ent moment, making it easier to survive a crisis without making it worse. The term 
IMPROVE is a way to remember the strategies. Any of three worksheets— Distress 
Tolerance Worksheets 7, 7a,  and 7b: IMPROVE the Moment —can be used to track 
practice of this skill. Each worksheet increases the number of practices that can be recorded, from two practices during the week (Worksheet 7) to practice of every skill twice (Worksheet 7a) to multiple daily practices (Worksheet 7b).
••Distress Tolerance Handout 9a: Sensory Awareness, Step by Step. The R in 
IMPROVE stands for Relaxing actions, and sensory awareness is a relaxing action 
you can take to improve the moment. This handout can be used as a guide to this 
exercise.
Reality Acceptance Skills
••Distress Tolerance Handout 10: Overview: Reality Acceptance Skills. The 
goal of reality acceptance is to reduce suffering and increase a sense of freedom by 
finding ways to accept the facts of your life. This handout briefly lists the six reality 
acceptance skills.
••Distress Tolerance Worksheets 8, 8a, 8b: Reality Acceptance Skills. These 
three worksheets cover practice of all the reality acceptance skills. They can be used to track practice of any of the skills in this section. There are also worksheets for specific reality acceptance skills, as mentioned below.
••Distress Tolerance Handout 11: Radical Acceptance. Radical acceptance is a 
complete and total openness to the facts of reality as they are, without fighting the facts or being willful and ineffective. This handout outlines what has to be accepted