Distress Tolerance
DBT SUD Skills
DBT
Who knows
Relapse Prevention
100

What is radical acceptance?

A distress tolerance skill that involves fully embracing the present moment, even when it's painful or difficult, without trying to change or avoid it.

100

What is dialectical abstinence?

The goal is not to engage in addictive behavior again— in other words, to achieve complete abstinence.

However, if there is a slip, the goal is to minimize harm and get back to abstinence as soon as possible.

100

What does DBT stand for?

Dialectical Behavioral Therapy

100

What is HALT?

(Hungry, Angry, Lonely, Tired)

100

What is a Relapse Prevention Plan?

This relapse prevention plan lists your triggers, coping skills, support people, goals, and so on. 

200

Why is it important to use distress tolerance skills for SUD?


To avoid acting on urges and to find alternative ways to reduce stress.




200

Define community reinforcement.


Community Reinforcement is the practice of creating and strengthening a recovery-supportive environment by surrounding yourself with people, activities, and resources that reinforce sobriety and make a substance-free life more rewarding than using substances.


Examples include:

  • Spending time with sober, supportive friends and family.
  • Attending therapy, DBT groups, or recovery meetings.
  • Participating in healthy hobbies, sports, volunteering, or employment.
  • Building relationships with people who encourage recovery.
  • Avoiding people, places, and situations that reinforce substance use.


 "Build a life where recovery is rewarded more than addiction." 

200

What are the 5 modules of DBT?

Mindfulness, Distress Tolerance, Emotion regulation, interpersonal effectiveness, and middle path

200

 What is Burning Bridges?

This DBT-SUD strategy means cutting off access to people, places, and things connected to substance use.

200

What are triggers?

These are people, places, things, or feelings that increase your risk of using.

300

What is IMPROVE?

Imagery, Meaning, Prayer, Relaxation, One thing in the moment, brief vacation, and encouragement

300

Give an example of how you can practice alternate rebellion

Shave your head, get piercings, dye hair.

300

What is level 1 validation?

Active listening

300

What is DEADS? (Craving Management) 

  • Delay
  • Escape
  • Avoid
  • Distract
  • Substitute

Purpose: Manage cravings until they decrease.

300

What is a craving (or urge)?

A strong, temporary desire to use alcohol or drugs or return to an unhealthy behavior.  

A craving is a feeling, not a command. You don't have to act on it.

400

What is Distract with ACCEPTS?

Activities, Contributions, Comparisons, Emotions, Push Away, Thoughts, Sensations

400

What are the DBT SUD 3 States of Mind?

Clear mind, clean mind, and addict mind

400

What are the 6 senses?

Sight, hearing, touch, taste, smell, movement

400

What is a Life Worth Living?

Dr. Linehan teaches that recovery is not only about avoiding substances but also about creating a Life Worth Living.

400

Give me an example of using self-validation when you're having a craving or urge to use or go back to old behavior.  

"It makes sense that I'm having this craving right now because I'm stressed and this is how I used to cope. I don't like this feeling, but I don't have to act on it. The urge will pass, and I can use my DBT skills instead."

500

What distress tolerance skill does not require any materials?

IMPROVE

500

Define burning bridges

Burn the bridges back to addiction, and build new bridges toward recovery.


Burning Bridges is intentionally creating distance from people, places, things, and behaviors that increase the risk of substance use or other harmful behaviors, making it harder to act on urges or cravings.

500

What are the 6 levels of validation?

  • Paying Attention – Being fully present and listening without distraction.
  • Accurate Reflection – Reflecting back what the person has communicated.
  • Articulating the Unverbalized – Putting into words feelings or thoughts the person has not yet expressed.
  • Validating in Terms of Past Learning or Biology – Understanding the response in light of the person's history, learning experiences, or biological vulnerabilities.
  • Validating in Terms of the Present Context or Normalizing – Communicating that the response makes sense given the current circumstances.
  • Radical Genuineness – Responding authentically and treating the person as an equal, recognizing their strengths and inherent worth.
500

What is urge surfing?

How to surf the urge?

Urge Surfing is noticing a craving or urge without fighting it or giving in to it. Instead, you observe the urge with mindfulness, allow it to rise and fall like a wave, and let it pass without acting on it.


How to Surf the Urge

  1. Notice the urge.
    • "I'm having the urge to drink."
    • "I'm craving marijuana right now."
  2. Observe it without judging it.
    • Notice where you feel it in your body.
    • Rate the intensity from 0–10.
    • Remind yourself that an urge is a feeling, not a command.
  3. Breathe and stay present.
    • Focus on slow breathing.
    • Watch the urge like a wave rising and falling.
  4. Don't act on the urge.
    • Continue observing until the intensity decreases.
    • Use additional DBT distress tolerance skills if needed.
  5. Refocus on recovery.
    • Engage in a healthy activity or coping skill once the urge has passed.

 

500

DISARM

DIBS

BUDD

Destructive Images and Self-Talk Awareness and Refusal Method

Dispute Irrational Beliefs.  

Building Up to Drink or Drugging 

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