Aims of this module
Using counseling conversations and structured exercises, these practice elements provide a variety of different opportunities in which young people can learn:

  • That painful events, memories and thoughts are universal experiences and cannot be avoided
  • That there are different levels of painful responses to negative events: the first level is a natural unavoidable response (we can call this pain) while the second level is created and exacerbated by unproductive responses (we can call this suffering)
  • That accepting the reality and inevitability of painful events helps to reduce unproductive responses
  • Techniques for promoting acceptance of painful events
  • Techniques for distracting attention from overwhelmingly painful feelings so that there is more time and space available to plan productive coping responses
  • Techniques for self-soothing and relaxation

When should this module be used?

The following conditions are provided as examples of situations in which the Distress Tolerance module is likely to be of benefit for clients. This list is not exhaustive. The potential benefits of this module should be discussed with the client and their agreement obtained.

  • Persistent suicidality, substance abuse, or other self-harming behaviours aimed at coping with overwhelming painful emotions are among the presenting issues or have been identified as problem issues in assessment.
  • One or more of the client’s primary goals involves coping better with painful feelings such as self-hatred, guilt, or anger.
  • Behavioural responses to painful feelings are interfering with progress towards another primary goal.
  • Functional analysis of substance use identifies overwhelming emotions or very painful feelings as a frequent trigger for substance use.
  • Functional analysis of self-harming behaviours identifies overwhelming emotions or very painful feelings as a frequent trigger for these behaviours.
  • Functional analysis of violent behaviours towards other persons or property identifies overwhelming emotions or very painful feelings as a frequent trigger for these behaviours.