TIPP Skills Telehealth Slides
DBT Distress Tolerance
Telehealth Skill Session
Crisis Survival Skills
The Emergency Brake:
T.I.P.P. Skills for Teens
How to hack your nervous system and drop high-voltage emotions fast.
Session Goal: Learn 4 body-based reset tools
Dialectical Behavior Therapy
01
Session Check-In & SUDS Meter
Where is your battery at right now?
0-30
Green Zone
Calm, grounded, able to focus, Wise Mind is fully online.
Status: Ready to learn
40-65
Yellow Zone
Agitated, restless, overthinking, feeling stressed or irritable.
Status: Need self-soothe
70-100
Red Zone
Fight/flight/freeze, panic, intense anger, feeling overwhelmed.
Status: TIPP Emergency Zone!
Quick Chat Prompt: What number is your distress level right now from 0 to 100?
02
Why TIPP? The Body-Brain Loop
Biology before Psychology
When Distress is 70+
- • Your amygdala hijacks the prefrontal cortex.
- • Logic, talking, and reasoning stop working.
- • Heart rate spikes, muscles tighten, breathing gets shallow.
How TIPP Solves It
- • Changes your body chemistry first.
- • Activates the parasympathetic brake.
- • Buys you time so you don't make things worse.
Key Rule: When emotions are flaming hot, change your body first, then your thoughts.
03
T — Temperature (Cold Water Reset)
The Mammalian Dive Reflex
How To Do It
Method 1: Dip your face in a bowl of cold water (or hold an ice pack wrapped in a cloth around eyes/cheeks).
Method 2: Hold your breath for 15-30 seconds while bending forward slightly.
Method 3: Hold ice cubes in both palms or splash cold water on your neck.
What Happens In The Body
Cold receptors around your temples and upper cheeks signal the brain that you are underwater.
⚡ Automatically forces heart rate to drop by 10-25 bpm within seconds!
Caution: If you have a heart condition or eating disorder, consult your doctor before extreme cold shock.
04
I — Intense Exercise (Burn the Surge)
20-60 Seconds of High Energy
Jumping Jacks
Do 30 rapid jumping jacks or high knees in your room.
Stair Sprint
Sprint up and down the stairs or run in place fast.
Wall Sits & Pushups
Burn muscle adrenaline with wall sits or fast pushups.
Why it works: Adrenaline & cortisol demand physical discharge. Give your body the release it needs! Duration: Just 1-3 mins
05
P — Paced Breathing (Vagus Nerve Hack)
Long Exhale = Slow Heart
The 4-in, 6-out Formula
1. Inhale deeply through your nose into belly for 4 seconds.
2. Exhale slowly out your mouth like blowing through a straw for 6-7 seconds.
3. Keep exhaling longer than your inhaling for 5 continuous cycles.
Live Practice
Let's do 3 cycles right now on video:
• Breathe in (1... 2... 3... 4)
• Breathe out slowly (1... 2... 3... 4... 5... 6)
Notice your shoulders dropping down from your ears.
The Science: Exhaling stimulates the vagus nerve, sending an immediate signal to your heart to decelerate.
06
P — Paired Muscle Relaxation (PMR)
Tension vs. Release
1
Hands & Arms
Make tight fists and squeeze forearms hard for 5 seconds as you inhale.
2
Shoulders & Face
Scrunch face, clench jaw, and pull shoulders up to your ears for 5 seconds.
3
Release & Pair
Release completely while exhaling, saying the word "Relax" silently.
By pairing the release with the cue word "Relax", your brain learns to trigger relaxation on command.
07
Scenario: The Group Chat Drama
Distress Level: 85
The Trigger
You open your phone and see screenshots of someone talking behind your back in a group chat. Your face gets hot, stomach drops, and you want to type an angry rant immediately.
The TIPP Response
1. Step away: Put phone face down across the room.
2. Temperature: Grab an ice pack or splash cold water on face.
3. Paced Breathing: 5 cycles of 4-second in, 7-second out.
4. Result: SUDS drops from 85 to 45. Ready for Wise Mind!
Remember: TIPP doesn't solve the drama—it stops you from sending a text you'll regret.
08
Your Personal TIPP Gameplan
Takeaway & Wrap-Up
T
Temperature
Ice pack in freezer / cold water bowl
I
Intense Exercise
30 jumping jacks or stair sprint
P
Paced Breath
4 sec inhale, 7 sec long exhale
P
Paired PMR
Tense hands & shoulders, say "Relax"
Between-Session Experiment: Test 1 TIPP skill this week when your SUDS hits 60+
Great work today!