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Radical Acceptance
Radical acceptance means fully acknowledging what is true, including the parts you wish were different, so you stop spending your energy fighting it. It is not approving, giving up or pretending it is fine.
Describe what happened or what is true right now, in plain facts.
Feelings, time, sleep, relationships, energy.
Let your body accept it too. Unclench your jaw and hands, let your shoulders drop, and let a slow breath out. It is hard to accept something with a body braced to fight it.
You may need to choose acceptance many times a day. That is normal. Accepting that something happened is also different from accepting that it should keep happening: if you are being hurt, accepting the facts can be the first step toward getting safe.
In crisis? If you are thinking about hurting yourself or ending your life, call or text 988 to reach the Suicide and Crisis Lifeline, any time. If you are in immediate danger, call 911.
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An educational aid to use with a therapist, teacher or parent. It is not a medical device and does not diagnose anything.
Free DBT worksheets
Dialectical behavior therapy (DBT) was developed by the psychologist Marsha Linehan. It teaches skills in four areas: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. These six worksheets practice skills from the first three. They are written by Crown Counseling in our own words and are not the official DBT handouts. They work best alongside DBT with a trained therapist or skills group.
| Worksheet | Skill area | Use it when |
|---|---|---|
| Radical acceptance | Distress tolerance | You keep fighting something you cannot change. |
| STOP | Distress tolerance | An urge hits and you are about to react. |
| Check the facts | Emotion regulation | A feeling seems bigger than the situation. |
| Wise mind | Mindfulness | You are torn between feeling and logic. |
| Pros and cons | Distress tolerance | You are deciding whether to act on an urge. |
| TIPP | Distress tolerance | Emotion is so intense you cannot think. |
Radical acceptance worksheet
When something painful happens, a lot of energy can go into wishing it were different, replaying it, or arguing with it. Radical acceptance means letting what is true be true, so that energy can go somewhere useful instead. The worksheet walks through it: name what you keep fighting, notice how you fight it and what that costs, separate what you cannot change from what you still can, choose words to say to yourself, and pick one next step. A 0 to 10 rating before and after shows any shift.
Acceptance is not approval, and it is not giving up. Accepting that something happened is different from accepting that it should keep happening. For someone in a harmful situation, accepting the facts is often the first step toward getting safe. Most people have to choose acceptance many times over, sometimes many times a day.
The STOP skill
STOP is for the moment between an urge and an action. The online version has a 10-second pause timer for the first step.
- S: Stop. Pause. Do not act on the urge yet. Give yourself a moment before you do anything.
- T: Take a step back. Put some space between you and the situation: leave the room, look away, or lean back. Let one slow breath out.
- O: Observe. Look around: what is actually happening, in plain facts? Then look inward and name the feeling, the thought and the urge.
- P: Proceed mindfully. Decide what you want to come out of this. Choose the action that moves you toward it, even if it is not the one the urge wants.
The practice log records the urge and how strong it was, what you noticed, what you chose, and how strong the urge was afterward.
Check the facts
Emotions are fast, and they often react to our interpretation of an event rather than the event itself. Checking the facts separates the two: name the emotion and rate it, write what happened as a camera would record it, write the story you told yourself, find other explanations, and ask whether you are expecting a threat. Then decide whether the emotion, and its strength, fits the facts. The worksheet suggests a next step for each answer.
Wise mind
DBT describes three states of mind. Tap each part of the diagram to see what it is like. Then use it on something real: write what emotion mind says, what reasonable mind says, and what wise mind says, where the two overlap.
- Emotion mind. Feelings are in charge. Thoughts and actions follow the mood, and everything feels urgent. Feelings carry real information, but not the whole picture.
- Reasonable mind. Logic is in charge. Calm, factual and good at planning, but it can skip over what you value and how you feel.
- Wise mind. Where the two overlap. You know what you feel and what the facts are, and a choice that respects both feels quietly right, even when it is hard.
Pros and cons
This version of pros and cons looks at both sides of an urge: the pros and cons of acting on it, and the pros and cons of not acting on it. Mark each item as long term if it matters beyond today. Urges usually win in the short term, so the long-term items tend to decide it. It works best written out when calm, ahead of the next strong urge.
TIPP skills
When emotion is at its peak, reasoning with yourself rarely works. TIPP works through the body. The online version has a one-minute exercise timer, a breathing pacer (four seconds in, six out) and a guided walk through paired muscle relaxation.
- T: Temperature. Cool your face fast. Splash it with very cold water, or lean forward and press a cold pack wrapped in a cloth against your face for about half a minute. Cold on the face can slow the heart rate.
- I: Intense exercise. Burn off the energy the emotion has built up. Move hard for a few minutes: run in place, jumping jacks, fast stairs. Even one hard minute can take the edge off.
- P: Paced breathing. Breathe low and slow, letting each breath out last longer than the breath in: for example, four seconds in and six seconds out.
- P: Paired muscle relaxation. Pair tension with the breath in and release with the breath out: tighten one set of muscles as you inhale, then let them go loose as you exhale. Move through your body one area at a time.
Safety: Check with a doctor first if you have a heart condition, a slow heart rate, an eating disorder, or take heart medicine. Never put ice straight on the skin. Exercise should stay within what is safe for your body.
DBT worksheets for teens and youth
Press Teens and every worksheet switches to teen-friendly wording: STOP becomes "for the second you are about to snap, send the text, or slam the door," and wise mind is "your feelings side and your logic side working together." The skills are the same. A version of DBT for adolescents, often called DBT-A, was developed by Alec Miller and Jill Rathus with Marsha Linehan, and brings parents into skills training.
- Pros and cons works well for decisions teens are already weighing, like skipping school or sending a message.
- Many teens like TIPP best, because it works fast and does not ask them to talk.
- Nothing is saved, so a teen can fill a worksheet in on their own phone privately.
- For more support, see teen counseling at Crown Counseling.
Using them in a session and over telehealth
- Teach the skill first, then fill in the worksheet together on a recent, moderate example.
- Over telehealth, share your screen and press Present mode, or send the link so the client fills it in on their own device.
- Press Copy as text to paste a worksheet into your notes, or Print this worksheet to save it as a PDF. Nothing is sent to us.
- For thought work, pair these with our CBT worksheets and anxiety worksheets.
DBT worksheets PDF
The free PDF has four pages: radical acceptance; STOP and TIPP together, for in-the-moment skills; check the facts; and wise mind with pros and cons. Print the whole set for a skills group binder, or one page as homework. Learn more about dialectical behavior therapy at Crown Counseling.
In crisis? If you are thinking about hurting yourself or ending your life, call or text 988 to reach the Suicide and Crisis Lifeline, any time. If you are in immediate danger, call 911.
