DBT Accepts Acronym. A key distracting skill is Wise Mind ACCEPTS. This acronym stands for: Activities. Contributing. Comparisons. Emotions. Pushing Away. Thoughts. Sensations. Explore More DBT Skills. Radical Acceptance DBT PDF


DBT stands for dialectical behavioral therapy, intensive therapy for people with high emotional responses that inhibit normal functions [1]. DBT suggests that there are times when we cannot change a situation or circumstance. Instead of solving the problem, we need to tolerate the moment. DBT suggests several distress tolerance skills to handle the moment. A way to remember this skill specifically is the word ACCEPTS or Accept Skill DBT.

DBT is a form of cognitive-behavioral therapy (CBT), or psychotherapy, that teaches individuals to appreciate their emotions and feelings with acceptance [2]. Originally, it was used for borderline personality disorder treatment (BPD) and was developed by Dr. Marsha Linehan. It is now widely used by many therapists, counselors, and psychologists for different types of emotional and mental health disorders. It can be used for almost any condition, including eating disorders, drug addiction, and alcoholism treatment.

DBT ACCEPTS skills outline strategies for distracting oneself from distressing feelings, giving them time to lessen the intensity or fade away. Using ACCEPTS DBT, individuals will learn various distraction techniques, including focusing on others, creating new competing emotions, and participating in distracting activities. DBT ACCEPTS skills allow us to calm our emotions during a crisis. It aims at teaching its clients different “Self-Help Activities.” So they don’t let the problem control them whenever they face difficult situations. Instead, they take control of the situation by checking their emotions and reactions.

accepts dbt
Accepts Skill DBT: Distress tolerance skills are intended to help distract us and get us through difficult emotional situations one moment at a time.


DBT is more about practice and repetition than simply remembering a skill’s name or completing an ACCEPTS worksheet DBT or DBT Accepts skills PDF. The more clients practice and use the skills, the more likely they find them useful when they genuinely need them. Over time and with lots of practice, most people find skills become automatic and replace maladaptive skills and behaviors. So practice, practice, and don’t give up!

Clients and therapists work as a team in individual sessions, focusing on learning and improving coping and social skills. They may also discuss general issues relevant to improving the client’s quality of life or specific issues like post-traumatic stress disorder or drug addiction. The DBT ACCEPTS acronym is a group of skills to help you tolerate a negative emotion until you can address and eventually resolve the situation.

A key distracting skill is Wise Mind ACCEPTS DBT. This acronym stands for:

  • Activities
  • Contributing
  • Comparisons
  • Emotions
  • Pushing Away
  • Thoughts
  • Sensations

It’s essential to call on your Wise Mind while using ACCEPTS. Distraction can all too easily turn to avoidance. One TV episode that takes your mind off things can quickly turn into a whole season and a day gone. DBT ACCEPTS PDF is meant to escape your present distressing situation for a moment so that you can return to it with a better mindset, meaning in Wise Mind. Taking a moment can kick you out of your Emotional Mind or even the Rational Mind and help you find that Middle Path.

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Focus attention on a task you need to get done. Rent movies; watch TV. Clean a room in your house. Find an event to go to. Play computer games. Go walking. Exercise. Surf the Internet. Write e-mails. Play sports. Go out for a meal or eat a favorite food. Call or go out with a friend. Listen to your iPod; download music. Build something. Spend time with your children. Play cards. Read magazines, books, and comics. Do crossword puzzles or Sudoku.


When we’re in an intense emotional state, it’s easy to feel like our problems and worries are all-consuming. Try to step outside of your own space and contribute to something else. You can text something encouraging to a friend, smile randomly at a stranger, donate to a worthy cause — whatever feels right to you.  

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ACCEPTS DBT Skill: Dialectical Behavior Therapy (DBT) offers many valuable approaches to understanding and tolerating distress. 


Put your life in perspective. Is there a time when you’ve faced more difficult challenges than today? Maybe not—maybe this is the most intense situation and most intense emotion you’ve ever experienced. (If so, you may need to return to the TIPP section.) If that’s the case, is there another person who has suffered more than you? Are you in your safe home while someone else is searching for food and shelter in another part of the world after a natural disaster? The goal of this exercise is not to add more distress and emotional pain to your current situation. Instead, use this skill to add a different perspective to what you’re experiencing right now.


You have the power to invoke the opposite emotion of your current distressing feeling. If you are feeling anxious, practice meditation for 15 minutes. If you’re feeling depressed, go ahead and Google Image search “adorable puppies”. (If you need a real laugh, search “ugly puppies”.) Adding a dose of the opposite emotion helps reduce the intensity of the negative emotion.

Pushing Away

Push the situation away by leaving it for a while. Leave the situation mentally. Build an imaginary wall between yourself and the situation. Block thoughts and images from your mind. Notice ruminating: Yell “No!” Refuse to think about painful situations. Put the pan on a shelf. Box it up and put it away for a while. Deny the problem for the moment.

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accepts dbt
To refresh your memory, DBT ACCEPTS stands for Activities, Contributing, Comparisons, Emotions, Push away, 


The idea behind Thoughts is that you can only truly focus on one thing at once. You can’t be thinking about that thing that’s bothering you if you’re engrossed in thinking about something else. Some examples are counting to 10 or counting the tiles on a floor, the panes in a window, or the stars in the sky, anything to keep your focus on counting. Similarly, you can name items around you. These are good ones to use in a sudden emergency when you need to quickly pull something out of your bag of tricks. They don’t require anything other than what’s around you.


The last skill in ACCEPTS is Sensations. A strong physical stimulus can jog, lose your connection to your pain and distract you from it. This is a great skill to use if your distress triggers self-injurious behaviors.

You might hold ice in your hand or apply it to the back of your neck, listen to loud music, take a hot, hard shower, a cold, hard shower, or swim in very cold water. After you try one of these activities, you may want to go on to another letter of ACCEPTS that works differently.

Explore More DBT Skills

Mindfulness Module

Mindfulness refers to putting one’s mind in a state of fullness. In other words, it is the ability to live intentionally aware of the present moment without judging and or staying attached to a particular moment.

There are three ways to practice mindfulness:

  • Participate
  • Observe
  • Describe


Participate refers to doing only one thing at a time. The idea is to allow the client to let go of self-consciousness, judgments, and fears; and to fully concentrate on a particular activity.

Examples for clients:

  • “Participating in only one activity might be different depending on which activity you are doing.”
  • “For example: If you are eating a piece of chocolate cake, you are just eating a piece of chocolate cake. You shouldn’t be watching TV, sending messages to your friends, and listening to music while you eat the cake.”


Observing means directly noticing the sensory experience. It is composed of what a person feels, tastes, sees, touches, and hears without putting any labels on it, reacting to it, or judging it.

Examples for clients:

  • “At first, it can be challenging for our minds, because they try to label what is happening rather than just being with the bare sensations of an experience.”
  • “One example of observing is when you are listening to music, imagine that your body is permeable to sounds and observe each one of those sounds. You can also experience observing while breathing gently and focusing your attention on the movement and pauses of your belly, how it rises and falls during your breath.”
  • “You can practice Observing by doing this activity of mindful breathing.”


Describe is based on observing. To describe is to put words to what you observe, whether it is a thought, a sensation, or an emotion.

This is a powerful tool to help clients identify and distinguish thoughts and feelings from facts. Susceptible clients can use this skill to reduce their reactivity. When someone describes, facts need to be checked to avoid jumping to wrong conclusions about oneself or others.

Examples for clients:

  • “Your own interpretations or assumptions shouldn’t be considered to describe what you observe. Just stick to the facts.”
  • “For example: imagine that your mind is a railroad and your thoughts and emotions are wagons of a train that circulates on it, describe them and label them as they pass by.”
  • “Imagine that your mind is a river, thoughts and emotions are ships that sail through it. You are sitting in front of it on the grass, you can describe them while they pass.”

Interpersonal effectiveness module

One of the greatest struggles of borderline or emotionally dysregulated patients is the difficulty in asking for what they want. Therefore, the interpersonal effectiveness module focuses on setting clear goals (Objective effectiveness), maintaining self-respect (Self-respect effectiveness), and having conflict-free relationships (Relationship effectiveness).

Dialectical behavior therapy uses acronyms to help clients remember the skills tied to each type of effectiveness.

Objective effectiveness: DEAR MAN

Be effective in maintaining your rights and wishes

  • D – Describe the situation
  • E – Express how you feel about it
  • A – Ask for what you want
  • R – Reinforce the other person
  • M – Be Mindful
  • A – Appear confident
  • N- Be willing to Negotiate

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Radical Acceptance DBT PDF

12 Best DBT Radical Acceptance Worksheets

The following worksheets and tools can help clients practice DBT radical acceptance coping skills.

1. The “What If” Bias

The What If Bias worksheet helps clients determine if their bias is positive or negative and look at both potential outcomes to a situation – positive and negative – rather than focusing only on negative ones. It helps alter polarized thinking into a middle ground.

2. Fact-Checking Thoughts

The Fact-Checking Thoughts Worksheet helps clients determine if their thoughts about a situation are realistic or if they are cognitive distortions. Once cognitive distortions are identified, they can be changed.

3. Radical acceptance of a distressing situation

When a client is in crisis, it may be difficult to objectively look at a distressing situation. This DBT Radical Acceptance worksheet helps clients partialize the event to analyze the situation as critical. It helps turn distorted, negative cognitions into an accounting of real facts.

4. Focus on the Present Moment for Radical Acceptance

When a client is in a distressing situation, it is common for them to focus on the “would-haves,” “should-haves,” and “could-haves.” This focus on the past serves no purpose other than mental self-harm.

When the client radically accepts a situation, such as what is featured in the Focus on the Present Moment exercise, it frees them from their feelings of guilt and helps them take logical next steps.

5. Countdown to calmness

When clients focus on the past or future, they may experience feelings of depression or anxiety.

This positive emotion exercise combines the five senses and a counting coping technique to help ground the client in the present moment. When focused on the present, they can more easily make logical steps to move toward change.

6. Problem-solving

Often, a client may get overwhelmed with their distressing emotions in a crisis. DBT Radical acceptance helps a client move away from a purely emotional viewpoint to more middle-road thinking (a gray area instead of black/white).

This Problem Solving Worksheet for Adults helps clients radically accept a situation by critically looking at the problem and objectively considering possible solutions.

7. Radical Acceptance Coping Mantras

The Radical Acceptance Coping Mantras worksheet is a list of phrases that can be repeated repeatedly (or read aloud) to help remind the client of the reality of the situation.

The repetitive aspect of mantras can help aid in self-soothing as well. This reinforces radical acceptance and helps calm the client to return to a more balanced state of mind.

8. Setting Radical Acceptance Goals

The Radical Acceptance Goals worksheet helps clients practice the coping technique of radical acceptance in non-distressing situations so they can use the skill in a crisis. It is more challenging to try a new skill when we are focused on our emotions.

The client needs to practice radical acceptance in everyday life to become a habit and easier to implement in a crisis. This is akin to learning to play a musical instrument or working out in a gym. The more we practice, the easier it becomes.

9. Meditation for Radical Acceptance

The Meditation for Radical Acceptance worksheet combines traditional meditation with radical acceptance skills so that clients can practice accepting a stressful situation wherever they are and calm themselves.

Mindful meditation helps a client ground themselves in the present moment.

10. The Ups and Downs

Radical acceptance is an essential part of objective decision-making. Although designed for children, the Ups and Downs worksheet can help clients of any age think through their decisions logically. It allows clients to break a situation down into the pros and cons to make more objective decisions rather than emotionally reacting to a distressing situation, which can cause more distress.

Objectively and logically deciding on a path will allow clients to feel more in control of their actions during a distressing time.

11. Practicing Radical Acceptance

The Practicing Radical Acceptance Worksheet helps a client accept a situation and develop a coping strategy to help tolerate associated distressing feelings.

Radical acceptance involves letting go of the need to control a situation. This worksheet helps a client view the situation as an outsider and act, rather than react, to a situation. Being proactive rather than reactive allows clients to feel more confident in making decisions.

12. Challenging Catastrophic Thinking

The Challenging Catastrophic Thinking Worksheet helps clients practice radical acceptance by partializing a crisis scenario.

The worksheet helps the client analyze the distressing situation to look at potential outcomes more logically. It moves them away from polarized thinking into a state of “wise mind.”

accepts dbt
Mental health is not the same thing as the absence of a mental illness. Mental health includes emotional, psychological, and social well-being.

Additional Resources: DBT ACCEPTS Skills PDF

DTB Therapy

Many individuals struggling with addiction also have another underlying mental health condition. When someone is diagnosed with other disorders along with addiction, it is referred to as a dual diagnosis or co-occurring disorder. Co-occurring disorders with addiction must be treated simultaneously. If the underlying condition leads to substance abuse and is left untreated, the person will return to drugs or alcohol because the original trigger was not handled. Finding success in sobriety can be more difficult for those with a dual diagnosis, but the right therapies can help get them on that path. DBT provides the skills and methods to sustain long-term recovery.

Dialectical behavior therapy benefits people in developing skills to handle intense emotions and stressful situations and maintain healthy relationships. These skills can help someone balance their emotions and state of mind to prevent damaging behaviors. DBT provides the opportunity to learn to handle emotions that may have led to substance abuse or other damaging actions.

We Level Up NJ rehab center uses individualized treatment plans for each client to ensure they can succeed in recovery. We know there is no one-size-fits-all recovery method. Treatment plans consider the substance that was abused, co-occurring disorders, past traumas, past treatments, and future planning that may be needed. We Level Up NJ dual diagnosis treatment centers has medical detoxMAT, residential or inpatient rehab treatment, and rehab aftercare planning programs for those struggling with drug and alcohol addiction. If you or a loved one are struggling with addiction, call our 24/7 admissions team.

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