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IMPROVE the moment in DBT: seven ways to make a painful stretch easier to bear

Your dad's surgery was supposed to take two hours, it's been four, and nobody at the desk can tell you anything yet. IMPROVE the moment is a set of crisis survival skills from dialectical behavior therapy (DBT) for stretches like this, when you can't change what's happening and don't want to make it worse. Each letter names a different way to make the next hour easier to bear.

Reviewed by our editors~11 min read

What IMPROVE the moment is, and when it fits

IMPROVE comes from DBT, the treatment Marsha Linehan developed. It belongs to distress tolerance, one of DBT's four skill modules, and it's the last of six sets of crisis survival skills in Linehan's teaching notes, after STOP, pros and cons, TIPP, Wise Mind ACCEPTS and self-soothing. The letters stand for Imagery, Meaning, Prayer, Relaxing actions, One thing in the moment, Vacation and Encouragement.

Linehan calls the set idiosyncratic, and it really is a mix. Some letters change how you see the situation or yourself, one works through your body, and two are about acceptance and letting go. All of them aim to make the present moment a little better, so it's easier to bear. Her notes say the skill helps most when you're overwhelmed by stress that may last a while, or when distraction and self-soothing aren't working.

Success is modest by design: if time passes and you haven't made things worse, the skill worked, even if you don't feel better. Linehan's handout rules out everyday problems, so if you could start fixing the problem now, do that instead. IMPROVE isn't a safety plan either. If you're thinking about suicide or about hurting yourself, reach out now, using the crisis contacts at the bottom of this page.

The seven IMPROVE skills, with examples

I for Imagery: picture a scene that calms you, like the dock at a lake you love, or replay a time when things went well. Linehan's notes describe building a safe room inside yourself, with furniture and locks you choose. You can also rehearse coping by picturing yourself getting through the next hour without acting on the urge. Her notes add that imagery needs practice on calm days before you can lean on it in a crisis.

M for Meaning: find a purpose in the pain, or make one, such as "I'm in this waiting room because I love him." Linehan points to Viktor Frankl's Man's Search for Meaning, his book about surviving the Nazi concentration camps. Her notes are also frank that life is sometimes unfair for reasons nobody can understand. You don't have to believe your suffering serves a purpose, and you can decide what it means to you with or without religion.

P for Prayer: this letter is optional. In Linehan's notes, the heart of prayer is opening yourself completely to the moment, which puts it close to radical acceptance. It isn't a plea for the pain to stop, and it isn't a "Why me?" either. Her handout suggests turning to God, a higher power or your own wise mind and asking for strength to bear what's happening. If you pray, use the words of your own faith. If you don't, try a quiet line like "This is what's happening, and I can stay with it."

R for Relaxing actions: do something that usually calms you down, like a hot shower, slow stretching or a warm drink. Linehan separates this from the paired muscle relaxation in TIPP, which works directly on how your body reacts to stress. Here you're widening the list of calming things you can reach for, and her notes say urges are easier to resist when you're relaxed. For structured versions, try progressive muscle relaxation or slow breathing.

O for One thing in the moment: give all your attention to what you're doing right now, like rinsing a mug or feeling your feet on the floor. Linehan treats it as another name for doing things one-mindfully, a mindfulness skill. Her notes point out that the only pain you have to survive is this moment's, and that much extra suffering comes from replaying old pain and bracing for more. In a 2010 study that sampled people's thoughts through their phones, they were usually less happy when their minds wandered.

V for Vacation: take a brief, planned break. Linehan calls it a vacation from adulthood, where you retreat for a bit or let someone take care of you. Her conditions are that it doesn't harm you and lasts anywhere from a few moments to a day at most. If people depend on you, ask someone to cover. Think of a nap with an alarm set, or a Saturday morning while a friend takes the kids. A 2022 meta-analysis found that short breaks between work tasks gave people a small lift in energy and a small drop in fatigue.

E for Encouragement: cheer yourself on and rethink the situation. Linehan's notes suggest talking to yourself the way you'd talk to someone you care about who's in a crisis, with lines like "You've gotten through nights like this before." Rethinking means answering the thoughts that say it's hopeless or will never end. In two 2014 experiments, people who used "you" or their own name instead of "I" while thinking through a stressful social task showed less distress.

IMPROVE skills examples: three made-up moments

The people below are made up. Their stories show what IMPROVE can look like in use, not how it will go for you.

A long night with a sick toddler. Chris's son has a stomach bug, his partner is on a night shift, and the nurse line has said to keep the boy sipping fluids and call back in the morning. Between cleanups, Chris tells himself, "You've done two nights like this, and you can do one more" (Encouragement). When he starts picturing a sleepless week, he brings his attention back to the warm washcloth in his hand (One thing in the moment). At 7, his partner takes over, and Chris sleeps until noon with his phone in another room (Vacation).

Bad news before a work shift. Sam's sister texts that their mom's cancer is back, ten minutes before Sam's shift at a pharmacy counter. She can't leave, and tuning out completely isn't safe at a job where mistakes matter. She takes a few slow breaths and thinks, "Getting through today is something I can do for Mom" (Meaning). At the counter, she gives each customer her full attention (One thing in the moment). On her break, she quietly says a prayer her grandmother taught her (Prayer).

A canceled flight on the way to a funeral. Rosa's connecting flight is canceled, and the next one leaves at 6 a.m., so she'll spend the night at the airport before her grandfather's funeral. She finds a quiet gate and pictures his garden in July, down to the tomato cages (Imagery). She buys tea and stretches her back against the wall (Relaxing actions). When she panics about arriving late, she tells herself, "You're doing everything you can from here" (Encouragement). She still cries some, and she still makes the flight.

Build your IMPROVE plan

Make the plan on a calm day, since a crisis is a bad time to come up with ideas. Linehan's IMPROVE worksheets build from two practices between sessions to several a day.

  1. Write one option per letter. Go through I, M, P, R, O, V and E, borrowing from the examples above or adding your own. Prayer is optional, and a quiet line about getting through counts.
  2. Build your image this week. Pick one calm scene or safe room and walk through it in detail a few times. In the 2026 study, people with more vivid imagery felt more relaxed afterward.
  3. Test your encouragement out loud. Keep the lines you'd say to a friend in the same spot, and cut any that make you wince.
  4. Put limits on the vacation. Write down how long it lasts, who covers for you and what you'll do when it ends.
  5. Match the letter to how upset you are. At a 9 out of 10, start with TIPP and save imagery and meaning for when you can think again.
  6. Practice on an ordinary bad day. Use one letter during a long line or after a tense call, and rate how well you can bear the distress before and after, on Linehan's 0 to 100 scale.
  7. Keep what helped and drop the rest. Count getting through without making things worse as a win, even if the number barely moves.

Add one last line for when IMPROVE isn't enough: the name of someone you can call, and a note that the crisis contacts are at the bottom of this page.

How IMPROVE differs from ACCEPTS, self-soothing and TIPP

Wise Mind ACCEPTS is distraction, which Linehan's notes say works by cutting down your contact with whatever set off the distress. IMPROVE works on the moment itself and on how you see it, and some of its letters keep you in contact with the painful situation. Linehan's summary puts encouragement, one thing in the moment and finding meaning in that group. Full distraction doesn't work everywhere, her notes say, such as during a work shift or a therapy session, and these letters fit there. When you need to break off a crisis response completely, ACCEPTS suits better.

Self-soothing comforts you through your senses, and it overlaps with IMPROVE's relaxing actions: a warm shower could count as either. IMPROVE adds letters that work on your thoughts, like meaning and encouragement, which self-soothing leaves alone.

TIPP changes your body chemistry fast with cold water, intense exercise, paced breathing and paired muscle relaxation, and it's meant for the peak. Much of IMPROVE takes some thinking. In a 2021 interview study of 24 people in DBT, 11 couldn't use skills that took mental effort or fine motor control when their tension ran very high. If you can't hold a picture in your mind, start with TIPP and turn to IMPROVE once you've come down a notch.

Where IMPROVE goes wrong

A vacation that turns into avoidance. Linehan's notes describe people who aren't in control of their vacations: they take them at the wrong times and stay too long. Watch for a day off that stretches into a week, or a nap that becomes your answer to every hard email. Set an end time before you start, and write down what comes next. Her notes warn that crisis skills used to dodge every painful situation turn into avoidance and leave problems unsolved.

Meaning that's forced too soon. Hunting for a silver lining while the pain is fresh can feel like one more test you're failing. In a 2006 meta-analysis of 87 studies, people who saw benefits in a hard experience reported less depression and more well-being, but also more intrusive and avoidant thoughts about it. Those studies can't show which came first. If no meaning comes, settle for a small one, like "I'm doing this for the people I love," or let the question wait.

Encouragement that rings false to you. A line that makes you wince can backfire. In two 2009 experiments, people with low self-esteem who repeated "I'm a lovable person" felt worse than those who didn't, and people with high self-esteem felt only a little better. Stick to lines about getting through, like "This is hard, and you're handling the next ten minutes." If a harsh inner voice drowns out anything kind, see our pages on the inner critic and self-compassion.

How strong the evidence is

We searched PubMed and found no study that tested IMPROVE the moment on its own. In the 2021 interview study, only 4 of the 24 people described using it, compared with 23 for ACCEPTS, 15 for self-soothing and 13 for TIPP.

Trials test DBT as a package. A 2015 trial of 99 women with borderline personality disorder who'd attempted suicide in the past year found that versions with skills training reduced self-injury and depression more than DBT without it. A 2010 analysis of 108 women linked rising skills use to fewer suicide attempts and less depression, but it averaged all the skills together. A 2015 review of 17 trials of skills training on its own called the evidence preliminary.

A few letters have research of their own outside DBT. A 2008 meta-analysis of 27 studies found that relaxation training lowered anxiety, with an effect the authors called medium to large, though these were structured programs, and longer ones worked better. In lab experiments, imagining positive events lifted mood more than thinking about them in words. In a 2026 trial, relaxation rose after people spent three minutes picturing a personal safe place, and those with more vivid imagery felt more relaxed. A 2005 meta-analysis of 49 studies linked positive forms of religious coping with better adjustment to stress and negative forms with worse.

None of this tested IMPROVE the way DBT teaches it, in a real crisis. It's reasonable to try when you need to get through a long, hard stretch without making it worse. It doesn't treat any condition, and it doesn't replace therapy.

Plan your IMPROVE skills with Helpy

The chat below runs with Helpy, the site's AI assistant. Describe a stretch that's hard to sit through, like a long wait for news or a shift after bad news. It can help you pick an option for each letter, find encouraging lines you'd believe and set limits on your break.

Evidence and sources

When improving the moment isn't enough

If you have urges to hurt yourself or thoughts of suicide, or your emotions keep reaching crisis level, IMPROVE won't be enough on its own. Standard DBT combines skills training with individual therapy, phone coaching and a consultation team for the therapists, and a doctor or therapist can help you find a program. If you're in danger right now, use the crisis contacts below.

Important

This is educational self-help content, not a substitute for professional care. If anxiety is intense, sticks around for weeks, or makes daily life hard, reach out to a mental-health professional or doctor. If you’re in crisis or thinking about suicide, get help now: call or text 988 (988 Suicide & Crisis Lifeline), text HOME to 741741 (Crisis Text Line), or call 911 for emergencies. Available 24/7.

Read next

Wise Mind ACCEPTS in DBT: seven places to put your attention until the worst of it passesDistraction on purposeThe self-soothe skill in DBT: comfort for a moment you can't fix yetComfort through the sensesDistress tolerance: the TIPP skill for getting through an unbearable momentWhen the emotion is at its peakPros and cons in DBT: four boxes to fill in before the urge hitsWeigh a crisis urge before you act

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