Free Therapist Training›Free DBT Toolkit›Diary Card
Last updated: November 11, 2026
This DBT diary card is a weekly card that the client fills in every evening and brings to each individual session. It tracks two targets you and the client agree on, plus self-harm, thoughts of suicide, and alcohol or drugs, each as a 0 to 5 rating with a yes or no for acting on it. Six emotions, medication, the skills used that day with a rating for how much each helped, and a short note complete each row. Under the grid, the client adds what they want on the next session's agenda and any coaching calls or texts, and the card comes with rating guides and how-to steps written for clients.
The card comes from the free DBT toolkit of the Sentio MFT program, which trains therapists with deliberate practice. Sentio's free DBT training goes with it: a webinar with Tali Boritz and Shelley McMain, and Practice Time episodes that walk through problem assessment, problem solving and informal emotional exposure.
This is an optional template from the Sentio MFT program's free DBT toolkit, an original design for you to adapt.
Download the PDFMake a copy in Google Docs
| Name: | Week starting: | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Day | Target 1: | Target 2: | Self-harm | Thoughts of suicide | Alcohol or drugs | Sadness | Anger | Fear | Shame | Joy | My pick: | Medicine as prescribed? | Skills I used and how much each helped | Notes on the day |
| Mon | ||||||||||||||
| Tue | ||||||||||||||
| Wed | ||||||||||||||
| Thu | ||||||||||||||
| Fri | ||||||||||||||
| Sat | ||||||||||||||
| Sun | ||||||||||||||
| What I want on my next session's agenda | Coaching calls or texts this week | Days I filled this in on the day |
|---|---|---|
How to rate
Urges, thoughts and emotions, 0 to 5: 0 none; 1 came and went; 2 on and off, easy to set aside; 3 strong, took effort to set aside; 4 very strong, hard to think of anything else; 5 as strong as it gets.
Acted on it, Y or N: after each urge or thought rating, write Y if you acted on it that day or N if you did not.
Skills, 0 to 3: 0 no help; 1 helped a little; 2 helped quite a bit; 3 helped a lot.
How to fill in the card
- Fill in your row every evening, at about the same time.
- Rate each urge, and any thoughts of suicide, at their strongest that day from 0 to 5. Then write Y if you acted on it or N if you did not.
- Rate each emotion at its strongest that day from 0 to 5. Use My pick for one more emotion you and your therapist choose.
- Write Y or N for your medicine. List each skill you used with a number from 0 to 3 for how much it helped, or write none.
- In Notes, write a few words about what happened, especially before a strong urge.
- If you miss a day, fill it in as soon as you can. Write the days you filled in on time in the box at the bottom of the card.
- Before your session, add what you want on the agenda and any coaching calls or texts. Bring the card to every session.
If you are in crisis
[Your clinic's crisis instructions: who to contact during office hours, after hours, and in an emergency.]
In the United States, call or text 988, or chat at 988lifeline.org, to reach the 988 Suicide & Crisis Lifeline. If you are in immediate danger, call 911.
What Does a Completed DBT Diary Card Look Like?
Lena is an invented client: 28, a receptionist at a dental office, about three months into standard DBT with weekly individual therapy and skills group, phone coaching, and a therapist on a consultation team. She is in stage 1. Self-harm is her life-threatening target, and suicidal thinking is monitored on the card. Her therapy-interfering targets are filling in the card late or partly, arriving late, and leaving group early when ashamed; her quality-of-life targets are drinking four or more drinks on weekend nights and missing work after conflicts. Her open columns name missing work and leaving group early (her group meets on Wednesday evenings), and her extra emotion is loneliness. This is her card for the week before session 14, on a Tuesday.
| Name: Lena | Week starting: Monday, the week before session 14 | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Day | Target 1: Missing work | Target 2: Leaving group early | Self-harm | Thoughts of suicide | Alcohol or drugs | Sadness | Anger | Fear | Shame | Joy | My pick: Lonely | Medicine as prescribed? | Skills I used and how much each helped | Notes on the day |
| Mon | 0 N | No group | 1 N | 0 N | 1 N | 1 | 0 | 1 | 2 | 2 | 1 | Y | None | Quiet day at work. |
| Tue | 1 N | No group | 3 N | 0 N | 2 N | 2 | 3 | 2 | 4 | 1 | 2 | Y | Self-soothe 3, distract 2 | Fight with my roommate about bills. Called for coaching, and the urge passed. |
| Wed | 0 N | 2 N | 1 N | 0 N | 1 N | 1 | 1 | 1 | 2 | 1 | 1 | Y | None | Group tonight. Stayed to the end. |
| Thu | 3 N | No group | 4 Y | 2 N | 2 N | 4 | 2 | 3 | 5 | 0 | 4 | Y | None | My supervisor criticized me in front of coworkers. Went home and did not call. Self-harmed tonight, did not need medical care. Thoughts of suicide, no intent. |
| Fri | 5 Y | No group | 2 N | 0 N | 4 Y, five drinks | 4 | 1 | 2 | 4 | 0 | 4 | Y | None | Called in sick, still ashamed about yesterday. Stayed in bed most of the day. |
| Sat | No work | No group | 2 N | 0 N | 3 N | 2 | 1 | 1 | 3 | 2 | 2 | Y | Self-soothe 2, called my brother 3 | Called my brother back. Better day. |
| Sun | No work | No group | 1 N | 0 N | 1 N | 1 | 0 | 1 | 1 | 2 | 1 | Y | None | Calm day. Urges low. |
| What I want on my next session's agenda | Coaching calls or texts this week | Days I filled this in on the day |
|---|---|---|
| What happened with my supervisor. I'm scared I'll lose my job. | Tuesday evening: one call after the fight with my roommate. The urge passed. No other calls or texts. | Mon, Tue, Sat and Sun. I filled in Wed, Thu and Fri in the waiting room. |
How Lena's Therapist Used the Card in Session 14
Session 14 opened with the card. Thursday's self-harm was the highest-priority behavior of the week, so it set the session's first target. Her therapist assessed risk with the clinic's structured protocol, the Linehan Risk Assessment and Management Protocol (LRAMP), reviewed and updated her safety plan, and led a chain analysis of Thursday, from the criticism at work to the self-harm that night. The missed coaching call is a link in that chain, so the solution analysis set a coaching plan: call or text when an urge reaches 3, before acting. Lena's own agenda item, her supervisor and her job, fit there too, as a plan for talking with her supervisor.
The rest of the agenda followed the hierarchy. The three days filled in late came next, as therapy-interfering behavior, and Lena chose to fill in the card at bedtime with a phone reminder. Friday's sick day and drinking came third, as quality-of-life targets, and Lena took home a chain analysis worksheet on Friday's drinking to bring to session 15. Skills came last, with her therapist reinforcing Tuesday's coaching call and Saturday's call to her brother. Her therapist also planned to check the coaching plan at session 15 and brought the case to the consultation team that week.
What Is a DBT Diary Card, and Why Is It Filled In Every Day?
A DBT diary card is a daily self-monitoring card on which the client records target behaviors and related information. The client logs urges, actions (problem behaviors) and skills use, and the card covers the treatment targets that client and therapist agreed on. Kelly Koerner describes it as filled in every day by the client and brought to each weekly individual session.
The daily rows are what make the review work. Going over the card shows the therapist what happened since the last session and which targets need attention in that session, and DBT assesses outcomes continually through diary cards reviewed in every session. A row filled in each evening also keeps the order of the week: on Lena's card, the Tuesday coaching call that worked and the Thursday when she did not call sit two rows apart.
How Does the Therapist Use the Diary Card to Set the Session Agenda?
Going over the diary card is the first step of each individual session. The therapist then sets priorities by the stage 1 target hierarchy for individual therapy, which runs in this order: life-threatening behaviors, therapy-interfering behaviors, quality-of-life-interfering behaviors, and increasing behavioral skills.
Life-threatening behaviors are those that could result in the client's death, including suicidal communication and ideation and any suicidal or nonsuicidal self-injury. Therapy-interfering behaviors are anything that gets in the way of effective treatment, such as arriving late or cancelling appointments, and they can come from the client, the therapist or both. Quality-of-life-interfering behaviors are the other behaviors and problems that stand between the client and a reasonable quality of life, such as relationship problems or a money or housing crisis.
Imminent risk of suicidal behavior or self-injury calls for crisis intervention first. Otherwise, any behavior in the first three categories that the card shows since the last session, or that happens in the session, becomes the focus, through a detailed analysis, in-session work and homework aimed at avoiding it next time; when none occurred, the issues the client wants to work on set the focus. The therapist may work on several targets in one session but puts the most weight on the highest-priority behavior of the past week, with a chain analysis of that behavior and solution analysis woven into it. DBT does not require a formal session agenda, though laying out the tasks at the start can help. The target hierarchy quick reference and the chain analysis worksheet cover those next steps.
A missing or incomplete card goes on the agenda too. In standard DBT, a card that is not completed, or not brought to session, counts as therapy-interfering behavior, so it comes after any life-threatening behavior and before quality-of-life targets. Late cards are one of Lena's therapy-interfering targets, and the box at the bottom of her card shows which days she filled it in on the day.
How Do You Tailor a DBT Diary Card to a Client?
Build the columns from the client's own targets, since the card covers the treatment targets that client and therapist agreed on. Those targets come out of pretreatment, where client and therapist formulate the problems, tailor a treatment plan, and agree on the goals and methods of treatment. Name the two open columns for the highest-priority behaviors the fixed columns do not cover: Lena's card names missing work, a quality-of-life target, and leaving group early, a therapy-interfering one.
Tie each column to the client's long-term goals, as DBT links reducing stage 1 target behaviors to them: Lena tracks missing work because she wants to keep her job. Pick the extra emotion from what shows up in the client's chains; for Lena it is loneliness. The skills group teaches the skills and individual therapy helps the client apply them to their own situations, so the skills column asks for each skill by name with a rating of how much it helped, which shows the therapist what is working and where to coach. For the skills themselves, Linehan's handouts and worksheets are published by Guilford Press. When a target stops showing up and another takes priority, change the column at a session and keep the old cards for comparison. For adolescents, the teen diary card adds school, home, friends and sleep.
Practice the Skill
A diary card review leads straight into problem assessment: the top-priority behavior on the card gets a chain analysis. Practice Time Episode 16 walks through DBT problem assessment on camera, so you can rehearse the questions that open a chain before you need them in session.
Keep reading
DBT Diary Card for Teens, a plain-words card for teens with columns for school, home, friends and sleep, and a completed example
DBT Chain Analysis Worksheet, the next step when the card shows a target behavior, with Lena's Thursday chain
DBT Target Hierarchy, the stage 1 targets in order, with a quick reference
Free DBT Toolkit, every template in one place
Frequently Asked Questions
What goes on a DBT diary card?
A DBT diary card records the client's urges, actions and skills use, and it covers the treatment targets the client and therapist agreed on. Sentio's card tracks two targets you name together, self-harm, thoughts of suicide, and alcohol or drugs, each as a 0 to 5 rating with a yes or no for acting on it. It also has six emotions rated 0 to 5, medication, skills with a 0 to 3 rating for how much each helped, and a daily note.
How do you fill out a DBT diary card?
The client fills in one row every evening. On Sentio's card that means rating each urge at its strongest from 0 to 5 with Y or N for acting on it, rating each emotion from 0 to 5, marking medication, listing each skill used with a 0 to 3 rating for how much it helped, and adding a few words about the day. In DBT the card is filled in every day and brought to each weekly individual session.
Is there a fillable DBT diary card?
Yes. The Google Docs version of Sentio's card is editable: make a copy, name the open target and emotion columns, and the client can type into it on a computer or phone. The PDF is for printing: the blank card comes first, then the rating guide and how-to steps, and a completed example comes after them. Both are free.
Can clinicians post or share Linehan's own diary card?
Not freely. Linehan's published DBT forms are copyrighted. For example, for the second edition of DBT Skills Training Handouts and Worksheets, Guilford's license lets the purchaser reproduce the materials only for personal use or use with individual clients, and it excludes blogs, file-sharing sites, internet and intranet sites, and handouts or slides for lectures, workshops or webinars. Guilford states that the revised edition's print book includes permission to photocopy for personal use or use with clients. Other uses need written permission from Guilford.
Is there a DBT diary card app?
Yes. Guilford Digital for DBT, a subscription platform from Linehan's publisher, gives clinicians customizable digital diary cards tailored to each client's target behaviors, emotions and skills, which clients complete on their phones through their own login. It also has a library of Linehan's skills handouts and worksheets and graphs that track patterns over time. A Google Docs copy of Sentio's card is a free option for clients who prefer to type.
References
Koerner, K. (2012). Doing dialectical behavior therapy: A practical guide. Guilford Press. ISBN 978-1-4625-0232-5. https://www.guilford.com/books/Doing-Dialectical-Behavior-Therapy/Kelly-Koerner/9781462502325
University of Washington Behavioral Research and Therapy Clinics. (n.d.). Dialectical behavior therapy. Retrieved November 9, 2026, from https://depts.washington.edu/uwbrtc/about-us/dialectical-behavior-therapy/
Comtois, K. A., Carmel, A., & Linehan, M. M. (2025). DBT Next Steps clinician's manual: Building a life worth living. Guilford Press. ISBN 978-1-4625-5811-7. https://www.guilford.com/books/DBT-Next-Steps-Clinicians-Manual/Comtois-Carmel-Linehan/9781462558117
Dimeff, L. A., & Linehan, M. M. (2008). Dialectical behavior therapy for substance abusers. Addiction Science & Clinical Practice, 4(2), 39-47. https://pmc.ncbi.nlm.nih.gov/articles/PMC2797106/
Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007). Dialectical behavior therapy with suicidal adolescents. Guilford Press. ISBN 978-1-4625-3205-6. https://www.guilford.com/books/Dialectical-Behavior-Therapy-with-Suicidal-Adolescents/Miller-Rathus-Linehan/9781462532056
Linehan, M. M. (2015). DBT skills training handouts and worksheets (2nd ed.). Guilford Press. ISBN 978-1-57230-781-0. https://www.guilford.com/books/DBT-Skills-Training-Handouts-and-Worksheets/Marsha-Linehan/9781462556342/prior-editions
Linehan, M. M. (2025). DBT skills training handouts and worksheets (Rev. ed.). Guilford Press. ISBN 978-1-4625-5634-2. https://www.guilford.com/books/DBT-Skills-Training-Handouts-and-Worksheets/Marsha-Linehan/9781462556342
Linehan, M. M., Comtois, K. A., & Ward-Ciesielski, E. F. (2012). Assessing and managing risk with suicidal individuals. Cognitive and Behavioral Practice, 19(2), 218-232. https://doi.org/10.1016/j.cbpra.2010.11.008
Guilford Press. (n.d.). Guilford Digital for DBT. Retrieved November 9, 2026, from https://www.dbt.guilford-digital.com/
University of Washington Behavioral Research and Therapy Clinics. (2016). Linehan Risk Assessment and Management Protocol (LRAMP) (Version 1.0). https://depts.washington.edu/uwbrtc/wp-content/uploads/LSSN-LRAMP-v1.0.pdf
988 Suicide & Crisis Lifeline. (n.d.). Get help. Retrieved November 9, 2026, from https://988lifeline.org/get-help/
About This Template
Corrections and suggestions: mabundez@sentio.org.
