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Two worksheets for tracking distress and intervening when it’s high. One measures, one acts.

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SUDS scale (0–100)

The Subjective Units of Distress scale, drawn vertically. A purple bar runs top to bottom with five anchor points:
  • 0 — neutral / no distress
  • 25 — mild / noticeable
  • 50 — moderate / hard to ignore
  • 75 — severe / strongly impacting
  • 100 — worst imaginable
Each anchor has its label written alongside, so the scale isn’t just numbers — it’s numbers with clinical reference points the client can calibrate to. Use it for: any clinical moment where you want to track distress intensity over time — EMDR sets (the SUDS rating is part of the 8-phase protocol), exposure hierarchies, in-session work where you’re checking “where are you right now?” periodically. The most common pattern: drop the SUDS, ask the client where they are, write their number on the scale or alongside it, repeat the check every few minutes. The change over time is often the clearest signal of whether the work is doing what you want.
Rivet’s EMDR workspace has its own integrated SUDS capture as part of the 8-phase protocol — see the SUDS scale in EMDR. The whiteboard SUDS preset is for non-EMDR work where you want the same scale on a shared canvas.

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TIPP — distress tolerance (DBT)

Four rows, one per skill in Marsha Linehan’s TIPP crisis-survival module:
  • Temperature — cold water on face, ice on wrists, 30+ seconds
  • Intense exercise — 5-10 min hard cardio, jumping jacks, sprint
  • Paced breathing — exhale longer than inhale, 4 in / 6 out, 2 min
  • Paired muscle relaxation — tense + release each muscle group, top to toe
Each row has the skill name in bold and the specific protocol in plain text alongside. Use it for: psychoeducation on DBT crisis-survival skills, especially with clients new to DBT or clients in distress-tolerance work who need a reference they can pull up between sessions. The protocols are specific on purpose — vague instructions like “do some deep breathing” don’t help in a real crisis; “exhale longer than inhale, 4 in / 6 out, 2 minutes” does. Drop the preset, walk through each one, and ask the client to mark the one they’re most likely to actually use when the moment comes. Export to PDF so they have the reference card.

Presets overview

All 29 worksheets.

Trauma + somatic presets

Window of tolerance pairs with TIPP.

Mindfulness + ACT

5-4-3-2-1 grounding as a parallel distress-tolerance skill.