Worksheet
IMPROVE Skills: DBT Distress Tolerance
This IMPROVE skills DBT worksheet teaches clients how to tolerate distress and regulate intense emotions using practical, research-backed techniques. Drawn from dialectical behavior therapy, the IMPROVE acronym helps clients facing painful emotions, stressful situations, or difficult moments find healthy ways to pause, reflect, and reduce suffering.
How to Use This Worksheet
This worksheet introduces clients to the IMPROVE skill—a core element of DBT distress tolerance. Therapists can walk through the worksheet in session to explore which techniques feel most accessible, or assign it between sessions as homework to reinforce distress tolerance practice in real-world scenarios.
Who It’s For
This worksheet is ideal for clients experiencing intense emotional distress, including those with symptoms related to borderline personality disorder, substance use challenges, anxiety, or depression. It can also benefit clients looking for practical ways to pause and cope when they feel overwhelmed or stuck in negative thought loops.
Expected Outcomes
- Increased ability to tolerate distress without resorting to harmful behaviors
- Enhanced emotional resilience through regular practice of DBT skills
- Greater self-awareness of which techniques reduce emotional intensity
- Improved capacity to stay grounded in challenging situations
Related Topics
References
Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. New York, NY: The Guilford Press.
Frequently Asked Questions About IMPROVE Skills: DBT Distress Tolerance Resources
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