DBT Distress Tolerance Skills Worksheet (Free PDF Download)

DBT Distress Tolerance Skills Worksheet example

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What is the DBT Distress Tolerance Skills worksheet?

This distress tolerance skills pdf collects four DBT skill sets on one handout: TIPP, Distract with ACCEPTS, IMPROVE the Moment, and Self-Soothing with the Five Senses. Every letter is expanded and given a one-line instruction. A practice section then puts each set to work on a named scenario.

How to use the DBT Distress Tolerance Skills worksheet

Give this out as homework after the client has tried one skill with you. Reading the list is not the same as using it, so send them to the Practice Section, where five scenarios name the skill set to draw from. Scenario 1: Feeling Overwhelmed asks for a TIPP skill and a description of how they would use it. Your clients can work one scenario a day rather than the whole sheet at once.

DBT Distress Tolerance Skills Worksheet Download – What’s Included

The download is a two-page printable handout, not fillable. Page one covers TIPP and Distract with ACCEPTS, expanding every letter into a one-line instruction. Page two covers IMPROVE the Moment and Self-Soothing with the Five Senses, then closes with five practice scenarios. The last one asks for the pros and cons of avoiding a challenge versus facing it.

Based on DBT skills developed by Marsha Linehan. Linehan, M. M. (2014). DBT Skills Training Manual (2nd ed.). Guilford Press.

Frequently asked questions

What is distress tolerance in DBT?

Distress tolerance is the DBT module for surviving a crisis without making it worse. The skills do not solve the problem or lower the emotion; they buy time until it passes or can be handled. This sheet’s opening paragraph frames them exactly that way, as crisis survival rather than change.

What are the 4 core skills of DBT?

Mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Linehan’s manual organizes skills training into those four modules. This handout sits inside the second one and covers four of its skill sets: TIPP, Distract with ACCEPTS, IMPROVE the Moment, and Self-Soothing with the Five Senses.

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Your Author

Tracy Collins, LCP

Tracy Collins is a licensed clinical psychologist with over six years of direct clinical experience in outpatient and telehealth settings. She specializes in cognitive behavioral therapy, structured treatment planning, and measurable therapy outcomes. Tracy has extensive experience writing SOAP and DAP notes, developing insurance-compliant treatment plans, and aligning documentation with ICD-10 and DSM-5-TR diagnostic criteria. Her clinical approach integrates cognitive behavioral therapy techniques, behavioral activation, exposure-based interventions, and mindfulness-based strategies to create structured and outcome-driven therapy plans. At Mentalyc, Tracy supports therapists by creating educational resources that simplify documentation workflows and improve treatment plan defensibility during audits.