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DBT Distress-Tolerance Skill

ACCEPTS

ACCEPTS is a DBT skill that offers seven ways to temporarily shift your attention when emotions or urges are too intense to deal with effectively in the moment.

What Is ACCEPTS?

Sometimes distress becomes so intense that trying to solve the problem right away is difficult or likely to make things worse.

In those moments, temporarily directing your attention somewhere else can give the intensity time to come down.

ACCEPTS is an acronym for seven types of distraction:

  • A — Activities
  • C — Contributing
  • C — Comparisons
  • E — Emotions
  • P — Pushing Away
  • T — Thoughts
  • S — Sensations

You do not need to use all seven. Think of ACCEPTS as a menu of options you can choose from depending on what works best in that moment.

Try This Now

Pick One ACCEPTS Strategy

  1. Notice how distressed or overwhelmed you feel right now.
  2. Ask whether you need to solve the problem immediately, or whether it can wait for a short time.
  3. Choose one ACCEPTS strategy below that seems easiest to use right now.
  4. Give it your attention for about 10–15 minutes.
  5. When your attention returns to the problem, gently redirect yourself to the activity.
  6. Check in again afterward and decide what you need next.

The goal is not necessarily to make the feeling disappear. The goal may simply be to get through the most intense part of the moment without making things worse.

The ACCEPTS Skills

A — Activities

Do something that occupies your attention.

Activities work best when they require enough focus to compete with whatever your mind is currently stuck on.

Examples:

  • Take a walk
  • Clean or organize something
  • Cook or bake
  • Play a game
  • Work on a hobby
  • Read
  • Do a puzzle
  • Exercise or stretch
  • Watch something engaging
  • Take care of a small task

Ask:

“What could hold my attention for the next 10 minutes?”

C — Contributing

Shift some of your attention outward by doing something helpful, thoughtful, or kind for another person.

Examples:

  • Check in with someone
  • Do someone a favor
  • Help with a household task
  • Send an encouraging message
  • Make something for someone
  • Volunteer
  • Help a family member, friend, or neighbor

Contributing is not about ignoring your own needs or putting everyone else first.

It is simply one way of temporarily shifting attention away from your own distress.

C — Comparisons

Use comparison to create perspective.

One helpful approach is comparing the present moment with another difficult time you have already survived.

Ask:

  • Have I gotten through something like this before?
  • What helped me then?
  • Am I coping differently now than I would have in the past?
  • Is there evidence that I have handled difficult moments before?

Some versions of ACCEPTS also suggest comparing your situation with people facing greater difficulties. If that gives you useful perspective, you can use it.

If it instead creates guilt, shame, or the thought that you are “not allowed” to be upset, choose another ACCEPTS strategy.

Someone else having a difficult experience does not make your own feelings invalid.

E — Emotions

Temporarily create an emotion that is different from the one currently overwhelming you.

For example, if you are feeling very sad, you might choose something funny or uplifting.

If you are highly agitated, you might choose something calm or comforting.

Examples:

  • Watch a comedy
  • Listen to music that changes your mood
  • Watch an uplifting video
  • Look at photos that bring up positive memories
  • Read something comforting or inspiring
  • Spend time with an animal

Choose something that moves your emotional state in a useful direction rather than something likely to intensify the emotion you are already struggling with.

P — Pushing Away

Temporarily put the situation aside in your mind.

You are not pretending the problem does not exist. You are choosing not to deal with it during this particular moment.

You might imagine:

  • Putting the problem into a box
  • Placing it on a shelf
  • Closing a door between yourself and the problem
  • Writing it down and setting the paper aside

You can also tell yourself:

“I am not dealing with this right now. I can come back to it later.”

If the situation needs attention, choose a time to return to it so temporary pushing away does not turn into long-term avoidance.

T — Thoughts

Give your mind something else to think about.

This can be especially helpful when your thoughts keep returning to the same problem.

Examples:

  • Count objects around you
  • Do a crossword or number puzzle
  • Name items that begin with each letter of the alphabet
  • Read something that requires concentration
  • Play a strategy or word game
  • Plan a meal or activity
  • Describe everything you can see in detail

The goal is to give your brain another task, not to argue with the distressing thoughts.

S — Sensations

Use a noticeable but safe physical sensation to pull attention toward your body and the present moment.

Examples:

  • Hold something cool
  • Splash cool water on your face
  • Take a warm or cool shower
  • Hold an object with an interesting texture
  • Smell something strong and pleasant
  • Eat a strongly flavored mint
  • Wrap yourself in a soft blanket
  • Step outside and notice the temperature or breeze

Choose sensations that are safe for your body. The purpose is to redirect attention, not to cause pain or harm.

How Do I Choose Which One to Use?

You do not need to work through ACCEPTS in order.

Start with whatever seems easiest and most likely to hold your attention.

If Your Mind Is Racing

Try something that requires mental concentration:

  • Activities
  • Thoughts
  • Sensations
If You Feel Stuck in Yourself

Try shifting your attention outward:

  • Contributing
  • Activities
If One Emotion Is Taking Over

Try:

  • Emotions
  • Sensations
  • Activities
If You Cannot Stop Thinking About the Problem

Try:

  • Pushing Away
  • Thoughts
  • Activities

Example

Waiting for an Important Response

Imagine you are waiting for an important message and repeatedly checking your phone.

Your anxiety is high, but there is nothing useful you can do until the other person responds.

You might try:

Activities: take a walk and then make dinner.

Thoughts: work on a puzzle that requires concentration.

Pushing Away: tell yourself, “I am putting this aside for the next 30 minutes.”

Sensations: take a shower and focus on the temperature and sensation of the water.

The response may still matter when you finish. ACCEPTS simply helps you get through the waiting period without spending every minute focused on it.

When ACCEPTS Can Be Useful

  • When emotions feel overwhelming
  • During a strong urge
  • When you need time before reacting
  • When you are waiting for something you cannot control
  • When repetitive thoughts are making distress worse
  • When a problem cannot be solved immediately
  • When you need to get through a difficult period before deciding what to do
  • When another coping skill feels too difficult to use because your emotional intensity is too high

Distraction vs. Avoidance

Healthy Temporary Distraction

Healthy distraction sounds like:

“I can't deal with this effectively right now, so I'm going to take a break and come back to it.”

It has a purpose: helping you get through a period of high distress without making things worse.

Avoidance

Avoidance happens when temporary distraction turns into repeatedly refusing to deal with something that needs attention.

Ask yourself:

“Am I taking a break from this, or am I trying to make sure I never have to deal with it?”

Build Your Own ACCEPTS List

It can be difficult to think of options once distress is already high.

Consider making a short list in advance.

My ACCEPTS Menu

Write down one or two options that genuinely work for you in each category:

  • Activities: What can keep me occupied?
  • Contributing: How can I briefly help or connect with someone?
  • Comparisons: What perspective helps me?
  • Emotions: What reliably creates a different emotion?
  • Pushing Away: How can I mentally set something aside?
  • Thoughts: What can occupy my mind?
  • Sensations: What safe sensory experiences grab my attention?

Your list does not need an option for every letter. Pay attention to which approaches actually help you.

What Comes After ACCEPTS?

Once your distress becomes more manageable, check in again rather than automatically continuing to distract.

Ask:

  • Has the intensity changed?
  • Is there a problem I can solve now?
  • Is there something I need to accept?
  • Do I need to communicate with someone?
  • Do I need another coping skill?
  • Can I return to what I was doing before the distress began?

Related Skills

  • Distraction — the broader strategy of temporarily moving attention away from distress.
  • IMPROVE — another DBT distress-tolerance skill for making a difficult moment easier to get through.
  • TIPP — helping reduce intense physical and emotional arousal.
  • Urge Surfing — observing an urge without automatically acting on it.
  • Change Environment — moving away from triggers that are increasing distress.
  • Radical Acceptance — working with realities that cannot currently be changed.
  • Problem Solving — addressing the underlying problem once you are able to think clearly enough to act.

Tips for Practice

  • You do not need to use every letter of ACCEPTS.
  • Choose something that actually holds your attention.
  • Keep a few reliable options available for moments when it is difficult to think clearly.
  • Switch strategies if the first one is not helping.
  • Use Comparisons only when they give you helpful perspective rather than guilt or shame.
  • Keep Sensations noticeable but safe.
  • Remember that distraction can be successful even if the emotion does not completely disappear.
  • Return to the underlying situation later if it still needs attention.