DBT ACCEPTS Worksheet
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Looking for a DBT ACCEPTS worksheet to use with clients in session or provide to them as homework?
Modalities like dialectical behavioral therapy (DBT) can enhance a client’s distress tolerance skills. One of the DBT tools and techniques is the ACCEPTS skill.
In this article, learn what the DBT ACCEPTS acronym stands for, different ways to use the DBT ACCEPTS worksheet with clients, and download a free DBT ACCEPTS PDF to save to your electronic health record (EHR) for future use.
What does the ACCEPTS DBT acronym stand for?
The main tenets of dialectical behavioral therapy include enhancing distress tolerance skills, developing mindfulness skills, strengthening emotional regulation, and improving interpersonal communication.
The ACCEPTS tool is one of several DBT techniques used to manage stress and regulate difficult emotions. It works by building distress tolerance, which is defined as the ability to accept present conditions as they are.
The letters in the ACCEPTS acronym stand for:
Activities
Find an activity to distract you from distressing thoughts or emotions, such as playing a computer game, participating in a favorite hobby, or other helpful activities.
Contributing
Focus on someone else by doing a good deed to shift your attention from the stressful situation.
Comparisons
Find perspective on your situation by comparing it to a time when you dealt with a more difficult situation. You may also recall how you handled the situation and apply the coping strategy you used to your current situation.
Emotions
Engage in an activity to evoke a different feeling or emotion, such as watching your favorite movie, which can help shift your perspective.
Pushing away
Use imagery to distract yourself from the painful situation. This might include listening to a guided meditation or thinking of a calm or safe place.
Thoughts
Use the power of your mind to think about something else. This could be naming five things that you see in front of you. For more stressful situations, you might want to run through the alphabet or find something in your room to name out loud or to say in your head.
Sensations
Focus on pleasant feelings or sensations, like petting an animal, standing barefoot in the grass, taking a hot shower or bath, or placing an ice cube on a part of your body.
The ACCEPTS acronym is included in the DBT ACCEPTS PDF provided in this article that you can download and save.
DBT ACCEPTS examples
Examples of how to use the DBT ACCEPTS skill include:
Activities examples
Distracting activities might include painting or drawing, knitting and crochet, playing a board game, exercise, talking to a friend, practicing a difficult yoga pose, or baking.
Contributing examples
Examples include offering to help a co-worker, volunteering at a local food bank or homeless shelter, donating clothes, going to a dog shelter and walking dogs, or calling an elderly family member and offering your time.
Comparisons examples
This could include thinking of situations where you’ve overcome a challenge in the past, like a loss or breakup. Or, a person might consider situations where people are much worse off, like those experiencing homelessness, poverty, and sickness.
Emotions examples
Ways to evoke different emotions might include calling a friend, hugging a loved one, listening to music, or watching a movie.
Pushing away examples
A group facilitator can lead a DBT ACCEPTS group activity, such as a guided meditation to find a calm or safe place.
For example, a person can ‘push away’ the negative thoughts or emotions by following this meditation:
- Think of an image of a person, place, or thing that brings a sense of calm or safety. This could be a pet, beach, favorite camping spot, or a cozy place at home where you relax.
- Notice the emotions and feelings when imagining that safe/calm place.
- Find a word or phrase that depicts this image that you can name when you need to retreat to a calm/safe place.
- Practice evoking this image several times a day, so when feeling distressed, you have a well-practiced tool to call on at any time.
Thoughts examples
Name five things beginning with the letter A, list three things you’ve achieved today, think of three things your friends say are your best qualities, or name five things you’ve done to help others.
Sensations examples
Try a short meditation, make a sensory basket of things you like to touch, smell, and look at, or find a cozy spot at home where you can relax, cover yourself in a blanket, and feel safe.
Other DBT tools and techniques for distress tolerance
The distress tolerance ACCEPTS tool is just one of several tools clients can use to strengthen their ability to withstand stress and crises.
Other DBT techniques include:
TIP skill
A tool to quickly calm an overwhelmed body by using temperature, exercise, and breathing techniques.
IMPROVE skill
The IMPROVE skill is another acronym that seeks to replace a distressing environment with a more positive one by focusing on: imagery, meaning, prayer, relaxation, focusing on one thing, vacation, and encouragement.
DEAR MAN skill
The DEAR MAN skill helps clients build better relationships by communicating effectively and expressing their needs.
Self-soothe skill
The self-soothe skill provides instant relief from stress or pain by engaging your senses in different activities.
Pros/cons
This is a tool to evaluate the pros and cons of making a decision.
Problem solving
Problem solving provides clients with a framework to solve problems and challenges.
Radical acceptance
The skill of radical acceptance helps clients completely accept reality, no matter the situation.
How to use the DBT ACCEPTS worksheet
You can use the DBT ACCEPTS worksheet with clients individually or in group sessions.
Page one of the DBT ACCEPTS worksheet describes the acronym for clients to easily reference, followed by fill-in-the-blank sections on the second page for clients to list out how they can use this technique.
You can download and save the free DBT ACCEPTS PDF to your practice software to easily print a template for each client or to form a resource library for future use.
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