The Pros and Cons Tool is a skill that is taught in Dialectical Behavior Therapy (DBT). During DBT, this tool is used to help you evaluate whether or not to engage in impulsive behaviors such as self-harm. But this tool can help you think through other kinds of decisions too. If you are struggling to decide what to do in a given situation, try this:
Getting Ready to Use the Pros and Cons Tool
Get a piece of paper and draw one horizontal and one vertical line to divide it into quarters. At the top of the upper left hand corner write “pros of ___________.” Fill in the blank by writing in whatever behavior you are thinking of doing. For example, if you are thinking of self-harming, write in “pros of self-harming.” If you are thinking of quitting therapy, write in “pros of quitting therapy.” At the top of the upper right hand corner write “cons of __________” and fill in the blank with whatever you wrote in the upper left hand corner (i.e., cons of self-harming, cons of quitting therapy).
Next, at the top of the lower left hand corner write “pros of ___________.” Fill in the blank with the behavior that is the opposite of whatever you are thinking of doing. So, if you are thinking of self-harming, write in “pros of not self-harming (i.e., tolerating the distress). Or, for the quitting therapy example, write in “pros of staying in therapy.” At the top of the lower right hand corner right “cons of ___________” and again fill in the blank with the behavior that is the opposite of the one you are thinking of doing.
Listing the Pros and Cons
Now that you have your sheet set up, fill in the squares with all the positive consequences (“pros”) and negative consequences (“cons”) that you can think of for each scenario. Feel free to use extra paper if you need it.
For example, for “pros of self-harming you might write: “Get rid of the emotional pain instantly.” For “pros of not self-harming” you might write, “Feel proud that I tolerated the distress without the help of a crutch.”
Or, for “pros” of quitting therapy you might write: “An extra hour each week to devote to other things.” For “cons” of quitting therapy you might write: “Have to try to find ways to reduce my symptoms on my own.”
How to Evaluate the Pros and Cons
Once you have completed the form with every consequence you can think of, take a look at it again, and see if anything stands out to you. Any patterns that you notice? Any quadrants that are empty, or full? After completing this exercise, does it change what you want to do?
For more skills to use to cope with borderline personality disorder (BPD) symptoms, see the following page:
Linehan MM. Skills Manual for Treating Borderline Personality Disorder. New York: Guilford, 1993.