DBT Diary Card Examples: How to Fill One Out

By Tanner Oliver, LCSW ·July 31, 2026

Most clients can follow a blank DBT diary card in the abstract, but the first one they bring back is often half-empty or filled out wrong. A concrete example fixes that faster than instructions do. Here's what a completed diary card actually looks like, section by section, and the mistakes that trip people up. (For the underlying tool, see the DBT diary card guide and free printable PDF; to build a custom one, use the diary card builder.)

The examples below are illustrative — composites, not real clients.

Before the first card: set it up together

The single biggest predictor of whether a card comes back completed is whether the client helped decide what's on it. Five minutes at the end of a session:

Name the target behaviors explicitly, in the client's own words. "Self-harm" is clearer than "unsafe behavior."
Agree the emotion list. Four to six is plenty. A card with twelve emotions gets abandoned by Wednesday.
Fix the scale and don't change it. 0–5 for emotions and urges, 0–7 for overall skills use. Changing scales mid-treatment makes everything before the change uncomparable.
Decide when it gets filled out. Attach it to something that already happens daily — after brushing teeth, before phone charging. "Whenever you remember" reliably means the car ride to session.

What a filled-out diary card looks like

Picture a client, "Sam," working on emotion regulation and reducing self-harm urges. A single day on Sam's card might read:

Emotions (rated 0–5): sadness 4, anger 2, fear 3, shame 4, joy 1.
Urges (rated 0–5): urge to self-harm 3, urge to quit therapy 1, urge to use substances 0. (Record the highest the urge reached that day, not where it ended.)
Target behaviors: self-harm — no; skipped class — yes.
Skills used (checked off), overall skills rating 0–7: used opposite action and TIPP; overall skills use rated 4 ("tried skills, helped somewhat").
Medication: taken as prescribed — yes.

That one row tells the therapist where to start the next session: high shame and sadness, a moderate self-harm urge that didn't become an action, and evidence the client reached for skills. The card is the session agenda.

A second example: different targets, same structure

The card adapts to the treatment plan. "Jordan," working on binge eating and avoidance, tracks a different set entirely:

Emotions (0–5): anxiety 5, shame 3, sadness 2, anger 0, joy 2.
Urges (0–5): urge to binge 4, urge to avoid/cancel plans 5, urge to restrict 2.
Target behaviors: binge episode — yes (1); cancelled plans — yes; ate regular meals — no (2 of 3).
Skills used, overall rating: check the facts, cope ahead; overall 3.
Sleep: 5 hours.

Same five components, entirely different content. This is why generic templates only get you so far — the structure generalizes, the targets don't.

How to fill out each section

Emotions. Rate each tracked emotion for the day on the 0–5 scale, where 0 is "not at all" and 5 is the most intense you've felt it. Rate the peak for the day, not an average.

Urges. Same 0–5 scale, recording the strongest each urge reached. Urges are tracked separately from whether the client acted — a high urge with no action is important, successful data.

Target behaviors. Mark the specific behaviors you and the client are monitoring as a yes/no or a count. These are individualized: self-harm, substance use, binge eating, skipped commitments — whatever the treatment targets.

Skills. Check off which DBT skills were used across the four modules, then give an overall skills-use rating on the 0–7 scale (0 = didn't think about skills; 7 = used skills and they helped). The DBT skills picker can help clients identify what to reach for in the moment.

Medication. Note whether prescribed medication was taken as directed.

The five most common mistakes

Filling it out retrospectively. A card completed from memory in the waiting room produces tidy, useless data. Real-time, once-daily entry is the whole point — which is why digital diary cards with reminders tend to beat paper on accuracy.
Recording where the urge ended, not its peak. "It's a 0 now" misses the 4 it hit at 2 p.m. Track the high-water mark.
Leaving skills blank on hard days. A 0 skills rating on the worst day is exactly the data the therapist needs — blanks erase it.
Conflating urge with action. A high urge that wasn't acted on is a success worth seeing, not something to hide.
Skipping days. Gaps make trends unreadable. A quick daily entry beats a perfect weekly reconstruction.

Reading a full week

A single row is a snapshot. The week is where the clinical information lives. Scanning across seven days, you're looking for three things:

Where urges peaked, and what preceded them. A Thursday spike with Wednesday's sleep at four hours is a vulnerability-factor story worth a chain analysis.
Whether skills use and outcomes move together. If skills ratings are high on days urges stayed low, name it out loud — that contingency is the thing you want strengthened.
What's missing. A card that's complete Monday to Wednesday and blank Thursday to Sunday is not a compliance failure to correct; it's data about when the week fell apart.

Coaching the first week

Expect the first card to be imperfect and say so in advance — clients who think they've failed at the diary card stop bringing it. Three moves that help:

Fill out one day together before they leave, using yesterday as the example.
Ask for one week, not forever. A bounded ask gets agreement.
Review it first thing at the next session, every time. Nothing kills diary card completion faster than a client discovering the therapist doesn't look at it.

How it's reviewed in session

The therapist scans the week first, before the client says anything — looking for spikes in urges or target behaviors, patterns across emotions, and whether skills use tracks with better days. That review sets the agenda, in line with standard DBT. For the mechanics of that review, see using the diary card in DBT sessions.

To track all of this digitally — with daily reminders and automatic trend charts instead of a stack of paper — the DBT diary card is free on every Theracharts plan.