DBT Self-Soothe Worksheet: Sensory-Based Distress Tolerance and Regulation

This DBT Self-Soothe Worksheet guides clients through a two-page process of creating and testing a sensory-based self-soothing plan. The first page prompts clients to identify two specific, personal examples for each of the six senses: Hearing, Sight, Smell, Taste, Touch, and Movement. This brainstorming phase ensures that the client has a multi-sensory repertoire of strategies that can be used in various environments. The second page moves into experiential evaluation, requiring the client to apply one of their chosen skills to a real-world stressful situation. By documenting the effectiveness of the skill on a 1-to-10 scale and reflecting on the outcome, the client engages in the “behavioral rehearsal” necessary for long-term skill fluency.

The structured layout requires clients to move from abstract intentions to concrete, observable actions. By documenting these strategies in advance and reviewing their efficacy after use, the client reduces the cognitive load required during an actual crisis, making it significantly more likely that they will utilize a healthy skill rather than falling back on habitual, unhelpful reactions.

How This Worksheet Can Be Used

Clinical Sessions:
Therapists use the worksheet during the Distress Tolerance module of skills training. It serves as a collaborative brainstorming tool where the clinician can help the client identify which senses (e.g., movement vs. smell) are most effective for their specific temperament and current environmental constraints.

Crisis Planning:
Clients use the completed worksheet as a “sensory menu” during high-stress moments. Because it is pre-populated with strategies the client has already vetted, it serves as an immediate guide when the “Emotional Mind” makes it difficult to think clearly about self-regulation.

Behavioral Rehearsal:
This tool is used to facilitate “in-vivo” practice. A clinician might have a client light a scented candle or listen to a specific piece of music in the office to observe the physiological shift, then use the worksheet to document the intensity change.

Benefits of the DBT Self-Soothe Worksheet

• Provides a structured, 6-category framework for effective sensory-based regulation.
• Lowers physiological arousal by activating the parasympathetic nervous system through the senses.
• Helps clients survive emotional crises without making the situation worse through impulsive actions.
• Includes a “Movement” section to address the somatic energy often associated with anxiety and anger.
• Uses pre- and post-skill ratings to provide empirical evidence of the client’s ability to self-regulate.
• Supports the “Crisis Survival” component of the evidence-based DBT protocol.

Integrating This Tool into Clinical Work

Integrating the DBT Self-Soothe Worksheet is most effective when clinicians emphasize that self-soothing is a “skill,” not an “indulgence.” Clinicians should guide clients to choose examples that are portable and accessible—for example, carrying a specific essential oil or having a curated playlist. In the “Movement” section, the goal is “gentle rhythmic action,” such as stretching or a slow walk, which differs from the high-intensity “Intense Exercise” of the TIPP skills. When reviewing the second page, the clinician should treat “low effectiveness” scores as valuable data—helping the client refine their list until they find the sensory anchors that truly work for them. By consistently reviewing and updating this worksheet, the clinician helps the client realize that they have a range of options to soothe their own nervous system, fostering a sense of mastery over their internal world.

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.