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From DBT Skills Training Handouts and Worksheets, Second Edition  by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan. Permis -
sion to photocopy this worksheet is granted to purchasers of this book for personal use only (see copyright page for details). Purchasers may 
download a larger version of this worksheet from www.guilford.com/dbt-  
worksheets .Distress tolerance Worksheet 4   (Distress Tolerance Handouts 6–6b)
Changing Body Chemistry with TIP Skills
Due Date:       Name:                   Week Starting:  
Des
cribe the situation you were in when you chose to practice each skill. Rate both your emotional 
arousal and distress tolerance before and after using the TIP skill. Describe what you actually did. 
Use the back of this sheet if necessary.
T
Chang In g My Fa C Ial TeM Per aTu re
Used cold water to change emotions
Situation:                 
                       
A
rousal (0–100) Before: 
   
 After:    
D
istress tolerance (0 = I can’t stand it; 100 = I can definitely survive) Before: 
  
 After:    
W
hat I did (describe):                                   
                                            
IInTenSe  exe rC ISe
S
ituation:                 
                       
A
rousal (0–100) Before: 
   
 After:    
D