Pros and Cons Worksheet (DBT): Compare the Costs and Benefits of Acting on an Urge
A DBT worksheet for crisis urges: weigh the pros and cons of acting on the urge against the pros and cons of resisting it, before you decide.
Reviewed by Michael Callans, MSW 
About this tool
Pros and cons is a distress tolerance skill in dialectical behavior therapy, and the DBT version has a specific twist that makes it powerful for crisis urges. 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. Filling all four quadrants forces an honest look that a simple two-column list misses.
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). The four-quadrant format is DBT's own adaptation of the older decisional balance technique: a standard decisional balance uses two columns for a single choice, while the DBT version splits each side into pros and cons of the action and pros and cons of not taking it, which is what makes it useful in a crisis rather than for an everyday decision.
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. If you are in immediate danger in the US, call or text 988.
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.
Cite this source
Psychology.com. (2026, September 14). 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.
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.
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.
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.
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.