> ## Documentation Index
> Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt
> Use this file to discover all available pages before exploring further.

# Emotion regulation presets — 2 worksheets

> SUDS scale 0–100 and TIPP distress tolerance skills (DBT).

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

## 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.

<Note>
  Rivet's EMDR workspace has its own integrated SUDS capture as part
  of the 8-phase protocol — see [the SUDS scale in EMDR](/emdr/the-suds-scale).
  The whiteboard SUDS preset is for non-EMDR work where you want the
  same scale on a shared canvas.
</Note>

## 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.

## Related articles

<CardGroup cols={3}>
  <Card title="Presets overview" icon="folder-tree" href="/whiteboard/presets-overview">
    All 29 worksheets.
  </Card>

  <Card title="Trauma + somatic presets" icon="waveform" href="/whiteboard/presets-trauma">
    Window of tolerance pairs with TIPP.
  </Card>

  <Card title="Mindfulness + ACT" icon="compass" href="/whiteboard/presets-mindfulness-act">
    5-4-3-2-1 grounding as a parallel distress-tolerance skill.
  </Card>
</CardGroup>