All posts DBT Basics

How to Fill Out a DBT Diary Card: Step-by-Step Examples

Learn how to record emotions, urges, target behaviors, and DBT skills with clear fictional diary card examples.

August 20, 2026 · Dbrief Team
How to Fill Out a DBT Diary Card: Step-by-Step Examples

A DBT diary card turns a day into information you and your therapist can review together. It is not a test. The useful entry records what happened—including urges, actions, and skill attempts—as accurately as you can.

Exact fields and rating scales vary by program. Some cards use 0–5 scales, others use different ranges or response choices, and medication fields may not appear at all. Follow the labels and instructions from your treating clinician rather than treating any example online as a universal standard. The VA MIRECC’s DBT resource page likewise lists a standard diary card alongside the treatment manuals while recognizing diary cards as part of a larger DBT treatment structure. (VA MIRECC, n.d.)

If you want the broader purpose before the practical steps, read what a DBT diary card is and why it matters.

What do you record?

A card commonly asks about some combination of:

  • Emotions: names such as sadness, fear, shame, anger, or joy, each rated for intensity.
  • Urges: how strongly you felt pulled toward a target behavior.
  • Target behaviors: whether the action actually occurred, sometimes with a count.
  • DBT skills: which skills you practiced or attempted.
  • Medication: whether prescribed medication was taken as directed, when that field is part of your card.

Diary cards support DBT’s structured attention to treatment targets and skills practice; they do not replace the rest of treatment. Linehan’s 1993 text presents the comprehensive DBT model, and the VA describes diary cards within a treatment that also includes individual therapy, group skills training, phone coaching, and a therapist consultation team. (Linehan, 1993; VA MIRECC, n.d.)

Step 1: Complete it close to the day

Choose a repeatable time when you can look back over the day without rushing. If your clinician asks for event-based or more frequent entries, follow that plan.

There is a limited reason to avoid rebuilding the whole week in the waiting room: global retrospective self-reports are vulnerable to recall bias, while real-time sampling is designed to reduce that bias. This measurement research did not test DBT diary cards. (Shiffman, Stone, and Hufford, 2008)

If you miss a day, do not invent precision. Mark it according to your clinician’s instructions and write what you can honestly remember.

Step 2: Rate emotions consistently

Use the scale printed on your card. First identify the emotion, then choose the rating that best matches its intensity during the period your card asks about. Decide with your therapist whether that means the day’s highest intensity, an end-of-day rating, or something else.

Consistency matters more than pretending a number is objectively exact. A “3” should mean roughly the same intensity from one entry to the next on your agreed scale. Do not copy the example’s 0–5 scale if your card uses another format.

Step 3: Separate urges from actions

An urge is the pull to do something; an action is what you actually did. Record them separately. You might have a strong urge and not act, or a mild urge followed by an action. Collapsing the two hides information your therapist may need.

For example: “urge to avoid: 4/5; avoided: no” says something different from “avoidance: 4.” Keep target descriptions brief and use the neutral wording agreed with your clinician.

Step 4: Record target behaviors and skill attempts

For a target behavior, use the requested yes/no, count, or rating field. If it did not occur, record zero or “no” rather than leaving the field ambiguous.

When a target did occur, the card identifies what to review; it does not explain why it happened. A therapist can use the DBT behavior chain analysis guide to reconstruct the vulnerability factors, prompting event, links, target behavior, and consequences around one specific episode.

For skills, record what you actually tried—not every skill you can remember. The distress tolerance guide distinguishes crisis-survival options such as paced breathing, ACCEPTS, and IMPROVE. The emotion regulation guide explains Check the Facts, Opposite Action, Problem Solving, and PLEASE. Skill terminology here follows Linehan’s official handouts. (Linehan, 2015)

If your card includes medication, complete only the field requested. A diary-card checkbox is a record for discussion, not an instruction to start, stop, or change medication.

One fictional daily entry

Fictional, non-diagnostic example using a fictional 0–5 card: On Tuesday, Alex receives a short email asking to revise a report. Alex rates anxiety 4/5 and shame 3/5. The urge to avoid the report is 4/5, but avoidance is recorded no. Alex records one skill attempt: Check the Facts, followed by twenty minutes revising the report. Prescribed medication is marked yes, taken as directed because Alex’s fictional card includes that field.

One fictional weekly pattern

Continuation of the same fictional example: Alex’s seven entries show anxiety at 4/5 on Tuesday and Thursday and 1–2/5 on the other five days. The urge to avoid reaches 4/5 on both high-anxiety days. Avoidance is no on Tuesday and yes on Thursday. Check the Facts is recorded on Tuesday; paced breathing is attempted Thursday. Medication is marked taken as directed on all seven days.

That pattern does not prove why Thursday differed. It gives Alex and the therapist focused questions: What happened before each urge? How was each skill used? What differed Thursday?

Common mistakes to correct

  • Using one number for an urge and an action. Give each its own field.
  • Changing the meaning of ratings day to day. Agree on anchors with your therapist.
  • Backfilling with false certainty. Record uncertainty instead of guessing.
  • Checking every skill. Mark actual attempts, including attempts that felt ineffective.
  • Leaving zeros blank. Follow your card’s instructions so “none” is not confused with “missing.”
  • Editing the week to look better. The card is treatment information, not a performance review.

How therapists use the completed card

The VA MIRECC lists a standard diary card among the treatment manuals and resources required for full DBT. Bring your completed card to session and follow your clinician’s instructions for reviewing it. The numbers organize what you recorded, but they do not diagnose a person or explain causes by themselves. (VA MIRECC, n.d.)

Paper and digital cards can record the same fields. Dbrief’s therapist dashboard supports reviewing diary cards between sessions. That workflow difference is not evidence that Dbrief itself produces better clinical outcomes.

A diary card is also not an emergency service and may not be reviewed immediately. If you need urgent help, use your local emergency services or crisis resources rather than relying on an entry to alert someone.

Further reading:

Back to all posts