Free printable DBT diary card
A blank one-week card for urges, emotions and skills use, on one landscape page of A4 or Letter. Print it, or choose "Save as PDF" in the print dialog. You don't need to sign up, and nothing on this page is stored or sent.
| Day | Urges | Emotions, 0 to 5 | Skills | Medication as prescribed | Note | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Self-harm urges | Suicidal thoughts | Urge to use (alcohol, drugs) | Your own: | Joy | Sadness | Anger | Fear | Shame | Guilt | Your own: | Mindfulness | Distress tolerance | Emotion regulation | Interpersonal effectiveness | Skills use 0 to 7 | |||||||
| 0 to 5 | Acted | 0 to 5 | Acted | 0 to 5 | Acted | 0 to 5 | Acted | |||||||||||||||
| Monday | Y / N | |||||||||||||||||||||
| Tuesday | Y / N | |||||||||||||||||||||
| Wednesday | Y / N | |||||||||||||||||||||
| Thursday | Y / N | |||||||||||||||||||||
| Friday | Y / N | |||||||||||||||||||||
| Saturday | Y / N | |||||||||||||||||||||
| Sunday | Y / N | |||||||||||||||||||||
How to fill it in
- Urges and emotions: 0 means none, 5 means strongest.
- Acted: tick if you acted on it that day.
- Skills: tick each area you used skills from.
- Medication: circle Y or N, or skip it if it doesn't apply.
- Your own: anything you and your therapist choose to track.
Skills use, 0 to 7
- 0Skills didn't come to mind
- 1Came to mind, no wish to use them
- 2Came to mind, wanted to, didn't use them
- 3Tried, couldn't use them
- 4Tried and used them, no help
- 5Tried and used them, it helped
- 6Used them without trying, no help
- 7Used them without trying, it helped
Skills I used this week
For my next session
Blank card from DiaryLog
eastframe-technology.github.io/diarylog-support
On a phone, scroll sideways to see the whole card. It prints at full size.
What is on the card
Each day gets one line. Reading across the line:
- Urges: self-harm urges, suicidal thoughts and the urge to use alcohol or drugs, each rated 0 to 5, with a box to tick if you acted on it. There is one blank pair for an item of your own.
- Emotions: joy, sadness, anger, fear, shame and guilt, each rated 0 to 5, and a blank one.
- Skills: a box for each of the four skill areas, and one number from 0 to 7 for how skills use went that day.
- Medication: whether you took it as prescribed, if you track that.
- Note: a few words about the day.
Below the grid there is room for the skills you used and for what you want to bring up at your next session. These are the same items the DiaryLog app tracks, so the card and the app can be read the same way.
A worked example
Say Tuesday was an uneven day. On Tuesday's line you might write 0 for each urge, 1 for joy, 3 for sadness and 2 for fear. You tick Mindfulness, because you used a skill from that area. Under Skills use you write 5, because you tried a skill and it helped. In the note you write: "Hard meeting. Talked to my sister after."
That takes about a minute. There are no right or wrong numbers. They are your own scale, and they only need to make sense to you and your therapist.
Limits
- This is a blank sheet for keeping track. It doesn't score anything, and it can't tell you how you are doing.
- It supports therapy and doesn't replace it. Filling in a card on your own isn't DBT.
- Your therapist may want different items or a different scale. Their version comes first.
Frequently asked
Is this an official DBT diary card? No. We designed it ourselves from the general idea of tracking urges, emotions and skills use. It isn't taken from a book or a programme, and DiaryLog is not affiliated with any DBT organisation. If your therapist or programme gives you a card, use theirs.
Can I change what is on it? Yes. Cross out what doesn't apply, and use the two spaces marked Your own for items you and your therapist choose. It is your card.
Will it fit on A4 and on Letter paper? Yes. The page is set to landscape and adjusts to either size. If your browser doesn't turn the page by itself, choose landscape in the print dialog. Turning off the browser's headers and footers there gives a cleaner page.
Is anything I do on this page saved? No. The page has no boxes for your diary, and it stores and sends nothing. What you write stays on your paper, so keep the card somewhere you feel comfortable with.
Do I need the app to use this? No. The card is free to print as many times as you like.
If you would rather keep the card on your phone, DiaryLog tracks the same items, and the daily card and week view are free. A PDF of your filled-in weeks is part of its one optional purchase. Get it on Google Play.