PLEASE Skill Worksheet for Therapists (Free PDF)

Authored by Dr. Hannah Lin, counseling psychologist trained in CBT, ACT, and IFS, with over a decade of clinical practice across anxiety and complex trauma.

Get the full DBT pack: This PLEASE skill worksheet is one of the original rehearsal sheets in the DBT skills worksheet pack. The pack is a companion resource, not a reproduced third-party handout or a substitute for DBT training.

A PLEASE skill worksheet gives a clinician and client one week of observations a smaller job. This PLEASE skill worksheet is not a wellness scorecard, a meal plan, a sleep prescription, a sobriety contract, or a crisis response form. The page asks: what physical-vulnerability factor needs attention, what did we notice, and what is one target we can review without turning the body into a grade?

In Dialectical Behavior Therapy, PLEASE names five physical factors: treat physical illness, balance eating, avoid mood-altering substances, balance sleep, and get exercise. The skill sits inside emotion-regulation work. This page translates that frame into an original clinician-assigned record. It does not reproduce a published manual or third-party worksheet.

The right assignment is modest: choose one target, observe a week, and bring the record back. A client may write, dictate, draw, use a brief code, or pass. Completion is not proof of motivation. A blank line is information about the fit of the assignment, privacy, health, or the week. Keep the PLEASE skill worksheet narrow enough to review rather than turning it into a total-health audit.

Educational content for licensed clinicians, not clinical, medical, legal, or emergency advice. This worksheet does not diagnose, prescribe, monitor risk, or replace medical care, substance-use treatment, an eating-disorder team, a safety plan, or crisis protocol.

What PLEASE is for

PLEASE is a physical-vulnerability lens. It can help a therapist and client notice whether illness, irregular nourishment, mood-altering substances, disrupted sleep, or movement patterns are part of the context around an emotional episode. It does not claim that any one factor caused the episode or that changing a factor will resolve a diagnosis.

Use it when the clinical question is concrete and collaborative:

• “What body or routine factor might be adding load this week?”
• “Which one change would be safe and realistic to observe?”
• “What would we want to review next session?”

Do not use it to prove that a client is noncompliant, to assign a moral value to food or rest, or to make the client responsible for symptoms that need medical or specialized care.

The TIPP skill worksheet has a different job: acute distress-tolerance rehearsal. The DBT worksheets pack hub covers the other shared-pack spokes. Keep those jobs separate.

The five fields

Field	What the client may notice	Clinician guardrail
Physical illness	Symptoms, appointments, pain, medication questions, or a health task already in care	Do not diagnose or change medication from this page. Coordinate with the appropriate medical provider.
Eating	Timing, access, appetite, restriction pressure, or energy patterns without calorie or weight scoring	Avoid prescriptive food rules. Screen for eating-disorder risk and refer or coordinate when indicated.
Mood-altering substances	Alcohol, non-prescribed drugs, prescribed medication concerns, or caffeine patterns relevant to the client’s formulation	Use non-shaming language. This is not a toxicology screen or substance-use treatment plan.
Sleep	Timing, interruptions, rest, nightmares, shift work, or a sleep barrier	Do not assume one sleep target fits every body, schedule, or condition.
Exercise	Movement, rest, pain, access, enjoyment, or a barrier	Do not prescribe intensity or duration here. Adapt for disability, pain, medical risk, trauma, and eating-disorder history.

The source frame names the five domains. The record adds two clinical questions: what did the client notice, and what is one target worth trying? Those additions are original to this worksheet.

Assign one target before the week starts

Begin in session. Ask what the client wants the page to help them notice. If the client names five targets, shrink the assignment before it leaves the room. A usable target sounds like “notice what gets in the way of eating regularly on workdays,” not “fix my health.”

Agree on the smallest safe observation:

1. Name the domain. Choose illness, eating, substances, sleep, or exercise.
2. Name the signal. Pick something observable: a missed appointment, an interruption, a barrier, a cue, or a support used.
3. Name the response. Decide what the client may do, if anything, and who owns that decision.
4. Name the review. Set when and how the record returns. It is not monitored between sessions unless the practice has separately agreed to that service.

A client can select “observe only.” Observation is a valid target when action would be unsafe, premature, or too large.

Walk the five fields in session

Physical illness: treat what belongs in medical care

Ask what health issue is already known, what care is pending, and what question belongs with a medical provider. The worksheet may hold “call clinic,” “bring medication question,” or “notice pain before group.” It should not become a diagnosis tool or medication-adjustment instruction.

If a client has acute symptoms, medication concerns, or a condition needing evaluation, leave worksheet mode and follow the appropriate medical and risk procedures. The therapist can document the referral or coordination step without asking the client to solve the illness on the page.

Eating: observe without turning nourishment into surveillance

Use neutral observations: access, timing, appetite, food-related fear, routine disruption, or support. Do not prescribe a menu, calories, weight change, or compensatory behavior through this worksheet. Ask permission before discussing food, and listen for eating-disorder symptoms, food insecurity, medical restrictions, and cultural context.

If tracking could increase restriction, bingeing, purging, body checking, shame, or coercive monitoring, pause. Coordinate with specialized care as appropriate. “No tracking this week” can be the clinically safest target.

Mood-altering substances: keep the record non-shaming

The client may notice when alcohol, drugs, caffeine, or a medication concern changes the context of a difficult moment. Keep the question specific to the formulation and consented purpose. A single worksheet cannot assess substance-use severity, withdrawal risk, intoxication, or treatment readiness.

Do not use this page as a test of abstinence or a substitute for withdrawal guidance, medication review, or substance-use treatment. If risk is acute, follow the practice’s emergency and consultation procedures.

Sleep: describe the barrier, not a perfect number

Sleep may be shaped by work, caregiving, pain, trauma, medication, housing, shift schedules, or a sleep disorder. Ask what the client wants to notice: waking, timing, a barrier, a support, or the difference between rest and time in bed. A target can be “write down the barrier” rather than “sleep eight hours.”

The goal is not to turn the page into a sleep log with a pass/fail grade. It is to bring a useful pattern back to the next appointment.

Exercise: movement is not a moral requirement

Ask what movement, rest, pain, access, disability, and enjoyment look like for this person. A walk, stretching, physical therapy plan, rest, or no movement target may be appropriate depending on the client’s health and formulation. Do not assume intensity, frequency, or duration; do not use exercise language to reinforce eating-disorder symptoms or compulsive behavior.

When to pause or switch forms

Pause this worksheet when the record could cost the client safety, dignity, treatment access, or privacy.

• Acute medical or safety risk: follow medical, risk, consultation, and emergency procedures first.
• Eating-disorder risk: avoid food, weight, exercise, or body tracking that could reinforce symptoms; coordinate specialized care.
• Substance-use risk: do not use the sheet as withdrawal advice, a sobriety test, or a replacement for treatment.
• Coercive monitoring: do not let a partner, caregiver, employer, court, or program use the page to police the client.
• Unsafe storage or privacy: agree where the record lives, who sees it, and how it returns.
• Too much activation or shutdown: shrink the task, complete it together, or choose a different intervention.
• Wrong clinical job: use a TIPP plan for a distinct acute body-led crisis-skill rehearsal, or another worksheet when the target is not physical vulnerability.

Before the page leaves, say who will read it, when, and what happens if it is blank. The APA Ethics Code keeps informed consent, competence, and client welfare in view; the worksheet should sit inside that conversation, not replace it.

Review the week without grading it

Open the record with curiosity. Ask what was easy to notice, what felt intrusive, what was missing, and what the client wants to carry forward. Review the context around a pattern before deciding what it means.

Return state	First review move
Complete	Ask what the record missed and which observation matters most to the client
Partial	Find the usable field; shrink or remove the field that became surveillance
Blank	Ask what happened around the assignment before interpreting motivation
Distressing	Stop tracking, validate the impact, and coordinate the next clinical step
One clear pattern	Choose whether to continue observing, make one safe experiment, or refer/coordinate

A concise review might sound like: “You noticed that late shifts made eating irregular, and writing the time felt shaming. Would it be more useful to track access and support, or to stop this record and coordinate with your dietitian?” The client remains the source of meaning. The therapist does not turn a line into a diagnosis.

Document the intervention, not the whole tracker

The progress note can name the formulation, the assignment, the client response, and the next step. Do not paste private food, substance, medical, or sleep details into the chart without a clinical reason and the practice’s documentation policy.

Reviewed original PLEASE physical-vulnerability record. Client chose sleep as the sole target and declined numeric scoring. Identified late-shift schedule and pain as contextual barriers. Agreed to one-line barrier observation and medical follow-up for medication questions. Will review fit next session; no between-session monitoring promised.

The note preserves the clinical decision without turning the worksheet into an archive.

How Emosapien carries the review loop

When a therapist assigns a physical-vulnerability tracker, Emosapien’s Scribe Agent can help organize the target, context, client response, and next-session question into a draft progress note. The clinician reviews and signs the record. Emosapien does not choose a target, prescribe care, assess withdrawal or medical risk, or monitor the client between sessions.

See AI clinical notes for the documentation workflow, while clinical judgment stays with you.

Download the pack

Get the printable PLEASE rehearsal from the shared DBT skills worksheet pack rather than a standalone download. The pack includes:

1. Clinician fit card: one skill this week, dose, privacy, and stop rules
2. PLEASE rehearsal: five-domain observation, one target, a week’s record, and next-session review
3. Thirteen other original skill rehearsals, used only when that skill is the week’s job
4. Next-session review

Assign one target at a time. If the client needs a food, substance, medical, sleep, or movement plan beyond this narrow record, coordinate the appropriate care rather than expanding the worksheet into a manual.

References

• Linehan, M. M. DBT Skills Training Manual. Guilford Press. Source for formal DBT skills training; this page does not reproduce its handouts.
• Fassbinder, E., Schweiger, U., Martius, D., Brand-de-Wilde, O., & Arntz, A. (2021). Emotion regulation, physical diseases, and borderline personality disorders: Conceptual and clinical considerations. Frontiers in Psychology. Source that states the PLEASE domains and places the skill in emotion-regulation work.
• American Psychological Association. Ethical Principles of Psychologists and Code of Conduct. Informed consent, competence, and client welfare considerations.