Small moments of meaning.
Practical care for your body.
Support that fits your capacity.
ABC PLEASE brings together positive experiences,
manageable achievements, preparation and bodily care.
Use the standard skills when they fit, or adapt them
to your health, circumstances and capacity.
You do not need a diagnosis to use this page.
You deserve care for your own sake.
You do not have to earn rest or become more productive.
Choose one useful support; this is not a daily checklist
you must complete.
What does “reduce vulnerability” mean?
In DBT, this means attending to factors that can make
painful emotions harder to manage.
ABC builds supportive experiences and skills;
PLEASE attends to bodily needs.
It does not mean that illness is your fault,
that emotions are always controllable or that
good self-care prevents disease.
These skills may support coping and daily life
alongside appropriate healthcare.
This is an adapted educational resource,
not a validated ALPIMS treatment programme.
Find a starting point that fits today
Capacity can vary between activities and from day to day.
These are options, not levels you need to progress through.
I have room to practise
Try an enjoyable activity, a manageable challenge
or a practical routine.
I need a smaller version
Shorten the activity, use a simpler step
or prepare fewer things.
I need help or adaptations
Use assistance, an aid or a change to the environment.
Care and recovery come first
On a very difficult day, prioritise essential care
and reduce demands.
ABC • Meaning, confidence and preparation
Choose something that is both useful and achievable.
That might be a full activity, a short version
or one step with support.
A • Accumulate positive experiences
Make room for something pleasant or meaningful,
without pressure to feel happy.
Small example:
meet a friend, enjoy a hobby or take a moment
to notice something pleasant.
B • Build mastery
Practise something achievable that helps you feel capable.
It does not have to be a chore.
Small example:
practise a recipe, learn part of a skill
or make one clear request.
C • Cope ahead
Prepare for a situation that may be difficult.
Choose support, a response and a way to pause.
Small example:
prepare for a meeting, plan a difficult conversation
or arrange a break during an appointment.
PLEASE • Care for your body
The letters are a memory aid:
PL = physical illness;
E = eating;
A = avoid mood-altering substances;
S = sleep;
E = exercise.
Below, exercise is adapted to medically appropriate
movement and energy protection.
PL • Attend to physical illness
Follow your care plan and seek help with symptoms,
treatment or access to care.
Small example:
ask someone to organise a prescription
or write down one concern for your clinician.
E • Nourish and eat regularly
Start with enough food and a manageable eating pattern.
Adapt to medical and sensory needs.
Small example:
arrange an easy, tolerated meal or snack
before you become very hungry.
A • Consider substance effects
Notice whether alcohol, recreational drugs
or stimulants such as caffeine affect
your mood, sleep or symptoms.
Small example:
ask a pharmacist about a concern rather than
changing prescribed medication yourself.
S • Support sleep and rest
Make sleep more accessible and seek care
for persistent difficulties.
Poor sleep is not a personal failure.
Small example:
reduce one tolerable source of light,
sound or discomfort before bed.
E • Move only as appropriate and tolerated
Choose enjoyable exercise or movement
that fits your health and capacity.
Adapt or rest when needed.
Examples:
walking, dancing or a suitable exercise session;
a shorter or supported option when needed.
Choose one small support today
What would make today a little more supported?
One easy meal. One request for help. One pleasant moment.
One appointment adaptation.
Or permission to stop and rest.
If choosing is too much, a supporter can offer
two manageable options and accept “neither”.
Example: everyday practice
A person plans lunch, takes a walk they enjoy,
practises a few chords on a guitar and rehearses
a calm request before a work meeting.
They are combining bodily care, a pleasant experience,
mastery and coping ahead.
Their next step is to see what helped and adjust,
rather than do every skill perfectly.
Example: a day with limited energy
A person has pain and very little energy.
They ask for a tolerated snack, look at a favourite photo
and practise saying, “I need to stop now.”
A supporter helps prepare a shorter appointment for tomorrow.
This combines nourishment, a positive experience,
practising a skill and coping ahead.
There is no requirement to add exercise
or complete every letter.
If you experience PEM, shutdown or a flare
Reduce the size and number of steps.
Reading, planning, emotional work and social contact
can all use energy.
Notice delayed effects as well as how you feel in the moment.
During shutdown, reduce questions and demands.
Use familiar supports and accessible ways to communicate.
Revisit skills practice when you have more capacity.
PEM, flares & recovery • Coming soon
Optional: when health or sensory needs affect the skills
Anxiety & Autonomic:
prepare for distressing situations while respecting
bodily symptoms and condition-specific care.
Laxity / Connective Tissue:
include joint protection, practical adaptations
and appropriate rehabilitation.
Pain / Bodily Sensitivity:
make room for symptom care, rest
and achievable participation.
Immune / Inflammatory:
follow treatment and necessary dietary
or environmental protection.
Mood / Mental Health:
practise positive experiences, mastery
and coping ahead alongside suitable mental health care.
Sensory / Neurodevelopmental:
use clear prompts, predictable choices
and sensory accommodations.
You do not need to explore these domains to use ABC PLEASE.
They are additional considerations when relevant.
The role is supportive.
ABC PLEASE is not established as a treatment
that corrects autonomic, immune or energy dysfunction
across these conditions.
For families and supporters
Ask what help is welcome.
Prepare food, reduce an environmental demand,
assist with care or make an activity accessible.
Recognise effort without requiring more.
Avoid using ABC PLEASE to monitor compliance,
judge motivation or make someone earn care.
Supporting care without pressure • Coming soon
Sources and scope
ABC PLEASE comes from DBT skills developed by Marsha Linehan.
The capacity-sensitive examples and adjustments here
are ALPIMS adaptations, not a separately tested programme.
Linehan, M. M. (2015).
DBT Skills Training Manual,
second edition. Guilford Press.
NICE NG206: ME/CFS recommendations
.
Energy management includes physical, cognitive,
emotional and social activity;
fixed activity increases are not recommended.
