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Last updated: March 16, 2026

What is this?

A guided DBT crisis survival skills tool with TIPP, STOP, and distress tolerance techniques for managing intense emotions.

Who needs it?

Anyone in emotional crisis who needs structured, step-by-step DBT skills to get through the moment safely.

Bottom line

Crisis skills are for surviving the moment without making it worse — they are not long-term solutions. This tool is for informational purposes only. Not a substitute for professional mental health treatment.

What Are DBT Crisis Skills?

How Do DBT Crisis Skills Work?

When Should You Use DBT Crisis Skills?

In crisis right now?

  • 988 Suicide & Crisis Lifeline: Call or text 988 (24/7)
  • Crisis Text Line: Text HOME to 741741
  • SAMHSA Helpline: 1-800-662-4357 (24/7, free)

DBT Crisis Survival Skills Cards

Evidence-based distress tolerance skills from Dialectical Behavior Therapy. Tap any card to see detailed instructions and examples. Use the random button when you need a skill fast.

TIPP: Change Your Body Chemistry Fast

Tap a card to flip it and see instructions

About DBT Distress Tolerance Skills

Dialectical Behavior Therapy (DBT) was developed by Dr. Marsha Linehan in the late 1980s, originally for people with borderline personality disorder and chronic suicidal thoughts. It has since been adapted for a wide range of conditions including depression, anxiety, substance use disorders, eating disorders, and PTSD. DBT is now one of the most extensively researched and evidence-based psychotherapies available.

Distress tolerance skills are one of DBT's four core skill modules (alongside mindfulness, emotion regulation, and interpersonal effectiveness). These skills are specifically designed for crisis moments — times when emotions are so intense that rational problem-solving is not yet possible. The goal is not to solve the problem or make the pain go away, but to survive the crisis without making it worse.

The four acronyms on this page — TIPP, STOP, ACCEPTS, and IMPROVE — represent different categories of crisis survival skills. TIPP changes your body chemistry quickly. STOP prevents impulsive reactions. ACCEPTS provides healthy distraction. IMPROVE makes the moment more bearable. Together, they form a toolkit for getting through intense emotional experiences safely.

These skills are educational resources and are not a substitute for DBT therapy with a trained clinician. If you are experiencing a mental health crisis, please reach out to a professional or contact one of the crisis resources listed on this page.

Authoritative Sources

Frequently Asked Questions

What are DBT distress tolerance skills?

Distress tolerance skills are one of four core skill modules in Dialectical Behavior Therapy (DBT), developed by Dr. Marsha Linehan. They are designed for crisis moments when emotions are so intense that you cannot think clearly or solve problems effectively. The goal is not to fix the problem or eliminate the emotion — it is to survive the crisis without making things worse. The skills on this page (TIPP, STOP, ACCEPTS, IMPROVE) give you concrete actions to take when you are overwhelmed, helping you ride out the emotional wave until it naturally subsides.

Which skill should I use first in a crisis?

If your distress is very high (8-10 on a 0-10 scale), start with TIPP — especially the Temperature skill (cold water on your face). This works the fastest because it triggers a physiological reflex that slows your heart rate within seconds. If you are about to act impulsively (send an angry message, use a substance, hurt yourself), use STOP first — literally freeze and do not act. Once you have brought the intensity down slightly, you can use ACCEPTS for distraction or IMPROVE to make the moment more bearable. If you cannot decide, use the Random Skill button — any skill is better than no skill.

Do I need to be in DBT therapy to use these skills?

No — these skills can be helpful for anyone experiencing intense emotions. However, learning them within a structured DBT program with a trained therapist is significantly more effective. A therapist helps you practice the skills, troubleshoot when they do not work, and understand which skills fit which situations. This page is an educational reference, not a replacement for therapy. If you are dealing with chronic emotional distress, self-harm urges, or suicidal thoughts, please seek out a DBT-trained therapist through the Behavioral Tech clinician directory or your insurance provider.

What is the difference between distress tolerance and emotion regulation?

Distress tolerance skills are for crisis moments — they help you survive intense emotions in the short term without making things worse. Emotion regulation skills are for the longer term — they help you understand your emotions, reduce vulnerability to negative emotions, and change unwanted emotional responses over time. Think of distress tolerance as the fire extinguisher (put out the immediate fire) and emotion regulation as the fire prevention system (reduce the chance of fires starting). Both are essential parts of DBT.

What if a skill does not work for me?

Not every skill works for every person or every situation. If one skill is not helping, try a different one — that is why there are 22 skills across four categories. Some people respond better to physical skills (TIPP) while others do better with cognitive skills (IMPROVE). Also, skills take practice. The first time you try paced breathing during a crisis, it may feel pointless. But with repeated practice (ideally when you are NOT in crisis), the skills become more effective over time. If you consistently find that no skills help, that is important information to share with a therapist.

Can these skills help with substance use urges?

Yes. Many DBT distress tolerance skills are highly effective for riding out substance use urges. Urges are intense but temporary — they typically peak and pass within 15-30 minutes if you do not act on them. TIPP (especially intense exercise and cold temperature) can reduce the physical intensity of cravings. ACCEPTS provides distraction until the urge passes. The Urge Surfing technique (available as a separate tool on this site) pairs well with these DBT skills. If you are in recovery, having these skills readily accessible on your phone can be a valuable part of your prevention toolkit.

Take a moment to consider these questions. There are no right or wrong answers — they are meant to help you make sense of your results.

  1. 1Which DBT crisis skills — TIPP, distraction, self-soothing, or pros and cons — felt most accessible to you?
  2. 2How quickly were you able to notice a shift in your emotional intensity after using a skill?
  3. 3Which skills would you want to have memorized for moments when you cannot access your phone or a guide?
  4. 4How could you practice these skills during lower-stress moments so they become second nature during crises?

These questions are for personal reflection only. If your results concern you, please share them with a qualified healthcare provider.

Related Mental Health Tools

Safety Plan

Build a crisis safety plan

Box Breathing

Guided breathing exercise

5-4-3-2-1 Grounding

Sensory grounding technique

Urge Surfing Timer

Ride out urges with a timer

Important Disclaimer

These DBT distress tolerance skills are presented for educational purposes only. This tool is not a substitute for professional DBT therapy with a trained clinician. While these skills are evidence-based, learning them in the context of a therapeutic relationship provides much deeper understanding and more effective application. If you are experiencing a mental health crisis, please contact a professional or use the crisis resources on this page.

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Crisis Resources

  • 988 Suicide & Crisis Lifeline: Call or text 988 (24/7)
  • SAMHSA National Helpline: 1-800-662-4357 (24/7, free, confidential)
  • Crisis Text Line: Text HOME to 741741
  • Veterans Crisis Line: Call 988, press 1

View all crisis resources and international helplines

Ready to take the next step? Here's how to bring your results to your doctor →

Reviewed by Jason Ramirez, CADC-II with 11 years of clinical experience in substance abuse counseling.

Last reviewed: March 2026