Pros and Cons Skill

Definition

Pros and Cons is a Distress Tolerance skill used to carefully weigh the advantages and disadvantages of acting on an urge or choosing alternative behaviors. It helps you make thoughtful decisions when emotions are high.

Purpose

Used to:

• Delay impulsive reactions.
• Clarify potential outcomes.
• Reinforce commitment to long-term goals.
• Increase motivation to use skills instead of problem behaviors.

When to Use

Use Pros and Cons when:

• You feel an urge to engage in a harmful behavior (e.g., self-harm, substance use, lashing out).
• You are deciding whether to tolerate distress or give in to urges.
• You need clarity on the impact of choices.

When Not to Use

Avoid using this skill if:

• You are in immediate danger and must act quickly.
• You are in a situation where delaying action would create harm.
• You are too dysregulated to think clearly (use STOP first).

How-To

1. Identify the Behavior.
   What are you considering doing? Example: Self-harm, using substances, quitting a job impulsively.

2. List Pros and Cons of Acting on the Urge.

   • Short-term benefits and drawbacks.

3. List Pros and Cons of NOT Acting on the Urge.

   • Long-term benefits and drawbacks.

4. Review Your Lists.
   Read them slowly and carefully. Focus on long-term goals and values.

5. Visualize Outcomes.
   Imagine the likely consequences of each option.

6. Decide Mindfully.
   Choose the path that aligns with your Wise Mind.

Tips & Variations

• Write lists down to make them concrete.
• Use a worksheet (DBT handouts often include templates).
• Keep your list somewhere visible to remind you during crises.
• Read your lists out loud to reinforce commitment.
• Revisit your lists regularly, even when calm, to strengthen motivation.

Example

Casey wants to binge eat after a stressful day.

• Pros of Binge Eating:

  • Immediate comfort
  • Numbs feelings

• Cons of Binge Eating:

  • Guilt and shame later
  • Stomach pain
  • Undermines health goals

• Pros of NOT Binge Eating:

  • Feels empowered
  • Stays on track with self-care

• Cons of NOT Binge Eating:

  • Has to tolerate uncomfortable emotions

Decision: Tolerate distress and use self-soothing skills.

Inventor / Origin

Pros and Cons is a core Distress Tolerance skill in DBT, developed by Marsha Linehan, PhD. It is adapted from cognitive-behavioral techniques that emphasize decisional balance.

Related Skills

• STOP Skill
• Crisis Survival Strategies
• Radical Acceptance
• TIPP Skills

Limitations

May not be effective if:

• You avoid reviewing the cons of harmful behavior.
• You rush through the lists without reflection.
• You are too dysregulated to think logically.

Evidence Base

Research shows:

• Pros and Cons increases motivation to use skills over maladaptive coping.
• Strengthens commitment to behavioral change.
• Reduces impulsivity.

Further Reading

• DBT Skills Training Handouts and Worksheets by Marsha Linehan
• DBT Self-Help: Pros and Cons
• The Dialectical Behavior Therapy Skills Workbook by McKay, Wood, and Brantley
• Decisional Balance in CBT

References

• Linehan, M.M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press.
• Linehan, M.M. (2015). DBT Skills Training Manual, Second Edition. New York: Guilford Press.