Distress Tolerance
ACCEPTS Distraction Plan
ACCEPTS offers seven healthy distractions for when you can’t solve the crisis – so you can ride it out without making it worse.
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Quick answer
What this DBT worksheet helps you do
The ACCEPTS worksheet helps you use healthy distraction on purpose so intense emotions have time to come down before you solve the real problem.
Best for: Short-term crisis survival when problem-solving too early would only escalate the moment.
Evidence base: Linehan DBT Skills Training Manual
How to practice it
Move through each step slowly. Notice what the skill asks for and how you can experiment in real life.
1
Activities
Engage in something absorbing—clean, craft, game, cook, watch a show—anything constructive that takes your focus off the distress.
2
Contributing
Shift attention outward. Text encouragement, do a roommate’s chore, donate, or help a colleague finish a task.
3
Comparisons
Remember times you coped well or setbacks others have survived. Note what is better now than before.
4
Emotions
Evoke a different emotion intentionally—watch a comedy, listen to energizing music, or read something hopeful.
5
Pushing Away
Set the problem aside mentally for a short time. Visualize placing it in a container, or schedule “worry time” later.
6
Thoughts
Occupy your mind. Count backward by 7s, recite song lyrics, list dog breeds alphabetically, or do a crossword puzzle.
7
Sensations
Stimulate your senses—hold ice, use aromatherapy, chew peppermint, take a hot/cold shower, or wrap in a weighted blanket.
Real-world examples
Try spotting moments like these in your week. Notice how the skill changes the ripple effect of a tough situation.
You’re waiting on scary medical results. Instead of doomscrolling, you bake cookies (Activities), drop encouraging notes to friends (Contributing), remember healthier chapters (Comparisons), watch a feel-good movie (Emotions), and plan to revisit the worry with your partner after dinner (Pushing away).
You crave self-harm after a breakup. You text a DBT buddy to check in (Contributing), count backwards from 100 by sevens (Thoughts), hold an ice cube (Sensations), and blast a hype playlist to shift the emotional channel (Emotions).
Practice Activity
Build an ACCEPTS toolbox. List specific options for each letter so you can reach for them fast when distress hits.
Activities: Which hobbies or chores absorb you?
Contributing: Who or what can you support when you need distraction?
Comparisons & Emotions: What memories or media help shift perspective?
Thoughts & Sensations: What mental games or sensory tools work best for you?
Keep going with related DBT guidance
Use this worksheet as a starting point, then connect it to a deeper explainer or a higher-level skill hub.
Want to practice distress tolerance with the WithMarsha app?
WithMarsha guides you through this skill in real time, keeps track of your practice, and helps you build your DBT toolkit day by day.
Download WithMarsha