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The materials teach how to survive without making the situation worse by accepting reality, replacing “stuck” suffering with ordinary pain and forward movement, and becoming free from intense demands of urges and emotions. Worksheets cover when to use crisis survival skills, what to avoid, and step-by-step STOP skills, pros-and-cons planning, and TIP strategies for rapidly changing body chemistry.",{"@graph":63,"@context":123},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":51,"@type":70,"position":76},"https://docshare.wps.com/template/general/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/distress-tolerance-handouts-crisis-survival-and-tip-skills/571542/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/distress-tolerance-handouts-crisis-survival-and-tip-skills/571542.png","ImageObject",442,249,{"name":88,"@type":89},"Ivy","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-22","2026-10-13",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",7,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115,119],{"name":106,"@type":107,"acceptedAnswer":108},"What are the main goals of distress tolerance in DBT?","Question",{"text":109,"@type":110},"The handouts focus on surviving crisis situations without making them worse, accepting reality, replacing suffering and being “stuck” with ordinary pain and the possibility of moving forward, and becoming free from having to satisfy intense urges and emotions.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"When should crisis survival skills be used?",{"text":114,"@type":110},"Use crisis survival skills when you are in a crisis that is highly stressful, short-term, and creates intense pressure to resolve the crisis now, especially when emotional distress is so strong it threatens to overwhelm you or when action may be necessary but difficult to handle skillfully.",{"name":116,"@type":107,"acceptedAnswer":117},"What does the STOP skill help you do during an urge or crisis?",{"text":118,"@type":110},"STOP helps you interrupt automatic reacting by stepping back, taking a break, letting go, taking deep breaths, observing internal and external events, and proceeding mindfully by considering thoughts, feelings, the situation, others’ perspectives, and your goals using Wise Mind.",{"name":120,"@type":107,"acceptedAnswer":121},"What are TIP skills and what do they do?",{"text":122,"@type":110},"TIP skills change your body chemistry to reduce extreme emotion mind quickly. They include temperature with cold water, intense exercise, paced breathing to slow respiration, and paired muscle relaxation synchronized with breathing out while releasing tension.","https://schema.org",{"og:url":78,"og:type":125,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":127,"canonical":78},"index,follow",{"doc_id":129,"site_id":56},571542,1792087323,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":88,"user_avatar":134,"doc_module":9,"category_id":50,"category_name":51,"doc_title":59,"doc_description":61,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":37,"language":140,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":61,"update_tm":144,"read_time":20},549758252649,"https://ap-avatar.wpscdn.com/avatar/8000253669c5317157?_k=1778319167496531819","Distress Tolerance Handouts  \n DISTRESS TOLERANCE HANDOUT 1 􀂐   \nGoals of Distress Tolerance  \nSURVIVE CRISIS SITUATIONS  \nWithout Making Them Worse  \nACCEPT REALITY  \nReplace Suffering and Being “Stuck”  \nwith Ordinary Pain and the Possibility of Moving Forward  \nBECOME FREE  \nOf Having to Satisfy  \nthe Demands of Your Own  \nDesires, Urges, and Intense Emotions  \nOTHER:    \n DISTRESS TOLERANCE HANDOUT 3 􀂐   \nWhen to Use Crisis Survival Skills  \nYOU ARE IN A CRISIS when the situation is:  \n• Highly stressful.  \n• Short-term (that is, it won’t last a long time) .  \n• Creates intense pressure to resolve the crisis now.  \nUSE CRISIS SURVIVAL SKILLS when:  \n1. You have intense pain that cannot be helped quickly.  \n2. You want to act on your emotions, but it will only make things worse.  \n3. Emotion mind threatens to overwhelm you, and you need to stay skillful.  \n4. You are overwhelmed, yet demands must be met.  \n5. Arousal is extreme, but problems can’t be solved immediately.  \nDON’T USE CRISIS SURVIVAL SKILLS for:  \n• Everyday problems.  \n• Solving all your life problems.  \n• Making your life worth living.  \nDISTRESS TOLERANCE HANDOUT 4  \n􀂐  \n(  Distress Tolerance Worksheets 2, 2a )  \nSTOP Skill  \nStoTakpe a step back  \nObserve Proceed mindfully  \nDo not just react. Stop! Freeze! Do not move a muscle! Your emotions may try to make you act without thinking. Stay in control!  \nTake a step back from the situation. Take a break. Let go. Take a deep breath. Do not let your feelings make you act impulsively.  \nNotice what is going on inside and outside you. What is the situation? What are your thoughts and feelings? What are others saying or doing?  \nAct with awareness. In deciding what to do, consider your thoughts and feelings, the situation, and other people’s thoughts and feelings. Think about your goals. Ask Wise Mind: Which actions will make it better or worse?  \nNote. Adapted from an unpublished worksheet by Francheska Perepletchikova and Seth Axelrod, with their permission.  \nDISTRESS TOLERANCE HANDOUT 5  \n􀂐  \n(  Distress Tolerance Worksheets 3, 3a )  \nPros and Cons  \nUse pros and cons any time you have to decide between two courses of action.  \n􀂉 An urge is a crisis when it is very strong and when acting on the urge will make things worse in the long term.  \n􀂉 Make a list of the pros and cons of acting on your crisis urges. These might be to engage in dangerous, addictive, or harmful behaviors, or they might be to give in, give up, or avoid doing what is necessary to build a life you want to live.  \n􀂉 Make another list of the pros and cons of resisting crisis urges—that is, tolerating the distress and not giving in to the urges.  \n􀂉 Use the grid below to evaluate both sets of pros and cons (this type of grid is also used in Distress Tolerance Worksheet 3) . Or you can use the type of grid seen in Distress Tolerance Worksheet 3a and in the pros-and-cons worksheets for other modules.  \n\n|  | PROS | CONS |\n| --- | --- | --- |\n| Acting on crisis urges | Pros of acting on impulsive urges, giving in, giving up, or avoiding what needs to be done.\u003Cbr> | Cons of acting on impulsive urges, giving in, giving up, or avoiding what needs to be done.\u003Cbr> |\n| Resisting crisis urges | Pros of resisting impulsive urges, doing what needs to be done, and not giving up.\u003Cbr> | Cons of resisting impulsive urges, doing what needs to be done, and not giving up.\u003Cbr> |\n\nBefore an overwhelming crisis urge hits:  \nWrite out your pros and cons; carry them with you. Rehearse your pros and cons over and over.  \nWhen an overwhelming crisis urge hits:  \nReview your pros and cons. Get out your list and read it over again.  \n• Imagine the positive consequences of resisting the urge.  \n• Think of the negative consequences of giving in to crisis behaviors.  \n• Remember past consequences when you have acted on crisis urges.  \n DISTRESS TOLERANCE HANDOUT 6 􀂐   \n(  Distress Tolerance Worksheet 4  )  \nTIP Skills: Changing Your Body Chemistry  \nTo reduce extreme emoti","cbCaijdW6UgW36nR","https://ap.wps.com/l/cbCaijdW6UgW36nR","pdf",358544,"English","# Goals of Distress Tolerance\n## Survive Crisis Situations Without Making Them Worse\n# When to Use Crisis Survival Skills\n## Crisis survival use criteria\n## When not to use crisis survival skills\n# STOP Skill\n## Step back and observe\n## Proceed mindfully and act with awareness\n# Pros and Cons\n## Evaluating acting vs resisting urges\n## Before and during a crisis urge\n# TIP Skills: Changing Your Body Chemistry\n## Temperature, intense exercise, paced breathing, paired muscle relaxation","[{\"question\":\"What are the main goals of distress tolerance in DBT?\",\"answer\":\"The handouts focus on surviving crisis situations without making them worse, accepting reality, replacing suffering and being “stuck” with ordinary pain and the possibility of moving forward, and becoming free from having to satisfy intense urges and emotions.\"},{\"question\":\"When should crisis survival skills be used?\",\"answer\":\"Use crisis survival skills when you are in a crisis that is highly stressful, short-term, and creates intense pressure to resolve the crisis now, especially when emotional distress is so strong it threatens to overwhelm you or when action may be necessary but difficult to handle skillfully.\"},{\"question\":\"What does the STOP skill help you do during an urge or crisis?\",\"answer\":\"STOP helps you interrupt automatic reacting by stepping back, taking a break, letting go, taking deep breaths, observing internal and external events, and proceeding mindfully by considering thoughts, feelings, the situation, others’ perspectives, and your goals using Wise Mind.\"},{\"question\":\"What are TIP skills and what do they do?\",\"answer\":\"TIP skills change your body chemistry to reduce extreme emotion mind quickly. They include temperature with cold water, intense exercise, paced breathing to slow respiration, and paired muscle relaxation synchronized with breathing out while releasing tension.\"}]","Distress Tolerance Handouts - Crisis Survival and TIP Skills | PDF",1791922136]