Distress Tolerance
Crisis Survival Strategy Builder
Assemble a runbook that combines STOP, TIPP, distraction, and self-soothing so you know exactly what to do when a crisis hits.
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Quick answer
What this DBT worksheet helps you do
Assemble a runbook that combines STOP, TIPP, distraction, and self-soothing so you know exactly what to do when a crisis hits.
Reviewed July 16, 2026 under WithMarsha editorial standards. Educational DBT practice only; not therapy, diagnosis, treatment planning, or crisis care.
How to practice it
Move through each step slowly. Notice what the skill asks for and how you can experiment in real life.
1
Warning Signs & Triggers
List the cues that tell you a crisis is brewing—thoughts, body sensations, situations, or behaviors. The earlier you notice, the faster you can intervene.
2
STOP Response
Write the exact actions you’ll take to run STOP: what helps you freeze, how you step back, what you observe, and the question you’ll ask before acting.
3
TIPP Sequence
Plan realistic Temperature, Intense exercise, Paced breathing, and Progressive relaxation options for home, work, and on-the-go.
4
Distraction Menu (ACCEPTS)
Choose Activities, Contributing ideas, Comparisons, Emotion shifts, Pushing away strategies, Thoughts, and Sensations that reliably pull your focus.
5
Self-Soothing Kit
Assign at least one calming tool for each sense. Note where you’ll keep them (desk drawer, backpack, bedside).
6
Support & Safety Steps
Record who you will contact, crisis lines, medication reminders, or environmental changes (lock away sharps, step outside) to keep yourself safe.
Real-world examples
Try spotting moments like these in your week. Notice how the skill changes the ripple effect of a tough situation.
Late-night urge plan
Warning signs: racing thoughts, doomscrolling. STOP: put phone face down, stand up, breathe. TIPP: cold washcloth, 60-second mountain climbers, 4-6 breathing, shoulder roll release. Distraction: watch cooking show, text DBT buddy, count backwards. Self-soothe: vanilla candle, peppermint tea, weighted blanket. Support: message therapist app, call hotline if urge > 7.
Workday crisis plan
Warning signs: clenched jaw, “I’m trapped” thought. STOP: pause typing, feet flat, name five objects. TIPP: splash restroom water, brisk stair climb, box breathing, neck stretch. Distraction: finish filing, reorder supply closet, listen to upbeat playlist. Self-soothe: lavender roller, tactile ring. Support: ping manager for five-minute break, step outside with colleague.
Practice Activity
Complete the builder and store a copy where you can reach it fast (phone notes, wallet, bedroom wall). Review it monthly.
What early warning signs tell you a crisis is forming?
What are your STOP and TIPP steps in detail?
Which distraction and self-soothing tools will you reach for first?
Who or what will you contact if the plan isn’t enough?
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.
