Free Therapist Training›Free DBT Toolkit›Treatment Plan
Last updated: November 11, 2026
This DBT treatment plan template records what client and therapist agree to work on: the client's own goals for a life worth living, the agreements made in pretreatment, and each target in the hierarchy with a goal, a baseline, measurable objectives, interventions, a measure of progress and a target date. The template adds the crisis or safety plan, the review dates and the signatures.
The template comes from the free DBT toolkit of the Sentio MFT program, which trains therapists with deliberate practice. Its completed example is the plan for Lena, an invented client in stage 1, written in pretreatment and updated after her first month of diary cards.
This is an optional template from the Sentio MFT program's free DBT toolkit, an original design for you to adapt.
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Client and agreements
| Item | What to record |
|---|---|
| Client | Name or code, and age. |
| Diagnosis | From the intake assessment. |
| Stage | Pretreatment, or stage 1, 2, 3 or 4. |
| Plan dates | When the plan was written, and the date of each update. |
| Goals for a life worth living | The client's own long-term goals, in the client's words. |
| Agreements made in pretreatment | What the client agreed to (modes of treatment, length of the commitment, the targets to work on, attendance, the diary card), what the therapist agreed to, and when both committed. |
Targets by hierarchy
| Target | Goal | Objectives, with baseline | Interventions | How progress is measured | Target date |
|---|---|---|---|---|---|
| 1. Life-threatening behaviors | |||||
| 2. Therapy-interfering behaviors | |||||
| 3. Quality-of-life-interfering behaviors | |||||
| 4. Behavioral skills to increase |
Safety, reviews and signatures
| Item | What to record |
|---|---|
| Crisis or safety plan | Where the written safety plan is kept and when it was last reviewed, the coaching plan, and the crisis contacts. |
| Review dates | When the plan will be reviewed with the client, and when the treatment agreement ends or is renewed. |
| Signatures | Client and therapist, each with the date. |
What Does a Completed DBT Treatment Plan Look Like?
Lena, 28, is an invented client who works full time as a receptionist at a dental office and shares an apartment with a roommate. Her intake assessment gave a diagnosis of borderline personality disorder; she has a history of self-harm and periods of suicidal thinking, with no suicide attempt in the past two years. Her therapist wrote the plan with her in pretreatment and updated it after the first month, once four weeks of diary cards gave a baseline for each target.
Client and agreements
| Item | Lena's plan |
|---|---|
| Client | Lena, 28 (Client 21). |
| Diagnosis | Borderline personality disorder, from the intake assessment. |
| Stage | Stage 1, after three pretreatment sessions. |
| Plan dates | Written at session 3, the last pretreatment session. Updated at session 7 with baselines from her first four weeks of diary cards. |
| Goals for a life worth living | In her words: "Keep my job and finish my medical billing certificate. Get my own apartment. Be closer to my brother." |
| Agreements made in pretreatment | Lena: one year of standard DBT (weekly individual therapy, a weekly skills group and phone coaching); work on the targets in this plan; attend sessions and group as scheduled; fill in a diary card every day and bring it to each session. Therapist: provide the best treatment possible, follow professional ethics, take part in the weekly consultation team, and offer phone coaching within the therapist's limits. Both committed verbally at session 3. |
Targets by hierarchy
| Target | Goal | Objectives, with baseline | Interventions | How progress is measured | Target date |
|---|---|---|---|---|---|
| 1. Life-threatening: self-harm. Suicidal thinking is monitored on the diary card. | No self-harm. | Baseline: self-harm on 8 days in the first four weeks of cards, about twice a week. (a) Self-harm on no more than 2 days in the four weeks before the month 3 review. (b) No self-harm in the eight weeks before the month 6 review. | Chain and solution analysis of each self-harm; distress tolerance skills; coaching before acting; safety plan; risk assessment with the clinic's protocol after any self-harm or rise in suicidal thinking. | Days with self-harm, and daily ratings of urges and suicidal thinking (0 to 5), on the diary card; reviewed every session and totaled every four weeks. | (a) Month 3. (b) Month 6. |
| 2. Therapy-interfering: diary card filled in late or partly; arriving late; leaving group early when ashamed. | A full card every week, on time to every session, and staying for all of each group. | Baseline: card filled in on the day on about 3 days in 7; late to 2 of 4 sessions; left group early twice in four weeks. (a) Card filled in on the day on at least 6 of 7 days, every week for four weeks. (b) On time to every session and staying for all of each group, four weeks in a row. | Orienting to the card's purpose; problem solving the barriers to filling it in; chain analysis of lateness and leaving group; opposite action for shame. | Days filled in on the day, asked at each card review; session start times; group attendance from the skills trainers. | (a) and (b) Month 3. |
| 3. Quality of life: drinking four or more drinks on weekend nights; missing work after conflicts. | Weekends without heavy drinking, and steady attendance at work so she keeps her job. | Baseline: four or more drinks on 2 nights most weekends; 2 workdays missed after conflicts in four weeks. (a) No more than 1 night with four or more drinks per weekend, four weekends in a row. (b) No nights with four or more drinks and no workdays missed after a conflict in the eight weeks before the month 6 review. | Chain and solution analysis of heavy drinking nights and missed workdays; a plan for weekend evenings; problem solving for conflicts at work. | Drinks each day and missed workdays on the diary card. | (a) Month 3. (b) Month 6. |
| 4. Behavioral skills: opposite action for shame; distress tolerance skills for urges; asking for help. | Skills in place of self-harm, heavy drinking and missed work. | Baseline: a skill recorded on about 2 days in 7; no coaching contacts in four weeks. (a) A distress tolerance skill on every day an urge reaches 3 or higher. (b) A coaching call or text before acting in every week with an urge of 3 or higher. (c) Opposite action for shame practiced on at least 3 days a week. | Weekly skills group; skills coaching in sessions and by phone; rehearsal in session; homework. | Skills recorded on the diary card; coaching contacts. | (a) and (b) Month 3. (c) Month 6. |
Safety, reviews and signatures
| Item | Lena's plan |
|---|---|
| Crisis or safety plan | Written with Lena at session 2, reviewed at session 7, and kept on her phone and in the record. It lists her warning signs (shame after criticism, urges at 3 or higher), skills she can use on her own, people and places that help, a coaching call or text before acting, and crisis contacts: the clinic's after-hours line and the 988 Suicide & Crisis Lifeline. |
| Review dates | Every four weeks, with the diary card totals; a full review at month 6; at month 12, when the one-year agreement ends, renew it or consider referral, depending on progress. |
| Signatures | Lena and her individual therapist, at session 3 and again at session 7. |
How Do DBT Sources Describe Treatment Planning?
DBT sources place treatment planning in pretreatment, the phase before stage 1, whose targets are orientation to DBT and commitment to treatment. Koerner (2012) describes it as the time when client and therapist formulate the problems, tailor a treatment plan, agree on the goals and methods of treatment, and commit to the plan they agreed. A client can start stage 1 once at least minimally committed, and commitment keeps being shaped during treatment. The individual therapist, as the primary provider, is ultimately responsible for building and keeping up the plan.
The agreements are in place before formal treatment starts. In Koerner's account, the client commits to working on agreed targets for a set time and to attending sessions, and the therapist commits to giving the best treatment they can, acting ethically and taking part in consultation. Koerner also notes that DBT does not depend on a written contract; it depends on client and therapist verbally committing to the treatment agreements, and consent must be voluntary. Miller, Rathus and Linehan (2007) describe setting a fixed period for the commitment, such as 16 weeks, 6 months or 1 year, and at its end renewing the agreement or considering referral if progress is insufficient. A written plan records those agreements, and its signatures show that client and therapist reviewed it together.
The targets come from the stage 1 hierarchy: life-threatening behaviors, therapy-interfering behaviors, quality-of-life-interfering behaviors, and increasing behavioral skills. Miller, Rathus and Linehan (2007) describe eliciting the client's long-term goals and linking the reduction of stage 1 target behaviors to them, and every stage's goals aim at a life the client finds worth living. Chain analysis feeds the plan from the start. Rizvi (2019) describes chain analysis as central to case formulation and treatment planning from the earliest stage of treatment onward, and Koerner (2012) describes a case formulation built from patterns across chain analyses, with a treatment plan that addresses what needs to go differently in the chain.
How Do Diary Card Data Become Measurable Objectives?
In this template, diary card data become objectives when each target is counted over a set period and the count becomes the baseline. DBT assesses outcomes continually through diary cards reviewed in every session, so four weeks of cards already hold the numbers a plan needs. The template turns them into objectives in four steps.
- Count each target over the first four weeks of cards: days with self-harm, days the card was filled in on the day, nights with four or more drinks.
- Write each count as the baseline, in the unit the card records.
- State each objective as a change in that count over a set window, such as no more than 2 days with self-harm in the four weeks before the month 3 review.
- Give each objective a target date tied to a review, total the cards at each review, and set the next objective from the new count.
Lena's first four cards showed self-harm on 8 days, about twice a week, so her first objective is self-harm on no more than 2 days in the four weeks before the month 3 review, and her second is no self-harm in the eight weeks before the month 6 review. Her card was filled in on the day on about 3 days in 7, and she drank four or more drinks on two nights most weekends; each count became the baseline for an objective in the same unit. Each target also ties to a goal she named: missing work after conflicts puts at risk the job she wants to keep.
Practice the Skill
A plan's interventions come from case formulation and problem solving. Alexandre Vaz's free training, Case Formulation and Treatment Planning in Therapy, pairs with the template, and Ep 17 of Sentio's Practice Time walks through DBT problem solving as Linehan's manual describes it.
Case Formulation and Treatment PlanningEp 17: Problem Solving
Keep reading
DBT Progress Note Template and Example, the session note that records each target in priority order
DBT Target Hierarchy, how the stage 1 targets are ordered
DBT Diary Card, the daily card that gives the plan its baselines
Free DBT Toolkit, every template, each with a completed example
Frequently Asked Questions
What are examples of DBT treatment plan goals and objectives?
Two examples from a stage 1 plan: the goal of no self-harm has the objective of self-harm on no more than 2 days in the four weeks before the month 3 review, from a baseline of about twice a week, and the goal of a full diary card has the objective of filling it in on the day on at least 6 of 7 days, every week for four weeks, by the month 3 review, up from about 3. Each goal names the change for one target, and its objective adds a baseline, a count and a target date.
How do you write a DBT treatment plan for borderline personality disorder?
Record the diagnosis from the intake assessment, then build the plan around behaviors in the stage 1 hierarchy, from life-threatening behaviors to skills, each linked to the client's own goals, with a baseline from the diary card and dated objectives. Marsha Linehan first developed DBT for chronically suicidal people with borderline personality disorder (BPD). A 2020 Cochrane review found that, compared with usual treatment, DBT may reduce BPD severity and self-harm and improve psychosocial functioning, and it rated that evidence low quality.
What happens in DBT pretreatment?
Pretreatment orients the client to DBT and builds commitment to treatment before stage 1 begins. Koerner (2012) describes it as the time when client and therapist formulate the problems, tailor a treatment plan, agree on goals and methods, and commit to the plan.
Does a DBT treatment plan need a written contract?
No. Koerner (2012) notes that DBT does not depend on a written contract; it depends on client and therapist verbally committing to the treatment agreements. Consent must be voluntary, so a client mandated to treatment has not entered DBT until a considered verbal commitment is given. A written plan can still record the agreements and the date of that commitment.
Who is responsible for the DBT treatment plan?
The individual therapist. As the client's primary provider in DBT, the individual therapist is ultimately responsible for building and keeping up the treatment plan. Each weekly individual session starts with the diary card review, which shows the therapist which of the plan's targets need attention, and the consultation team keeps the therapist motivated and competent.
How often should a DBT treatment plan be reviewed?
This template reviews the plan every four weeks, when the diary cards are totaled, and again at the end of the agreed treatment period. The diary card is reviewed in every session, so progress on each target is visible weekly, and a four-week review totals the cards against each objective. At the end of the agreed period, Miller, Rathus and Linehan (2007) describe renewing the agreement or considering referral if progress is insufficient.
References
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/
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/
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
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
Rizvi, S. L. (2019). Chain analysis in dialectical behavior therapy. Guilford Press. ISBN 978-1-4625-3890-4. https://www.guilford.com/books/Chain-Analysis-in-Dialectical-Behavior-Therapy/Shireen-Rizvi/9781462538904
Storebø, O. J., Stoffers-Winterling, J. M., Völlm, B. A., Kongerslev, M. T., Mattivi, J. T., Jørgensen, M. S., Faltinsen, E., Todorovac, A., Sales, C. P., Callesen, H. E., Lieb, K., & Simonsen, E. (2020). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, Issue 5, Art. No. CD012955. https://doi.org/10.1002/14651858.CD012955.pub2
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.
