ACCEPTS Skill

Definition

ACCEPTS is a Distress Tolerance skill in DBT used to distract yourself temporarily from overwhelming emotions. Each letter stands for a category of distraction techniques that can help you get through a crisis without making things worse.

Purpose

Used to:

Reduce emotional intensity to a tolerable level.
Interrupt harmful impulses.
Create space for wiser decision-making.
Help you cope ahead with short-term distress when problems can’t be solved immediately.

When to Use

Use ACCEPTS when:

You feel emotionally flooded and unsafe.
You are experiencing strong urges to act impulsively.
You cannot change the crisis right away.
You need to ride out an emotional wave without escalation.

When Not to Use

Avoid using ACCEPTS if:

The situation requires urgent problem-solving (e.g., medical emergency).
You are using distraction to avoid important commitments long-term.
You are denying the existence of real problems indefinitely.

How-To

Here is what each letter stands for and how to apply it:

A – Activities

Engage in healthy activities that require focus (e.g., cleaning, hobbies, exercise).

C – Contributing

Do something kind for others (e.g., volunteer, send a caring text).

C – Comparisons

Compare to a time you felt worse and survived, or to others coping effectively.

E – Emotions

Generate different emotions by watching a funny video or listening to uplifting music.

P – Pushing Away

Temporarily set the distressing situation aside mentally.

T – Thoughts

Distract your mind by counting, doing puzzles, or reciting something memorized.

S – Sensations

Use strong sensory input to shift focus (e.g., holding ice, taking a cold shower).

Tips & Variations

Try combining more than one letter for stronger distraction.
Make an “ACCEPTS toolkit” with reminders for each category.
Be mindful not to let distraction turn into chronic avoidance.

Example

Monica was triggered by an argument.

Activities: Took her dog for a walk.
Contributing: Sent an encouraging message to her friend.
Comparisons: Reminded herself she survived worse arguments.
Emotions: Watched a lighthearted comedy show.
Pushing Away: Put her thoughts about the fight in an imaginary box.
Thoughts: Counted backward from 100 by sevens.
Sensations: Squeezed a stress ball.

Inventor / Origin

Developed by Marsha Linehan, PhD, as part of DBT’s Distress Tolerance module. The acronym draws on cognitive-behavioral and mindfulness-based distraction methods.

Related Skills

IMPROVE the Moment
Self-Soothing
TIPP
Radical Acceptance

Limitations

May not be effective if:

Used exclusively to avoid solving real problems.
Emotions are left unprocessed over time.
There is an immediate safety issue that requires action.

Evidence Base

Research shows:

Distraction reduces acute emotional arousal.
Incorporating sensory strategies helps regulate nervous system responses.
Regular practice increases emotional resilience.

References

Linehan, M.M. (2015). DBT Skills Training Manual, Second Edition. New York: Guilford Press.
Neacsiu, A.D., Rizvi, S.L., & Linehan, M.M. (2010). "Dialectical Behavior Therapy Skills Use as a Mediator and Outcome of Treatment for Borderline Personality Disorder." Behaviour Research and Therapy, 48(9), 832–839.

ACCEPTS – Distress Tolerance DBT Tool