Pros and Cons Worksheet (DBT): Compare the Costs and Benefits of Acting on an Urge
A DBT pros and cons worksheet helps you compare acting on a strong urge with resisting it. Write down immediate and longer-term consequences, then choose a safer next action.
Reviewed by Michael Callans, MSW 
About this tool
A DBT pros and cons worksheet is a distress tolerance exercise for deciding how to respond to a strong urge. It helps you compare immediate relief with the consequences of acting or resisting before choosing what to do next. Instead of two columns, you fill in four: the pros and cons of acting on the urge, and the pros and cons of resisting it and tolerating the distress instead. Completing each area includes the uncomfortable parts of resisting as well as the reasons to wait.
The reason this matters is that in the heat of a crisis, the short-term relief of acting on an urge looms huge while the long-term costs fade from view. Whether the urge is to use a substance, self-harm, quit, lash out, or escape, the mind in crisis mode tends to see only the immediate payoff. Writing out the cons of acting and the pros of resisting brings the longer view back into the room when you most need it.
This skill works best when you complete it ahead of time, while calm, for an urge you know tends to show up. Then, when the urge hits, you have your own reasoning ready to read rather than trying to think clearly through a flood of emotion. Many people keep their completed pros and cons saved on their phone for exactly that moment.
This exercise comes from Marsha Linehan's dialectical behavior therapy skills training, where it is taught as part of the distress tolerance module alongside skills such as TIPP and radical acceptance (Linehan, 2015). Linehan's handout compares the consequences of acting on crisis urges with the consequences of resisting them. Decisional balance worksheets can also examine benefits and costs on both sides of a change; their layout varies. Here, the defining focus is a specific urge and a response that protects your safety and longer-term goals. The format alone does not make the worksheet a treatment.
The most common mistake is filling in only three of the four boxes, usually skipping the cons of resisting because they feel like giving ground. Leave that box in. Naming that resisting is genuinely hard, not just virtuous, is part of what makes the finished worksheet trustworthy enough to read again when the urge returns.
If crisis urges are frequent, involve self-harm, or feel unsafe to manage alone, this worksheet is not a substitute for treatment. A DBT-trained therapist, findable through Psychology.com's therapist directory, can teach the complete distress tolerance skill set and help build a personalized crisis plan. For immediate crisis support in the US, call or text 988. If there is immediate physical danger or a medical emergency, contact emergency services.
For example, imagine wanting to send an insulting reply after a tense conversation. Acting might briefly release anger, while creating a message you cannot take back. Waiting may preserve the chance to explain your concern clearly, while leaving you frustrated for now. Your final action could be to put down the phone, write an unsent draft, and return to the conversation when you can state your request respectfully. These are possible consequences to consider, not predictions about another person.
The completed sheet has no pass mark or diagnostic score. A long list of minor benefits does not outweigh a serious risk simply because it contains more entries. Mark which consequences matter most to your safety and values, and distinguish what is likely from what is merely possible. If you keep rewriting the same list without reaching a useful next action, pause and discuss the stuck point with someone who can support you.
The DBT Skills Library offers other ways to respond when distress makes decision-making difficult. Use a Cope Ahead Plan to rehearse the response you choose here. A BPD Test is only a screening aid if you have broader concerns about recurring emotional or relationship patterns; needing help with an urge does not establish that you have borderline personality disorder.
The Urge Surfing Worksheet offers a related practice for noticing how an urge feels while delaying a response. If you use it alongside your pros and cons, keep your chosen action visible so reflection leads to a concrete step. You can bring both completed exercises to a therapy appointment to discuss what was difficult to put into practice.
References
- Linehan MM. DBT Skills Training Manual. 2nd ed. Guilford Press; 2015.
- Linehan MM. DBT Skills Training Handouts and Worksheets. 2nd ed. Guilford Press; 2015.
- Linehan, M. M. (2015). DBT Skills Training Handouts and Worksheets. Distress tolerance handouts and worksheets. Guilford Press. https://www.guilford.com/add/linehan6_old/lin-c-4.pdf?t=1
- 988 Suicide & Crisis Lifeline. What to Expect. https://988lifeline.org/get-help/what-to-expect/
Cite this source
Psychology.com. (2026, September 16). Pros and Cons Worksheet (DBT). Psychology.com. https://psychology.com/tools/pros-and-cons
Pros and Cons Worksheet (DBT) FAQ
How is the DBT pros and cons different from a normal list?
It uses four quadrants instead of two: the pros and cons of acting on the urge, and the pros and cons of resisting it. Filling all four, including the pros of acting and cons of resisting, gives a more honest picture for crisis urges. The aim is to compare meaningful consequences rather than declare a winner by counting entries.
When should I use this skill?
When a strong urge tempts you toward something you might regret, such as substance use, self-harm, or an impulsive action. It is most effective when completed ahead of time and reviewed during the urge. Keep the wording specific to the behavior you want to change. If you cannot stay safe, seek immediate support instead of waiting to finish the worksheet.
Why fill in the pros of acting on the urge?
Because being honest about the short-term payoff is what makes the exercise believable. Ignoring it would make the list feel false. Seeing it next to the long-term costs is what tips the balance toward a wiser choice. Recognizing relief does not endorse a harmful action. It identifies a need you can try to meet in a safer way.
Is my information saved?
No. Everything stays in your browser. Your entries are never uploaded or stored, and the PDF is generated on your own device.
Does the DBT pros and cons worksheet work for anxiety, not just crisis urges?
Yes, though it was designed for crisis urges. The same four-quadrant structure can weigh the pros and cons of avoiding an anxiety-provoking situation against the pros and cons of facing it. For everyday anxious avoidance rather than a crisis, a cost-benefit analysis worksheet or an exposure hierarchy may fit the decision better. Facing a situation should never mean remaining in actual danger or ignoring a safety concern.
How often should I use this worksheet?
There is no fixed schedule. Use it any time a strong urge appears, and consider filling one out in advance for urges that recur, such as a specific craving or a self-harm trigger, so it is ready to read during the next crisis instead of written from scratch under pressure.