Urge Alternatives Plan (Teens)
A DBT-informed safety worksheet for adolescents that explores the function of self-harm urges, warning signs, safer alternatives grouped by need, supports and means restriction.
2-page fillable PDF · US Letter (prints on A4) · DBT-informed · Safety
- Approach / concern
- Teens (13-18)
- Technique
- DBT-informed · Safety
- 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 Urge Alternatives Plan (Teens)?
Self-harm often serves functions such as relieving intense emotion, ending numbness or self-punishment. Understanding the function helps young people choose safer alternatives that meet the same need. This plan is designed to be completed collaboratively with a clinician or trusted adult.
Why it works
Research identifies affect regulation as the most common function of self-injury (Klonsky, 2007). DBT for adolescents teaches distress tolerance skills as safer alternatives and includes family involvement (Rathus & Miller, 2015).
When to use it
- Adolescents with self-harm urges or behaviour
- Alongside a safety plan and risk assessment
- DBT-A and school counselling
- After an emergency visit for self-harm
How to use it in session
- Complete a risk assessment first.
- Explore the function of urges without judgement.
- Identify warning signs and matched alternatives.
- List supports and means-restriction steps.
- Review regularly and share with caregivers as agreed.
Clinician tips
- Validate the pain behind urges.
- Alternatives don’t have to be perfect, only safer.
- Always pair with a full safety plan and crisis resources.
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 self-harm the same as being suicidal?
Not always, but self-harm is a risk factor for suicide and should always be taken seriously and assessed.
Should parents be told?
Confidentiality limits depend on risk and local law. Clinicians should discuss this openly with the young person.
References
Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27(2), 226-239.
Rathus, J. H., & Miller, A. L. (2015). DBT skills manual for adolescents. Guilford Press.
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.
