Cimone Safilian-Hanif, PhD Profile Photo
Medically Reviewed by
Cimone Safilian-Hanif, PhD in International Psychology, on February 5, 2024


Welcome to the first DBT exercise of the Distress Tolerance module!

People often have mixed motivations when they enjoy a certain behavior that may not be good for them: "I want to give up smoking because I know it's bad for my health, but I really find it relaxing", "I know that I have anger issues which sometimes harm my relationships, but I feel kind of relieved after I expressed my anger." This exercise is all about looking more closely at the costs and benefits of a problematic behavior, but also about the costs and benefits of engaging in a healthier, alternative behavior.

Do this exercise when you are thinking about changing a problematic behavior. Cost Benefit Analysis will help you decide if this is something you actually need to change. And if you decide it needs to change, it will help you create some of the leverage you need to make it stick.

Distress Tolerance: Cost Benefit Analysis helps you decide whether a problematic behavior is worth changing
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Do this DBT exercise three times, working on different problematic behavior each time. Then use as needed

Listing the costs and benefits of engaging in a behavior that is harmful for you is a powerful tool for changing your bad habits. This technique can help you see more clearly things that you overlooked. Also, it will help you accept and make peace with the fact that there is concrete evidence for why it's bad for you to engage in the problematic behavior. This is a very good start for changing the bad habit.

Step One: Choose a Behavior

First, think of behaviors in your life that are not particularly useful to you. It can be anything. Which one of your habits would you like to change? Maybe you already tried changing them but you still haven't succeeded in that. Perhaps you want to eat healthy or work out regularly. Other common problematic behaviors may include: smoking, eating too much, spending a lot of money impulsively, spending a lot of time in front of the TV, drinking too much alcohol. It can be anything. Take a moment and think about the habits in your life that you want to change. Then pick one habit that you want to work on the most.

For this exercise, you will need to be writing things down so you will need to print out the worksheet. After you do this exercise you will want to remind yourself of the costs and benefits that you wrote down, or maybe you would want to add other costs and benefits that you may come up with later.

Step Two: Cost of Engaging in Problematic Behavior

Write down every negative consequence that results from you doing the bad habit. Take your time and brainstorm. Start with what is already obvious to you, and then try to extend your list to all the cons that you can think of. In the beginning, you might not be used to thinking about your habit in this way, but gradually you will come up with pros and cons more easily.

Step Three: Benefits of Engaging in the Problematic Behavior

Write down the reasons why you do the bad habit in the first place. We all have certain reasons for whatever problematic behavior we engage in. Usually, these "benefits" are just short-term rewards that make us feel good immediately, but in the long-term they might do us more damage than good.

Step Four: Costs of Engaging in an Alternative Behavior

It is not easy to change a habit. In this part, think of all the negative sides of changing your behavior. Changing behaviors requires effort and energy, paying close attention to what you choose to do. It is usually a stretch out of our comfort zone and it may take a while until you become comfortable with this new alternative behavior. So, think of all the costs of making the change.

Step Five: Benefits of Engaging in an Alternative Behavior

Be creative and just visualize and have fun with all the possible benefits you'll have once you change the problematic behavior. Again, start with the obvious ones, and then really think about it and extend the list with benefits that maybe you previously haven't thought of. Try not only to list the benefits so that you'll complete the exercise, but really try to imagine the feeling of these benefits! Feel how much more energy you'll have, the long-term satisfaction, and fulfillment you'll feel!

Step Six: Score Costs and Benefits

For every cost or benefit you'll write down, think about the importance that each of these reasons has for you. Write it down on a scale of 1 to 5 (5 being extremely important) after each cost or benefit. You'll find that even if you can immediately list a lot of benefits to engaging in the problematic behavior, they will probably not be as important as the costs of doing the bad habit. Then compare the points of importance. You will probably notice that the costs of engaging in the problematic behavior and the benefits of doing the alternative action are much more important.


Problematic Behavior: Eating too much junk food

Costs Benefits
  • It lacks nutrients, and my body is not being fed with healthy ingredients. (5)
  • My energy crashes after the fast food meal. (4)
  • I gain weight and I don't feel good about my appearance. (5)
  • I catch colds more often when I eat too much junk food. (4)
  • Eating fast food is addictive and sometimes I eat way too much. (3)
  • I feel guilty and like I don't have self-control or discipline. (4)
  • It tastes good. (4)
  • It's fast and I don't have to cook. (4)
  • I feel very satisfied when I eat fast food. (3)
  • When I'm not at home, it's easy to find a fast food place. (2)
  • There are many options I can choose from. (2)
  • When I feel sad or depressed, eating fast food makes me feel a little better.(3)

Alternative Behavior: Eating healthy

Costs Benefits
  • It doesn't taste as good (although I haven't tried to find good recipes). (3)
  • I have to cook more often. (3)
  • It will be difficult for me to stick to a healthy diet. (4)
  • I don't want to look pretentious when I order a healthy meal in front of my friends. (2)
  • I'll have to find another way to deal with stress. (3)
  • I'll have much more energy. (5)
  • I will be more healthy and I'll prevent some diseases. (5)
  • I will feel better because I'll lose weight. (4)
  • I won't have the usual energy crash after a big fast food meal. (4)
  • I will be in a much better mood, and it will help with my depression. (5!)
  • I will sleep bettter. (4)
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Download the worksheet and do your Cost Benefit Analysis. It is important to write it down and not just think about it. Writing down the costs and benefits will help give you leverage over yourself when changing the behavior gets hard.

DBT Distress Tolerance: Cost Benefit Analysis

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What if I still choose to do the bad habit after doing the exercise?

Changing a habit is not an easy task, it is a gradual process. It is normal if you don't immediately succeed in persuading yourself to do the healthy alternative action. It takes a daily commitment and reminders of what you want to change and why. That is why you can come back to the list, and really think about it as much as you need. Every day for one week, put time into reading the list of cost-benefit analysis for the habit you want to change. You can add new costs and benefits as well. Be persistent, and willing to work for your change!

How can I be sure that the benefits of the alternative, healthier behavior will really feel beneficial?

If you never tried the new action you want to take, it is normal that perhaps you can't imagine how you would feel and if it would be different for you. That is why you can start by trying out a new action and test it out. For example, if you are not sure that eating a healthier diet will actually make you feel better, try it for a couple of days and see how you'll feel. Be open to this new alternative and to the change.

I can't think of many benefits or costs to write down. What should I do?

If you do this exercise for the first time, it takes a little time to get used to the format and to thinking about the behavior in this way. Think about how the action that you want to change affects different aspects of your life. Also, try to think about how this problematic behavior affects your everyday life. If you are not sufficiently informed about the negative sides of a certain behavior, such as smoking, drinking too much alcohol or eating too much junk food, then you can spend a little time to do some research on the subject.

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If you have any behavioral health questions or concerns, please talk to your healthcare or mental health care provider. This article is supported by peer-reviewed research and information drawn from behavioral health societies and governmental agencies. However, it is not a substitute for professional behavioral health advice, diagnosis, or treatment.

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Comments About Cost Benefit Analysis

  1. Thanks for making all these DBT worksheets available for download. Is there a way to download them all at once?

    ADMIN – Hi Miel,

    Happy to hear you are finding the worksheets useful. Unfortunately, we don’t have them all compiled in one place, at the moment you need to download each DBT worksheet indivisually.

  2. I just want to take a moment to express my gratitude for this website as an incredible resource. I’ve been facilitating a DBT group at a long-term residential treatment facility for over two years, and this is the best site I’ve found to have easy to understand DBT skills info & worksheets.

  3. Thank you for the video and article of Distress Tolerance! This was my first attempt at DBT skills. I thought I won’t like it and was absolutely irritated at first, but I made/drew out the chart instead of printing the PDF and completed this tutorial that way and I enjoyed myself. Thank you again!

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