Thoughts at the end of the day are only thoughts. Thoughts can be added to the mind to create distraction. Doing something intricate to cultivate thoughts related to the effective activity being done. An example could be playing I spy with paintings or nature. 

Eastern Michigan University

The purpose of this skill is to help patients distract themselves from harmful urges using multiple domains. The skill includes the following:

A- Activities

C- Contributing

C- Comparisons

E- Emotions

P- Pushing Away

T- Thoughts

S- Sensations


ACCEPTS Skill in Crisis Survival Skills Within Distress Tolerance of Dialectical Behavior Therapy

Linehan, M. M. (2015). DBT Skills Training Manual (2nd ed.). The Guilford Press. https://survivingcptsd.files.wordpress.com/2018/01/dbt_skills_training_handouts_and_worksheets_-_linehan_marsha_srg_.pdf
- The manual has 3 modules: distress tolerance, emotion regulation, and interpersonal effectiveness. Each module has handouts, which are essentially the lesson plans with descriptions and teachings of the skill. 

DBT Skills Training Manual

When patients are in crisis, the ACCEPTS skill tells them to compare their current state to a time when they were better. Remembering that it is possible for them to be in a better state gives them hope that they can get through this crisis. Additionally, sometimes looking at the less fortunate shows that patients are blessed and that they can get through this obstacle. This skill is about teaching patients gratitude to what they have and bringing hope into their lives. 

ACCEPTS Skill: C-Comparisons

When patients are not feeling well, they can try to help others. It will make the patients feel good about themselves. The goal is to do an act of kindness to the people around and in the community. This could be volunteer work, making something nice for someone else, or checking up on someone living alone. Sometimes when patients help others in times of need 
that can lead to the patients finding solutions to their own problems. 

ACCEPTS Skill: C-Contributing 

Patients would find any type of activity they enjoy. This could be watching TV, playing video games or sports, going out with a friend, and doing puzzles. The list of things is infinite. The goal is to occupy themselves during distressing moments to avoid giving in to the urges.

ACCEPTS Skill: A-Activities

In order for patients change unwanted emotions, they have to do something that will elicit a pleasant emotion or opposite emotion from the one they are currently feeling. Examples could be watching a comedy show or scary movie, listening to upbeat music or inspirational music. The idea is to bring an alternative emotion that will combat the negative one.

ACCEPTS Skill: E-Emotion

In order for the patients to keep themselves safe and others safe, sometimes it is good to teach the patients to push away the upsetting situation mentally (the idea is to push it away for a short period of time until the patient are ready to deal with the situation). The patients are told to Imagine putting the pain in a box and dropping that box in the ocean. Mentally detach themselves from the painful emotions and the situation that is causing the pain.

ACCEPTS Skill: P-Pushing Away

ACCEPTS Skill: T-Thoughts

It is eliciting different sensations in the body. This could be showering with cold water, feeling different textures, listening to loud music, or playing with slime. Stimulate the five senses and give each sense a new experience. 

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