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Subjective Units Of Distress Scale (SUDS)

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The SUDs Rating Scale, or Subjective Units of Distress Scale is a self-assessment tool widely used in therapy. It is designed for clients to subjectively rate the intensity of their emotional states, such as anxiety, anger, agitation, stress, and other painful feelings.

The Subjective Units Of Distress Scale (SUDS) handout asks clients to reflect on their current emotional state and choose a number from the scale ranging from 0 to 10. A higher number indicates increased distress while a lower number indicates minimal distress. This version of the SUDS has a column that displays possible DBT distress tolerance skills that can be used at each level of distress. Based on the client’s rating, they can be guided to use a specific distress tolerance skill.

For kids and teens, this handout can be an effective tool for clearly communicating their distress levels to caring adults. Feel free to incorporate this in various settings, such as during therapy sessions, group counseling in schools, or support groups. Regardless of the environment, remember to communicate respect and understanding of the child’s personal experiences.

This handout pairs well with our Subjective Units Of Distress Scale Worksheet, which allows individuals to apply the scale to their own personal experience.

*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. Kiyimba, N., & O’Reilly, M. (2017). The clinical use of Subjective Units of Distress scales (SUDs) in child mental health assessments: a thematic evaluation. Journal of Mental Health, 29(4), 418–423. https://doi.org/10.1080/09638237.2017.1340616
  2. Wolpe, J. (1969). Subjective units of distress scale [Dataset]. In PsycTESTS Dataset. https://doi.org/10.1037/t05183-000
  • Instant digital download
  • File: PDF
  • Size: 8.5" x 11"

Customer Reviews

Based on 1 review
Lexi P.
SUDs Scale

Its works really well for clients who have a hard time explaining how they feel or cant find the words to explain in the moment.

Hi Lexi, thank you for your positive review of our SUDS Handout! We're glad to hear that it's been helpful for your clients. Wishing you all the best in your practice, keep up the great work!