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TIPP is a distress tolerance skill from DBT, which is an evidence-based treatment that focuses on learning how to cope with change and distressing situations. Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation (TIPP) are distress tolerance skills based on the idea that a calm physical body helps create a sound mind. TIPP skills are usually recommended alongside other treatments.

The DBT TIPP skills PDF handout is used to de-escalate a distressing situation. This learning material can be used to calm down physically and mentally by helping you regulate your breathing and relaxing your muscles.

Each exercise helps to reduce physical and emotional distress quickly and effectively. Kids and teens can use this handout to help them increase mindfulness and emotional regulation during stressful situations. Caring adults and mental health professionals can use this to assist kids and teens to build their distress tolerance and resilience.

The DBT coping statements handout can be used alongside the TIPP handout to help kids, teens, and young adults to accept reality, feel better, and handle the situation well. This handout can be paired with our DBT TIPP skills worksheet.

*This item is an instant digital download. A link to download your files will be emailed to you once payment is confirmed.

Want more resources like this? Check out our full catalog of DBT worksheets and handouts.


  1. Linehan, M. M. (2014). DBT skills training handouts and worksheets. Guilford Publications.
  2. McClellan, J. (2023). Dialectical Behavioral Therapy. DOI: https://doi.org/10.1016/j.jaac.2023.07.823
  3. McIvor, L., & Atnas, C. (2022, July). Reflections on developing a group intervention within a Home Treatment Team. In Clinical Psychology Forum (Vol. 355, p. 23).
  4. Mock, A.A., Saito, E. McGee, M., Wolosyzn, P., Venuti, M. (2019). Efficacy of dialectical behavior therapy versus treatment as usual for acute-care inpatient adolescents. P149-156. DOI:https://doi.org/10.1016/j.jaac.2019.01.020
  5. Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2014). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy (DBT). Research on Social Work Practice, 24(2), 213-223
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