DBT Diary Card: Track Emotions, Urges and Skills Each Day

About the technique

The diary card is the daily self-monitoring sheet at the center of dialectical behavior therapy, developed by Marsha Linehan (Linehan, 1993). Each day the client rates emotions and urges, records agreed target behaviors such as self-harm or substance use, and marks which skills they used. In standard DBT the therapist reviews the card at the start of each individual session and uses it to set the agenda, taking life-threatening behaviors first, then behaviors that interfere with therapy, then quality-of-life targets (Linehan, 1993).

The card turns a week into shared data, surfaces patterns between urges and skills use, and points to which behavior needs a chain analysis. DBT has strong trial support: in a two-year randomized trial, women with borderline personality disorder and recent suicidal behavior who received DBT were half as likely to attempt suicide as those treated by community experts and needed less hospitalization for suicidal ideation (Linehan et al., 2006). Increased skills use statistically accounted for the drop in suicide attempts and depression (Neacsiu et al., 2010), one reason tracking skills matters. The card has not been tested as a separate intervention.

It suits adolescents and adults in DBT or DBT-informed care and works as daily homework, with skills drawn from the manual (Linehan, 2014). Agree with the client on exactly what to track, and treat missed days with curiosity rather than criticism. A diary card is not a crisis tool: when urges are high, the safety plan and crisis contacts come first, including 988 in the US.