← Back to Resources ⬇ Download PDF
Free Resource
DBT Skills · Part 1 of 4

Distress Tolerance Skills

Surviving the Storm
Healing Light SA — Client Worksheet
How to survive a crisis: the IMPROVE skills and Radical Acceptance
Print & Write
A4 Printable
Use Alone or in Session
Dialectical Behavior Therapy (DBT) was created by psychologist Marsha Linehan. This worksheet covers one part of the Distress Tolerance module — skills for getting through a crisis without making it worse. Work through each prompt in the order that helps you most; there's no wrong way to use this.

Crisis Survival: IMPROVE

Crisis and stress are part of life. Sometimes bad things happen and there isn't much you can do about it in the moment. The skills below can help you bear the crisis until it passes.

I — Imagery

What images help you feel calmer — real or imagined? Describe one.

Tip: put together a collection of pictures to look at when you need to get your mind off a stressful event.

M — Meaning

Is there a meaning you can find in what you're going through? Is there any good outcome that could come from it?

P — Prayer

Write your own "thank you" or gratitude prayer. List a few things you feel thankful for right now.

R — Relaxation

What helps you relax? List a few things you could do right now.

O — One-Minded

Focus on one thing at a time. What's an activity you could do to get your mind focused on something other than the stress?

V — mini-Vacation

A full vacation isn't always possible — but a small one is. Looking at the stars, drinking a coffee slowly. What's your mini-vacation?

E — Encouragement

Who encourages you? What have they said to you that stuck? And what encouraging thing can you say to yourself right now?

Radical Acceptance

Sometimes bad things happen and there isn't anything we can do about it. Refusing to accept that only adds more distress on top of the original pain. Accepting that it is what it is doesn't mean you like it — it means you stop fighting a reality that's already true.

What can you accept, even if you don't like it?

Name something real that you could stop resisting, so you can stop fighting a battle that's already decided.

Wrap-Up: Distress Tolerance Skills

Part 1 of 4 Next: Interpersonal Effectiveness →

References (APA 7th)

RecTherapyToday. (2018). DBT skills workbook. https://www.rectherapytoday.com/wp-content/uploads/2018/09/DBT_workbook.pdf

Linehan, M. M. (2014). DBT skills training manual (2nd ed.). Guilford Press.

Reformatted by Healing Light SA from the original combined RecTherapyToday PDF into four standalone skill-module worksheets. Free to reproduce for educational/non-commercial use with source credit retained. DBT itself was developed by Marsha M. Linehan, PhD.