Subjective Units of Distress Scale (SUDS) Worksheet: A Simple Tool for Measuring Emotions

It’s hard to fix a problem when you can’t measure it, and the same goes for managing your emotions. Sometimes, answering the question, “What’s wrong?” can feel impossible for a child to answer. That’s where our Subjective Units of Distress Scale worksheet can come in handy.

SUDS is like an alternative feelings thermometer that kids can use to express the intensity of their emotions at any time. Using this scale can remove the guesswork out of emotional check-ins and get your child back to stability.

This quick article will explore SUDS in detail and explore a helpful worksheet you can use to help your child express themselves more effectively.

Subjective Units of Distress Scale (SUDS)

The Subjective Units of Distress Scale (SUDS) is a subjective tool that measures the intensity of social anxiety. The scale ranges from 0 to 100, and can help therapists adjust treatment for their patients.

South African behaviorist Joseph Wolpe developed the scale in 1969 as a way to treat phobias and other anxiety disorders [*]. It has since become a mainstay in cognitive-behavioral treatments, including the following:

• Exposure therapy: SUDS is an effective tool for determining someone’s response to a certain phobia. During exposure therapy, clients can use SUDS to track how their anxiety peaks and falls. Therapists use it to gauge a client’s tolerance for exposure and whether to intensify the trigger or remove it [*].
• Specialized trauma therapy: SUDS is an effective tool for establishing someone’s baseline when they are about to undergo specialized therapy, such as Eye Movement Desensitization and Reprocessing (EMDR) [*].

While the intensity of emotions on the scale may vary from person to person, its effectiveness lies in internal consistency. That means you can create benchmarks for your own progress. Therapists can also use SUDS to determine how well a certain coping skill is working for their client.

How SUDS Helps Identify Emotional Intensity

SUDS is a subjective scale, and it helps therapists understand their patients’ state of mind. The therapists themselves don’t set the scale, though it may look something like this:

• 0: Completely calm
• 10: No distress, still aware and focused
• 20: Slight distress
• 30: More upset but able to function
• 40: Upset with mild anxiety
• 50: More upset but still functional
• 60: Moderate to strong level of discomfort
• 70: Highly upset, discomfort is disrupting functionality
• 80: Beginning to panic, somatic symptoms beginning, discomfort is high
• 90: Extremely anxious, barely able to function, somatic symptoms are intense
• 100: Extremely upset, unable to function, on the verge of a complete meltdown

SUDS is an effective method of identifying your emotional intensity, as it simplifies feelings that may sometimes be hard to articulate. It’s helpful to therapists who need to track how social anxiety affects an individual and whether there is any improvement over a period of time.

SUDS can also help therapists recognize irrational thoughts and reactions in their patients, which can help them tailor their approach.

Subjective Units of Distress Scale Worksheet

Using SUDS is especially effective for children who may not have the vocabulary to articulate their emotions. Our Subjective Units of Distress Scale worksheet is a good starting point for children who are just learning to communicate the intensity of their feelings.

It asks children to rate the intensity of their feelings on a scale of 0 to 10 or 0 to 100. It features two corresponding tables—one to describe how they feel in words and the other to list coping skills that may help.

Here’s an example of how you can use this worksheet with your child:

1. Ask your child to describe how they feel according to the scale. For example, for 0 to 1, they may list words like “calm” or “relaxed.” As they move toward the top of the scale, they might use words like “angry” or “anxious.” Encourage them to also describe what they feel physically. For instance, under 10, they might describe feeling tightness in their chest or an ache in their stomach.
2. For each number, brainstorm coping skills your child can use to calm down. For example, if they are starting to feel anxious at level 4, they might use a calming mantra or affirmation to keep themselves grounded. If they are becoming paralyzed with anxiety by level 9, the most effective way of coping may be to seek the help of a trusted adult.
3. Encourage your child to use this worksheet when they need to express their emotions and need a bit of help coping.

If your child is new to the concept of SUDS, our Subjective Units of Distress Scale handout offers a comprehensive starting point for explaining what it is and how to use it.

This handout already assigns feelings and coping skills to each level, which can be helpful for kids who are just learning to understand their emotions.

Summary

Instead of constantly trying to find the words to express how they feel, children can use SUDS as a simple tool for gauging their emotions. Being in tune with their emotions helps children identify triggers and recognize when a coping strategy is working (or not).

Encourage your child to talk more about what they’re feeling with a little help from our feelings worksheets.

Sources:

1. Mattera E, Zaboski B. “Rethinking the Subjective Units of Distress Scale: Validity and Clinical Utility of the SUDS.” Clinics and Practice, 2025.
2. Benjamin CL, O’Neil KA, Crawley SA, Beidas RS, Coles M, Kendall PC. “Patterns and Predictors of Subjective Units of Distress in Anxious Youth.” Behavioural and Cognitive Psychotherapy, 2010.
3. Kim D, Bae H, Park YC. “Validity of the Subjective Units of Disturbance Scale in EMDR.” Journal of EMDR Practice and Research, 2008.