STOP Skill Practice Card
A one-page DBT distress tolerance worksheet that teaches the four steps of the STOP skill and includes a fillable log so clients can track when they used it and what happened.
2-page fillable PDF · US Letter (prints on A4) · Distress tolerance
- Approach / concern
- DBT
- Technique
- Distress tolerance
- Format
- Fillable PDF, 2 pages (US Letter / A4)
- Access
- Pro and Advanced plans (3-day free trial)
- For
- Licensed clinicians to use with clients
- Updated
- October 2026
Key facts
What is the STOP Skill Practice Card?
STOP is a crisis survival skill from Dialectical Behaviour Therapy (DBT), developed by Marsha Linehan. It is designed for moments when emotions are high and the urge to act impulsively is strong. The four steps (Stop, Take a step back, Observe, Proceed mindfully) build a pause between trigger and reaction so that wise mind has time to come online.
Why it works
DBT skills training has been shown to reduce emotion dysregulation, self-harm and impulsive behaviour across many populations (Valentine et al., 2015). STOP is quick to learn and easy to remember, so it is one of the first skills many clients actually use in real situations.
When to use it
- Emotion dysregulation and anger outbursts
- Urges to self-harm, use substances, or binge
- Interpersonal conflict and reactive texting
- Teens learning impulse control
- Any client in DBT skills group
How to use it in session
- Teach the four steps using a recent example where the client acted on an urge.
- Role-play the steps in session, slowing down at ‘Observe’.
- Help the client identify early warning signs so they can catch the urge sooner.
- Assign the log for the week and review successes and near-misses.
- Pair with TIPP or paced breathing for higher-intensity moments.
Clinician tips
- Encourage clients to keep a photo of the card on their phone lock screen.
- Celebrate partial use: stopping for even five seconds is progress.
- Use ‘Observe’ to slow down judgement. Describe facts, not interpretations.
- For very high arousal (8+/10), body-based skills may need to come first.
Worked example
Sharing with clients
Members can download the PDF to print or email, or copy a private client link from the download box. Your client opens the link and downloads the worksheet on any device. No client account is needed, and nothing your client writes is stored on TherapyAid.
Frequently asked questions
Is STOP only for people with BPD?
No. While DBT was developed for borderline personality disorder, its skills are now widely used for anyone who struggles with intense emotions or impulsivity.
How is STOP different from TIPP?
STOP is a cognitive and behavioural pause. TIPP uses the body (temperature, intense exercise, paced breathing, paired muscle relaxation) to bring down very high arousal quickly.
References
Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.
Linehan, M. M. (2015). DBT skills training handouts and worksheets (2nd ed.). Guilford Press.
Valentine, S. E., Bankoff, S. M., Poulin, R. M., Reidler, E. B., & Pantalone, D. W. (2015). The use of dialectical behavior therapy skills training as stand-alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology, 71(1), 1-20.
This worksheet is an educational tool for use by, or under the guidance of, a licensed or registered mental-health professional. It is not a diagnostic instrument or a substitute for clinical judgement. If a client is in crisis in Canada, call or text 9-8-8 or call 9-1-1.
