DBT · Distress Tolerance

Distress Tolerance Plan Card

Pocket-sized crisis-survival card — written calm, used not-calm

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A pocket-sized crisis-survival card. Written when the client is calm and clear; used when they're not. Print small; fold; carry in wallet or phone case.

My distress plan

Use in order. Don't skip.

1. STOP.

Do not act on the urge for the next 15 minutes.

2. TIPP one thing:

Cold water on face · slow paced breathing · muscle release · brisk walk.

3. Text this person:

4. Distract for 20 min with:

5. If still in danger, call:

988 (US) · 111 press 2 (UK) · local ED

One reason I am worth waiting 15 minutes for

About this worksheet

A distress tolerance plan works in the moment or it doesn't work at all. This card is written when the client is calm and clear, and used when they're not. Five ordered steps: STOP (do not act on the urge for 15 minutes) → TIPP one thing (cold water, paced breathing, muscle release, brisk walk) → text one specific person (client fills in) → 20 minutes of distraction (client fills in two options) → crisis line if still in danger (client fills in local number; card lists 988 US, 111 press 2 UK, local ED as reference). Closes with one prompt: 'one reason I am worth waiting 15 minutes for'. Designed to be printed small, folded, carried in wallet or phone case. The specificity is the intervention — 'text someone' fails in crisis; 'text J.' works.

When to use it

Any client with suicidal ideation on an agreed safety plan.
Self-harm urges — the 15-minute delay disproportionately reduces action.
Impulsive substance use.
Panic attacks — the card gives sequence when working memory is unavailable.
Borderline personality organization and emotion-regulation-informed treatment.

How to use it

1
Fill in-session, not as homework
In-session filling lets the clinician calibrate — the person named must actually pick up, the distraction must be plausible, the crisis line must be current.
2
Specificity beats completeness
'Text J.' beats 'reach out to friends'. 'Watch [specific show]' beats 'distract myself'.
3
Rehearse out loud once
Reading the card in session while calm builds a state-dependent association that improves retrieval under distress.
4
Print small, laminate, carry
Wallet-size is not decorative — it's how the card is present in the moment when the phone is the trigger.

Frequently asked questions

Is this a safety plan?+

It's a distress-tolerance card, not a full Stanley-Brown safety plan. Some clinicians use it as the between-session, portable version of a fuller safety plan; some use both.

What if the client says they have no one to text?+

That's clinical material, not a card-completion problem. Fill the slot with a warmline or crisis line rather than leaving it blank, and address the isolation as a treatment target.

Is this worksheet free?+

Yes. Free printable PDF. Sign in to send as a secure client link.

Related worksheets

Worksheet — Distress Tolerance Plan Card — provided by TherapistAssist for clinical use. Not a substitute for assessment or treatment.