Understanding the Subjective Units of Distress Scale (SUDS): A Tool for Managing Anxiety

Anxiety can often feel overwhelming, especially when it surfaces unexpectedly. At Mountain Valley, we understand the importance of equipping individuals with effective tools to navigate these intense emotions. One such tool we regularly employ is the Subjective Units of Distress Scale (SUDS). Before our group and individual psychotherapy sessions, we often ask participants to share their SUDS levels. This practice not only promotes self-awareness but also fosters open communication about one’s emotional state.

What Is the Subjective Units of Distress Scale?

The Subjective Units of Distress Scale, commonly known as SUDS, is a simple self-assessment tool used to quantify the intensity of distress or anxiety an individual feels at a particular moment. Developed by psychologist Joseph Wolpe in the 1960s, SUDS assigns a numerical value—typically ranging from 0 t0 10 (or 0 t0 100)—to represent one’s current level of discomfort. A score of 0 indicates complete calmness, while 10 signifies the highest level of distress imaginable.

How Does SUDS Work?

SUDS is inherently subjective, relying on personal perception rather than objective measurements. Here’s how it generally works:

1.   Identification: When an individual begins to feel anxious or distressed, they pause to acknowledge these feelings.
2.   Assessment: They assign a numerical value to their level of distress based on the SUDS scale.
3.   Reflection: This number helps them—and the MV team—to understand the severity of their symptoms at that moment.
4.   Action: Based on the SUDS score, appropriate coping strategies or therapeutic interventions can be applied to manage the distress.

Why Is SUDS Important for Managing Anxiety?

Promotes Self-Awareness

One of the first steps in managing anxiety is to recognize when it’s occurring.. By regularly assessing their SUDS score, individuals become more attuned to their emotional states. This heightened self-awareness can lead to earlier interventions and prevent anxiety from escalating.

Facilitates Communication

Articulating feelings of anxiety can be challenging. SUDS provides a straightforward way to communicate distress levels to therapists, caregivers, or peers. At Mountain Valley Treatment Center, sharing SUDS scores before group sessions helps create a common language that enhances understanding and fosters effective support.

Guides Therapeutic Interventions

In therapeutic settings, SUDS is often used during exposure therapy—a treatment commonly employed for anxiety disorders and phobias. By assigning distress levels during exposure to anxiety-provoking stimuli, therapists can tailor the intensity and duration of exposures to optimize treatment outcomes.

Research Supporting SUDS

A study published in the Journal of Anxiety Disorders highlighted the efficacy of using SUDS in exposure therapy for patients with obsessive-compulsive disorder (OCD). The research found that patients who consistently used SUDS to report their anxiety levels experienced a more significant reduction in symptoms compared to those who did not use the scale¹.

Another study in Behavior Research and Therapy demonstrated that SUDS scores could predict treatment outcomes in cognitive-behavioral therapy (CBT) for panic disorder. Higher initial SUDS scores were associated with greater improvements by the end of treatment, suggesting that SUDS can be a useful prognostic tool².

Implementing SUDS in Daily Life

While SUDS is often used in clinical settings, it can also be a valuable tool for personal use. Here are some tips for integrating SUDS into daily routines:

• Regular Check-Ins: Set aside moments during the day to assess your SUDS score, even when not feeling particularly anxious. This practice can help track patterns and triggers over time.
• Journaling: Keep a log of your SUDS scores along with notes about situations or thoughts that may have influenced your anxiety levels.
• Coping Strategies: Use your SUDS score to determine when to employ relaxation techniques, such as deep breathing, mindfulness, or physical activity.

How We Use SUDS at Mountain Valley

At Mountain Valley, the SUDS scale is an integral part of our therapeutic approach. Before group sessions, we encourage participants to share their SUDS levels. This practice serves multiple purposes:

• Encourages Open Dialogue: Sharing SUDS scores helps break down barriers and promotes honesty about one’s feelings.
• Tailors Group Dynamics: Understanding the collective distress levels allows facilitators to adjust the session’s focus to better meet the group’s needs.
• Monitors Progress: Regularly tracking SUDS scores provides tangible data on an individual’s progress over time.

The Benefits of Using SUDS at Mountain Valley

• Personalized Treatment Plans: By consistently monitoring SUDS scores, our therapists can customize treatment plans to address specific anxiety levels.
• Empowerment Through Self-Monitoring: Patients learn to take control of their anxiety by recognizing and addressing distress as it occurs.
• Enhanced Peer Support: Sharing SUDS levels in group settings fosters a sense of community and mutual understanding among participants.

The Subjective Units of Distress Scale (SUDS) is a powerful yet simple tool that empowers individuals to understand and manage their anxiety. By quantifying distress, it transforms abstract feelings into concrete data that can guide personal coping strategies and therapeutic interventions.

At Mountain Valley, we are committed to providing evidence-based approaches like SUDS to support adolescents and young adults dealing with anxiety and OCD. By incorporating tools like the SUDS scale into our programs, we help individuals develop the skills they need to navigate their emotions and lead fulfilling lives.

If you or someone you know is struggling with anxiety, don’t hesitate to reach out. We’re here to help.

References:

1.  Kircanski, K., & Peris, T. S. (2015). Exposure and response prevention process predicts treatment outcome in youth with OCD. Journal of Anxiety Disorders, 36, 45-51.
2.  Meuret, A. E., Rosenfield, D., Seidel, A., Bhaskara, L., & Hofmann, S. G. (2010). Respiratory and cognitive mediators of treatment change in panic disorder: Evidence for intervention specificity. Behavior Research and Therapy, 48(8), 698-706.