DBT IMPROVE the Moment Worksheet: Overcoming Stressful Situations

This DBT IMPROVE the Moment Worksheet guides clients through a detailed, multi-page exploration of the IMPROVE skills. Each section is dedicated to a specific strategy: creating a calming “Imagery” space, finding “Meaning” or purpose within pain, utilizing “Prayer” or connection to a higher wisdom, and engaging in physical “Relaxation.” The worksheet also emphasizes mindfulness through the “One thing in the moment” exercise and behavioral breaks via the “Vacation” skill. Finally, the “Encouragement” section helps clients develop positive self-talk to counter habitual self-criticism.

The structured layout includes a critical “Reflect” section on the final page. By requiring clients to evaluate which skills worked and which did not, the worksheet facilitates experiential learning and helps the client build a personalized “crisis toolkit” based on their specific emotional needs and responses.

How This Worksheet Can Be Used

Clinical Sessions:
Therapists use the worksheet to help clients pre-plan for high-stress situations. By describing relaxing imagery or writing out a prayer/affirmation in session, the client builds the “behavioral fluency” needed to access these tools when they are actually in distress.

Between-Session Practice:
Clients use the worksheet as a real-world coping guide when they notice emotional intensity rising. It serves as a structured alternative to maladaptive coping, providing immediate instructions on how to shift their internal state.

Distress Tolerance Training:
As a primary tool in the Distress Tolerance module, this worksheet is used to teach the “Crisis Survival” skills. It helps clients understand that while they may not be able to change a situation, they always have the power to “improve the moment.”

Benefits of the DBT IMPROVE the Moment Worksheet

• Provides a comprehensive menu of cognitive and behavioral skills for surviving emotional crises.
• Supports emotional regulation by shifting focus from distressing triggers to calming internal states.
• Encourages the development of “Wise Mind” through meaning-making and prayer/mindfulness.
• Reduces physiological arousal through structured relaxation and one-thing-in-the-moment tasks.
• Increases self-efficacy by providing clients with concrete, actionable steps to manage their own distress.
• Includes a reflection phase to identify which specific skills are most effective for the individual.

Integrating This Tool into Clinical Work

Integrating the DBT IMPROVE the Moment Worksheet is most effective when clinicians emphasize that these skills are “temporary bridges” to get through a difficult time. Clinicians should guide clients to be as sensory-specific as possible in the “Imagery” and “One Thing” sections, as detailed descriptions improve the skill’s effectiveness in grounding. In the “Meaning” section, the goal is not to justify pain, but to find a way to “bear it” by connecting it to a larger value. When reviewing the reflection section, the clinician should treat “failed” skills as data—helping the client understand that not every skill works for every crisis. By consistently practicing these skills when distress is at a moderate level, clients “muscle-build” the capacity to use them when distress is at a peak, leading to greater long-term emotional stability.

References

• Linehan, M. M. (2014). DBT Skills Training Manual (2nd ed.). Guilford Press.
• Linehan, M. M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. Guilford Press.
• Koerner, K. (2012). Doing Dialectical Behavior Therapy: A Practical Guide. Guilford Press.
• McKay, M., Wood, J. C., & Brantley, J. (2019). The Dialectical Behavior Therapy Skills Workbook. New Harbinger Publications.