Craving Spike Skills Card: A Free DBT Distress-Tolerance Handout
Behavioural Addiction · DBT · Clinical consensus
A pocket-sized DBT distress-tolerance card — TIPP, a short urge-surfing sequence, and distraction or opposite-action ideas — built for the sharpest few minutes of craving when a phone is physically out of reach, such as during a school phone-ban period.
Underlying mechanism: TIPP Distress Tolerance
What it helps with
- Getting through the most intense minute or two of a craving spike without needing the phone back.
- Giving a client something physical to do with their hands and body when the urge itself feels unbearable.
- Building a pre-committed plan for the specific moments a client already knows will be hardest.
How clinicians use it
- Rehearse at least one full TIPP sequence in session — paced breathing and paired muscle relaxation are the two elements most feasible in a school setting.
- Ask the client to pre-commit to a specific skill for their two or three most likely high-craving moments in the coming week.
- Suggest carrying the card physically, since a craving spike is a poor moment to be searching an app for the skill.
Introducing the Card
- Rehearse one full sequence together in session so the first real use is not also the first attempt.
- Name the two or three moments in the coming week most likely to spike, and pre-commit to a skill for each.
- Frame the 90-second recheck as the point of the exercise — the aim is to notice the number drop, not to eliminate the urge.
What the worksheet looks like
| Skill | What to do | When to use it |
|---|---|---|
| Temperature | Cold water on the face or wrists for 30 seconds | The very first spike of an intense craving |
| Paced breathing | Out-breath longer than in-breath, for one minute | Any craving, any time — the most portable skill |
| Paired muscle relaxation | Tense then release one muscle group at a time | When restlessness is the main feeling |
| Check again in 90 seconds | Rate the urge 0-10 again before deciding anything | After using any of the above |
Clinical cautions
Intense-exercise and temperature elements should be adapted for any relevant physical health conditions (e.g. cardiac issues, cold-sensitivity conditions) before assigning.
References
- Marlatt, G. A., & Gordon, J. R. (1985). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. Guilford Press.
- Linehan, M. M. (2014). DBT Skills Training Manual (2nd ed.). Guilford Press.
Part of
Screen Craving in the Phone-Ban Era
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