MORE THAN THERAPYTHE RESOURCE LIBRARY

MODULE 19 / 24 · Distress tolerance · 15–25 MINUTES

Pros and Cons

Compare acting on an urge with using a skill across short- and longer-term consequences.

Try the worksheet

Understand the skill

A four-part comparison can make tradeoffs visible before an urge is strongest. Consider benefits and costs of acting on the urge, and benefits and costs of resisting or responding skillfully. Honest acknowledgment of short-term relief supports a useful plan.

Practice step by step

  1. Define one specific target behavior without labeling yourself.
  2. List short- and longer-term benefits and costs of acting on it.
  3. List benefits and costs of choosing a skillful alternative.
  4. Choose a reminder and support step you can access when the urge returns.

TRY IT · SOLO OR WITH A GROUP

A practice activity

Decision grid: use a fictional urge to send an angry message. Complete four quadrants and circle the consequences most connected to the person's longer-term values.

Group option: Work from a fictional example for five minutes, rehearse or compare choices for five minutes, then discuss one useful adaptation. Pass, write, observe, or work alone.

Your practice worksheet

Writing is optional. Responses stay in this open tab and are not submitted or automatically saved. Closing or refreshing clears them. Avoid names or identifying details. Printing or downloading includes your words.

Use paper or discuss the prompts if you prefer.

Recovery connection

Compare a specific substance-use urge with an accessible support action, accounting for the real discomfort of delaying use and the person's chosen recovery goals.

Facilitator notes

Avoid coercion or voting on someone's recovery choice. The grid supports reflection; it is not a risk assessment.

Adaptation and care: Do not use a decision worksheet to delay emergency help or medically needed withdrawal care.

Between-session practice: Choose one manageable situation to try this skill. Notice the context, what you did, and what helped or needs adjusting. An attempt counts as practice even when feelings do not change.

Background and sources

DBT skills concepts originate in Marsha M. Linehan's work. These are original More Than Therapy activities, not reproductions of official worksheets or endorsed materials.

References inform the skill framework; they do not validate these particular exercises. Life-structure modules are DBT-informed applications, not additional standard DBT core modules.