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Distress Tolerance Skills Inventory

Assess Your Use of Evidence-Based Crisis Survival Strategies

DBTAssessmentFree ResourceLast reviewed April 2026
Interactive version · FreeOpen the TIPP skills walkthrough with timers in your browser.

Distress Tolerance Skills Inventory

Assess Your Use of Evidence-Based Crisis Survival Strategies

Distress Tolerance Skills Inventory

Assess Your Use of Evidence-Based Crisis Survival Strategies

Distress tolerance is a core module of Dialectical Behavior Therapy that teaches skills for surviving emotional crises without making the situation worse. Dialectical behavior therapy, which teaches these skills, reduces self-harm and the use of psychiatric crisis services (DeCou et al., 2019). Rate how frequently you use each skill below to identify your strengths and areas for growth.

1Not at all2Rarely3Sometimes

Radical Acceptance

123
I acknowledge painful realities I cannot change rather than fighting against them
123
I practice accepting situations fully, both mentally and emotionally, even when I dislike them
123
I recognize when my suffering comes from refusing to accept what has already happened
123
I use self-talk to remind myself that acceptance does not mean approval

Self-Soothing with Senses

123
I intentionally use calming visual experiences (nature, art, candlelight) when distressed
123
I listen to soothing sounds or music to help regulate my emotions
123
I use comforting touch (warm blanket, soft fabric, warm bath) to self-soothe
123
I engage my sense of taste or smell with pleasant stimuli (tea, favorite scent) during difficult moments

Distraction (ACCEPTS)

123
I engage in absorbing activities to redirect my attention during emotional crises
123
I shift focus outward by contributing to others or performing acts of kindness
123
I put my situation in perspective by comparing it to past difficulties I have survived
123
I deliberately generate competing emotions (humor, calm, gratitude) to offset distress
123
I mentally set aside overwhelming thoughts until I am in a better state to process them
123
I occupy my mind with cognitively demanding tasks to interrupt rumination
123
I use safe physical sensations (cold water, sour taste) to ground myself

IMPROVE the Moment

123
I use guided imagery or visualization to create a sense of calm during crises
123
I look for meaning or growth opportunities within difficult experiences
123
I draw on prayer, meditation, or connection with my values for strength
123
I practice relaxation techniques (deep breathing, progressive muscle relaxation) under stress
123
I focus on one thing at a time rather than being overwhelmed by the whole situation
123
I give myself brief mental "vacations" by doing something enjoyable or nourishing
123
I use encouraging self-talk and affirmations to sustain myself through hard moments

References

  • DeCou, C. R., Comtois, K. A., & Landes, S. J. (2019). Dialectical behavior therapy is effective for the treatment of suicidal behavior: A meta-analysis. Behavior Therapy, 50(1), 60-72. https://doi.org/10.1016/j.beth.2018.03.009

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See also

Riding the Wave: A Practical Guide to Urge SurfingPersonal Crisis Safety PlanSensory Grounding for Trauma RecoveryClinical Self-Harm Screening GuideDaily Emotion Tracker: Triggers, Responses, and Outcomes

Clinical guides that use this worksheet

DBT Worksheets by Module: The Complete Clinical GuideThe MSI-BPD (McLean Screening Instrument): Scoring, the 7-Point Cutoff, and What a Positive Screen MeansRadical Acceptance in DBT: What It Is, What It Isn't, and How to Teach It

Common Questions

What is the Distress Tolerance Skills Inventory worksheet?

Distress tolerance is a core module of Dialectical Behavior Therapy that teaches skills for surviving emotional crises without making the situation worse. Dialectical behavior therapy, which teaches these skills, reduces self-harm and the use of psychiatric crisis services (DeCou et al., 2019).

How do I use the Distress Tolerance Skills Inventory worksheet?

Rate each item honestly. This is a self-assessment tool, not a clinical diagnosis. Bring your results to your next therapy session for discussion.

Is the Distress Tolerance Skills Inventory worksheet free?

Yes. Like every worksheet on Therapy Resource, it is free to read, print, and download as a PDF, no account required. A Pro subscription adds online filling with saved progress, practice-branded PDF exports, and secure client sharing.

Can I fill out the Distress Tolerance Skills Inventory worksheet online?

Yes. Switch the worksheet to "Type on Screen" mode to fill in the fields directly in your browser before printing. Pro members can also save their entries across sessions and export the completed worksheet as a branded PDF.

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