Tracking your mental health can be a powerful tool for self-improvement and healing. One of the most effective ways to do this is using diary cards, a technique that comes from DBT, Dialectical Behavior Therapy. DBT diary cards help you chart your emotions, behaviors, and the skills you use to manage them. They can be especially helpful for LGBTQ+ people, who face particular challenges. In this guide, we’ll dive into what DBT diary cards are, how to use them effectively, and how they can benefit your mental health journey.

Understanding DBT

DBT stands for Dialectical Behavior Therapy. It’s a treatment that balances making change and accepting reality. The original developer of this type of therapy is Marsha Linehan, who created DBT in the 1990s. She initially used DBT to target self-harming behaviors and the symptoms of borderline personality disorder. In the time since, it has been adapted to address a variety of situations, including depression, substance use, eating disorders, ADHD symptoms… it’s a long list. I’ve written here about how DBT is especially helpful for hair-pulling, and here about how DBT is used to treat anxiety. What you need to know is that DBT is the combination of behavioral techniques and acceptance practices, with a grounding in zen mindfulness.

What Are DBT Diary Cards?

DBT diary cards are tools used to track your emotions, urges, behaviors, and coping skills on a daily basis. You can use diary cards to help you get objective data on your patterns, triggers, and progress over time. Monitoring these elements helps you get a clear understanding of your mental health. From that understanding, you can make informed decisions about your therapy and self-care routines, about how you want to structure your days, even about what skills you want to prioritize. 

Benefits of Using DBT Diary Cards

Increased Self-Awareness

One of the main benefits of using DBT diary cards is that you get good information to work with. By regularly recording your emotions and behaviors, you can establish your mental health baseline. From there, it’s easier to identify patterns and monitor triggers that affect your well-being overall. Knowing what your patterns are can help you feel more in control, and empower you to accept those parts of yourself, or even to change them. This awareness is the first step towards making positive changes and managing your emotions more effectively.

Improved Emotional Regulation

Diary cards help you identify and regulate your emotions by tracking what comes up for you each day. What are the emotions that feel overwhelming? What urges come up for you when you are in the midst of those emotions? How do you ride out those urges? Over time, you’ll have concrete data on which skills work best for you and in what situations. This can help you develop a more effective strategy for managing intense emotions. Also, it can help reduce the amount of time you spend on habits that are hurting you, or that you want to drop.  

Customizing to Fit Your Needs

Although DBT was initially developed to help get relief from self-harm behaviors, there is a wide range of different behaviors you can use diary cards to help you get a handle on. When you first came to therapy, what did you want to work on? I’ve used mine for tracking how much time I spend doom-scrolling on instagram. And I’ve helped clients track things like procrastination, substance use, and fighting with their partner. In addition, you might focus on people-pleasing behaviors, how often you shower, or nightly insomnia; whatever shows up in your life that you would like to change. Customizing your diary card to fit your specific needs is key. Adapting your diary card to meet your needs makes it more relevant and ultimately, more useful to you. 

Enhanced Communication with Therapists

Having a completed diary card to bring to your therapy sessions provides your therapist with valuable data. It allows us to see patterns in your behavior and emotions at a glance. From there, we can tailor our approach to better support you. Constructing your diary card is ideally a collaborative process, where you design it together. This can lead to more effective therapy and speed up your progress.

Personal Accountability and Growth

Using diary cards encourages a bit of personal accountability. In order to track your daily experiences and behaviors, you have to take an active role in your mental health work. The accomplishment of filling it out each day, and the consistency of gathering useful info week to week, help you feel empowered in your own therapy. This sense of ownership and agency can motivate you to stay committed to your therapy and to your goals. This commitment in turns fosters personal growth.

Setting Up Your DBT Diary Card

Read on for some how-tos and helpful hints for how to get the most of out your diary card.

Choosing the Right Format

There are various platforms available for DBT diary cards. You can go the old school paper and pencil route, use a collaborative website, or use an app or a template. Some people like the tactile experience of writing on paper, or the chance to use fancy stationery. Others may prefer the convenience and accessibility of digital tools. One client I had constructed a beautifully ornate diary card in the form of a bullet journal. Although that route might be the most labor-intensive, filling it out aesthetically helped this person stay motivated to complete it each day. As long as you can bring it into the therapy session and your therapist can take in the information, it works! Choose whatever format you like best. And don’t be afraid to experiment a little, to see which options you like. 

One research study from 2019 compared paper diary cards to an app version. They published their findings in an article called “Using a Mobile Diary App in the Treatment of Borderline Personality Disorder: Mixed Methods Feasibility Study.” The authors found that many clients in the study preferred to use the app, calling it “easy to use” and “always there.” One negative was the time it took to get comfortable using the app. Also, I have some concerns about the privacy of using apps to track mental health data. Many companies run apps in order to track user data for targeted ads, often storing data and sharing it with other companies that we as the users don’t find out about. One participant in this study shared a similar fear, saying “Why does it need to track my phone calls and my emails? What is it for? I think it’s creepy.” That’s one additional concern to keep in mind when tailoring DBT cards to your own needs.

Essential Components

A standard DBT diary card includes all of the following sections: emotions, urges, behaviors, and DBT skills used. It has a daily rating scale to measure the intensity of your emotions and urges. For the emotions and the urges, I like to go from 0 to 10, with my clients choosing a number between 0, I did not feel this emotion at all, all the way up to 10, I felt this emotion overwhelm me completely. And then for behaviors and skills used, you rate yourself as either yes or no, I did the thing or I did not. The more things you track, the more data you have. One word of caution: the fewer things you track, the more likely you are to actually fill it out every day. We need to balance breadth of data with barriers to getting it done. 

Tips for How to Use DBT Diary Cards Effectively

Set a routine for filling out your diary card. I find it works best to fill it out at the same time of day every day. This could be in the morning, right when you get home from work, or any time that works best for you. Consistency is key. Try and make it a regular part of your day. You might find it helpful to set a reminder on your phone. Or you can incorporate it into another daily routine, like filling it out while you brush your teeth at night. 

Being Honest and Specific

Be as up front as you can be when you fill out your diary card. Fully honest answers are going to be more helpful that “aspirational” answers. You also want to be as specific as possible about your emotions, behaviors, and skills. Having accurate data will help you and your therapist understand your experiences better. Incomplete information, or incorrect info, is not going to help us identify effective strategies. Fibbing a little bit is ultimately going to make it more difficult to use this tool to manage your mental health.

Reflecting on the Data

Once you have the data, it’s time to figure out some patterns! Reviewing your diary card enables you to identify trends and areas for improvement. Also, it gives you an excuse to celebrate your wins! Maybe you can tie this to a particular reward. For instance, if I follow through on this particular skill this many times, I reward myself with a class I want to take or by using the expensive bath products. Reflecting back on your time using a diary card can help you see the progress you’ve made and pinpoint any persistent challenges. Discussing these insights with your therapist leads to more targeted and effective therapy sessions. We therapists love cheering you on!

Overcoming Common Challenges

Diary cards feel a bit like homework sometimes, I’ll admit it. Particularly if you’ve already got lots on your plate, you might be hesitant to add on an extra to-do every day. It's normal to feel resistant to tracking this stuff. Especially when you consider that it can bring up shame or uncomfortable feelings. Acknowledge this up front. Maybe remind yourself of the long-term benefits. And of course, talk it out with your therapist about any hesitation you experience. It’s part of our job as therapists to offer support and strategies to help you stay on track with tracking. 

Conclusion

Using DBT diary cards to track your mental health can be transformative. Diary cards are a tool that can provide self-awareness, improve emotional regulation, and enhance your relationship with your therapist. By customizing your diary card so that it is personalized to your needs, and staying consistent, you can take an active role in your mental health. That means more powerful progress towards your therapy goals.