with Distress 8-Step DBT Worksheet

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Distress is an unpleasant or overwhelming emotion, feeling, thought, condition, or behavior.

Distress Tolerance is a skill used to help individuals deal with intense feelings and emotions, and learn to tolerate things that cannot immediately change. 

What Are The Theories Behind This Worksheet?

  1. Dialectical Behavioral Therapy (DBT)

This is a type of talking therapy specifically adapted to treat individuals who suffer from extremely intense emotions. DBT is used to help individuals identify and positively change negative thinking patterns.

DBT focuses on providing therapeutic skills in mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and The Middle Path.

Distress Tolerance is one of the skills taught in DBT and is often referred to as “crisis survival skills” as it helps individuals navigate the perceived or actual crisis. 

The most frequently taught distress tolerance skills are:

  • Self-Soothing Technique
  • IMPROVE Skill
  • Radical Acceptance
  • ACCEPTS Skill
  • TIP Skill
  • The STOP Skill
  • Pros and Cons
  • Distraction

How Will This Worksheet Help You?

This worksheet will help individuals learn crisis survival skills for situations that cannot be avoided. Individuals also learn the important concept of acceptance of reality.

How Should You Use This Worksheet?

Individuals should use this worksheet when going through any emotional or physical pain (short-term or long-term) that could lead to destructive or self-harm behaviors.  

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DBT Tools. (© 2023). Distress Tolerance Skill. Available at: [Accessed April 23, 2023]

2.- (No Date). Distress Tolerance. Available at: [Accessed April 23, 2023]


Positive Psychology. (© 2023). What Are Distress Tolerance Skills? Your Ultimate DBT Toolkit. Available at: [Accessed April 23, 2023]