The Dialectical Behavior Therapy Skills Workbook for Anxiety

Advanced Distress Tolerance Skills: Improve the Moment 61

CREATE NEW COPING STRATEGIES FOR

DISTRESSING SIT uATIONS WHEN YOu’ RE ALONE

Distressing Situation Old Coping Strategies Unhealthy

Consequences

New Coping

Strategies

Healthier Possible

Consequences

Example: Sometimes

I feel scared when I’m

alone.

I smoke pot. I go to the

bar and drink. I cut

myself. I spend money

on my credit cards.

I feel sick after smoking

or drinking too much.

I get into fights at the

bar. I bleed. I spend too

much money for things I

don’t need.

Use mindful breathing.

Remember my connec-

tion to the universe. Use

safe-place visualization.

Remember what I value.

I won’t feel as anxious.

I won’t hurt myself. I’ll

have more money. I’ll

feel more relaxed.

1.

2.

3.

4.

On each worksheet, pick four distressing situations from the past and examine how you
coped with them. Identify the unhealthy coping strategies you used and what the consequences
were for you and anyone else who was involved. Then record which new distress tolerance skills
could have been used to cope with those situations in a healthier way. Review chapters 1 and 2
and pick the distress tolerance skills that you found to be helpful. Consider these to be options for
the “New Coping Strategies” column as you’re completing the two worksheets. Most importantly,
be specific. If you write, “Use a new coping thought,” write what that thought is. Or if you write,
“Take a time-out,” include what you’re going to do. Be specific so you don’t forget in the future.
Finally, record what the healthier consequences would have been if you had used your new distress
tolerance skills.

Use the examples provided to guide you, and make photocopies of the worksheets if you need

additional space.

CREATE AN EMERGENCY COPING PLAN

Hopefully, you’ve been practicing the new distress tolerance skills from chapters 1 and 2 and you

now have a good idea about which ones work best for you. Or maybe using the New Coping

Strategies worksheet in the last section helped you predict which ones are going to work best for

you. Now you’ll be ready for the next step, which will help you create a personally tailored plan for

dealing with some common distressing situations, both when you’re with other people and when

you’re alone.

For situations when you’re with other people, list four coping strategies that you think will

be the most effective for you. Again, be specific and include as many details about that strategy as

you can. Begin with your most effective strategy, then the second most effective strategy, and so

on. The plan is that you’ll try the first strategy to see if it helps you cope with the distressing situ-

ation; then if it doesn’t, you’ll move on to the next strategy, and so on. Again, refer to any distress

tolerance skills you found helpful in chapters 1 and 2, your New Coping Strategies worksheet in

the last section, and any experience you have using the distress tolerance skills so far.

My eMergency copIng plan for dealIng wIth sI tuatIons

When I’m Upset and Dealing with Other People

First, I’ll

Next, I’ll

Then, I’ll

Finally, I’ll