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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.

Tip: jot notes below, then print or “Save as PDF.”

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?

Practice DBT skills in real time with WithMarsha — download the app at withmarsha.app

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.

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WithMarsha is inspired by the work of Dr. Marsha Linehan, creator of Dialectical Behavior Therapy (DBT), but is not affiliated with or endorsed by her or the Linehan Institute.

WithMarsha is not therapy and is not a substitute for professional mental health care. If you're in crisis, call 988.

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WithMarsha app icon
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.

How to practice it

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

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?

Practice DBT skills in real time with WithMarsha — download the app at withmarsha.app