Understanding Crisis and Safety through DBT Lens

May 13th, 2024
What a crisis looks like: 
In DBT you’re considered in crisis when your level of feeling distressed is a score of 70/100 or 7/10 or higher. Likely to be in a crisis when there are urges to engage in self-destructive behaviors. 
Signs of a crisis: 
1. Unable to complete daily tasks like getting dressed, brushing teeth, bathing, etc
2. Intrusive thoughts or actions of self-harm or suicide 
3. Isolation from school, work, family, and friends
4. Increased agitation, risk-taking/out of control behavior
5. Abusive behavior to yourself or someone else
6. Having dramatic shifts in mood, sleeping or eating patterns
7. Loss of touch with reality, paranoia
What to do in a crisis: 
1. Use TIPP to being distress down (TIPP is described in the blog about vulnerability)
2. After TIPP use other distress tolerance skills
3. Reach out to someone supportive and let them know you’re not doing well
4. Follow a safety plan created with an adult, therapist, doctor, or friend
5. Contact services that can help you immediately: dial 988, text “home” to 741-741, contact the University of Utah Warm Line, head to the local emergency room. 
suds thermometer
Create your own Coping Toolbox: 
A distress toolbox is essentially a box filled with items and notes of coping strategies to help you regulate and express your emotions in a more connected way. It can be good to have one at home and one for on the go. 
What to use as a toolbox: shoebox, food container, plastic tub, basket, cloth or plastic pouch. 
Ideas for each of the 5 senses: 
Touch – smooth rick or worry stone; fidget spinner or cube; stress ball; fluffy stuffed animal; massage roller; soft or weighted blanket
Smells – candle or candle melts; lavender scented items; essential oils; air freshener; container of lotion or sunscreen
Sound – music playlist; meditation chimes; recorded affirmations; white noise
Sight – coloring book; a sand garden; photos of loved ones or pets; soothing images of nature
Taste – chewing gum; hard candy; sour candy; chocolate; tea
A way to self soothe with the five senses – 
self soothe with the 5 senses