How to Fill In a DBT Diary Card (With a Free One That Stays on Your Phone)

Fill in a DBT diary card once a day, at roughly the same time each day: score how strongly you felt each emotion and each urge, usually from 0 to 5, note whether you did any of the behaviours you are working on, and tick the skills you used. Then take the week's card to your sessions. In standard dialectical behaviour therapy (DBT), developed by Marsha Linehan, the card is brought weekly to both individual therapy and the skills group, and it shapes what the session covers first.

I have BPD and I have filled in a lot of these. The mechanics take a minute. The hard part is honesty, and what to do on the days you did not manage it. That is most of this page.

If you want to start now, there is a free DBT diary card on this site. It saves what you write only in the browser on your own phone or computer. There is no account, and I never receive it.

What is a DBT diary card?

It is the daily self-monitoring record used in DBT. An NHS Highland factsheet on DBT describes it plainly: every week, the person completes a diary card and brings it to both individual and skills group sessions, recording how they have felt each day, whether they have had thoughts of harming themselves, and whether they have actually harmed themselves.

A 2022 paper summarising Linehan's method describes the card as tracking "life-threatening behaviors, as well as other behavioral targets, emotions, and skills used over the previous week". Its job is to show the therapist how target behaviours show up in your life, and to reveal patterns.

What does a standard DBT diary card include?

Cards vary between services, and therapists often adapt them for the person in front of them. Most include four things:

• Target behaviours. Anything you and your therapist have agreed to work on, starting with self-harm and suicidal behaviour. You record whether it happened each day.
• Urges. How strongly you wanted to do each target behaviour, even if you did not. Usually scored 0 to 5.
• Emotions. How strongly you felt particular emotions each day, again usually 0 to 5.
• Skills used. Which DBT skills you used. These come from the four skills modules: core mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.

A Danish trial described the core of it in one line: participants registered "the emotions, urges, and skills used". Many cards also leave room for anything new you and your therapist decide to track.

I am not going to reproduce anyone's published card here. You do not need a particular template; you need one that has those four parts and that you will actually use.

Why do DBT therapists use a diary card?

Because DBT sessions have a set order, and the card tells the therapist where to start. The NHS Highland factsheet lists that order:

1. Life-threatening behaviours, including suicide attempts and any self-harm.
2. Therapy-interfering behaviours, such as lateness, missed sessions, or not bringing diary cards regularly.
3. Quality-of-life-interfering behaviours, such as drug or alcohol use or behaviour that damages important relationships.

The factsheet also explains that "behaviour" in DBT means anything you think or do, and that using diary cards to record behaviours is how targets for change are identified. When something on the card is a target, the therapist goes through it in detail using a behavioural analysis, often called a chain analysis.

It also helps you. In a review of what patients say about DBT, people described diary cards as useful because they could visually see their progress week by week.

How do you fill in a DBT diary card?

This is how I do it.

1. Pick a time and attach it to something. End of the day, after brushing your teeth, works for me. A DBT study protocol asked people to complete all items daily "at a regular time each day".
2. Score each emotion for the day as a whole. Not just the last hour. 0 means not at all, 5 means as strong as it gets.
3. Score each urge, even if you did nothing with it. A 4 for an urge to self-harm on a day you did not self-harm is not a failure. It is the most important thing on the card.
4. Record what you actually did. Yes or no for each target, or a number if your therapist asks for one.
5. Tick the skills you used, including the clumsy attempts. Many cards simply ask whether you used a skill, not whether it worked perfectly.
6. Write one line if something big happened. You will not remember the detail by your session.

A filled-in day might read: sadness 3, anger 1, shame 4, urge to self-harm 3, self-harm no, skills used: did one thing at a time, cold water. That is an example, not anyone's real card, but it is the kind of day that tells a therapist a lot.

How do you fill in a diary card honestly?

By remembering who it is for. It is not a school report and it is not graded. Validation is a core part of DBT: the NHS Highland factsheet explains that every behaviour makes sense on some level, even the ones you are trying to change. A high number is information, not a confession.

Some things that help:

• Score the urge, not the version you wish you had felt. Under-scoring urges is an easy way to make a card less useful.
• Do not round your good days up to please your therapist. A card full of zeros makes it harder for them to see where help is needed.
• Write down the shameful one. Shame often scores highest on my card, and it is the one I most want to leave blank.

Common diary card mistakes

• Filling in the whole week in the waiting room. You will remember the last two days and guess the rest.
• Leaving the urges column empty because nothing "happened".
• Only ticking skills that worked. An inpatient study of 44 people in DBT found suicidal ideation was lower on days with successful skill use, and also higher on days when people used skills but felt they did not work than on days with no skill use. That is worth discussing, which is why it belongs on the card.
• Not bringing it. In DBT that counts as a therapy-interfering behaviour, so it becomes something to work on together rather than a secret.

What should I do if I missed a day?

Do not panic, and do not invent it.

• Fill in what you honestly remember, and mark those days as filled in from memory, so you and your therapist know which ones are a reconstruction.
• Leave a day blank if you cannot remember it. A blank is true. A guessed number is not.
• Tell your therapist the card has gaps. That is part of the work, not a failure of it.

Real DBT programmes allow for this. In one community mental health programme, people filled in their cards at the start of group each weekday, and on Monday they filled in the cards for Friday, Saturday and Sunday. In an adolescent programme with an online diary card, a young person who forgot to complete it could complete it in session.

If you have skipped a whole week, start again today. The card is only ever about the next seven days.

Is a DBT diary card app better than paper?

There is one randomised trial worth knowing. In Denmark, 78 people with BPD in DBT were randomised to a mobile diary app or paper diary cards. The app group had on average 37.1 more days of treatment and recorded 3.16 more skills per week. The paper group had a significantly larger gain in quality-adjusted life years and fall in depression. The authors concluded there were "both positive and negative consequences".

A 2021 review of 21 free DBT apps found only five included a diary card feature. And in one published patient account, a man in DBT said carrying a paper notebook in public felt embarrassing, which is a real reason people stop filling them in.

My take: use whichever one you will fill in every day. I compare the main apps, including what each does with what you type, in the best DBT app.

A free DBT diary card that stays on your phone

The Esme Hartley DBT diary card is free and needs no signup. It asks, for each day, how strongly you felt sadness, anger, shame, fear and joy, how strongly you wanted to hurt yourself, drink, use or binge, or give up on therapy, all from 0 to 5, and which skills you used in each of the four DBT groups, with plain-English names and the clinical names beside them. There is also a section for rupture and repair with your children, because I write for parents.

Everything is saved in the browser on your own device, not on my website. You can print a week for your therapist, or save a backup file if you are changing phones. It is a tool, not therapy.

Does filling in a diary card actually help?

It is hard to separate the card from the therapy around it, so be wary of anyone who says the card alone works. What the research shows:

• In an outpatient DBT programme where skills use was tracked on weekly diary cards, more skills use was associated with improvement in BPD features, even after controlling for diary card compliance.
• In a small trial for binge eating, women given supported diary card self-monitoring alone, without formal skills teaching, showed large and significant improvements in binge eating, as did a group DBT arm. The authors called it preliminary.

These are associations and small studies. NICE recommends considering a comprehensive DBT programme for women with BPD for whom reducing recurrent self-harm is a priority. If you want the real thing, see what DBT is and how to get DBT on the NHS.

Sources

• NHS Highland Personality Disorder Integrated Care Pathway. Dialectical Behaviour Therapy (DBT) factsheet. Published on Right Decisions, NHS Scotland.
• Yaden DB, Earp D, Graziosi M et al. Psychedelics and psychotherapy: cognitive-behavioral approaches as default. Front Psychol, 2022. PMID 35677124 (section describing DBT diary cards, citing Linehan).
• Laursen SL et al. Mobile diary app versus paper-based diary cards for patients with borderline personality disorder: economic evaluation. J Med Internet Res, 2021;23(11):e28874. PMID 34762057.
• Probst T et al. Suicidal ideation and skill use during in-patient dialectical behavior therapy for borderline personality disorder. A diary card study. Front Psychiatry, 2018;9:152. PMID 29731724.
• Stepp SD, Epler AJ, Jahng S, Trull TJ. The effect of dialectical behavior therapy skills use on borderline personality disorder features. J Pers Disord, 2008;22(6):549-63. PMID 19072676.
• Klein AS, Skinner JB, Hawley KM. Targeting binge eating through components of dialectical behavior therapy. Psychotherapy, 2013;50(4):543-52. PMID 24295464.
• McCool MW, Mochrie KD, Lothes JE et al. Dialectical behavior therapy skills and urges to use alcohol and substances: an examination of diary cards. Subst Use Misuse, 2023. PMID 37328431.
• Mena MP, Del Rey GM, Gutierrez MA et al. Culturally informed and flexible family based treatment for adolescents. Front Child Adolesc Psychiatry, 2025. PMID 41220424.
• Fischer A, Rosner R, Renneberg B et al. Suicidal ideation, self-injury, aggressive behavior and substance use during intensive trauma-focused treatment. Borderline Personal Disord Emot Dysregul, 2022. PMID 34974844.
• O'Grady C, Melia R, Bogue J et al. A mobile health approach for improving outcomes in suicide prevention (SafePlan). J Med Internet Res, 2020. PMID 32729845.
• Hall A, Gregg L, O'Ceallaigh B et al. Transdiagnostic patient experiences of dialectical behavioural therapy: a systematic review and metasynthesis. Front Psychiatry, 2025. PMID 41122754.
• Wilks CR et al. A systematic review of dialectical behavior therapy mobile apps for content and usability. Borderline Personal Disord Emot Dysregul, 2021;8(1):29. PMID 34857035.
• Cristol S. Patient's perspective on using mobile technology as an aid to psychotherapy. JMIR Ment Health, 2018. PMID 30355552.
• NICE. Borderline personality disorder: recognition and management (CG78), recommendation 1.3.4.5.

Read from the published abstracts and guidance on 5 October 2026. If something here is out of date or wrong, tell me.

Nothing here is medical advice, it's lived experience, meant to sit alongside real support, not replace it. If you're struggling, please see the support resources. If you're in crisis in the UK, call Samaritans free on 116 123, or dial 999 in an emergency.