Individual Session Reminder Sheet



I have consulted my target hierarchy so I know what kind of things this patient is tracking on the diary card before they arrive

I am reviewing the diary card with the patient to see which is the top target behaviour that has occurred since we last met

I am fixing the exact day and time of the incident of the target behaviour that we will work on in this session

I am conducting a chain of the events surrounding the target behaviour

I am paying particular attention to affective (emotion) links

I am looking for dysfunctional links in the chain

I am asking ‘what is the function of this behaviour?’

If the dysfunctional link is a skills deficit I will coach skills

If the dysfunctional link is problematic thoughts I will coach cognitive modification and mindfulness

If the problematic link is an unwarranted emotion I will use exposure techniques

If the problematic link is that the environment is rewarding unskilled behaviour or failing to reward skilled behaviour I will look at contingency management

I am conducting a solution analysis on a particular link in the chain (I will get more points for choosing the affective links.)

I am getting the client to ‘rehearse’ the new skill by practicing here in the room e.g. mindfulness or interpersonal role-play, and by getting them to describe EXACTLY what they need to do. (No rehearsal = NO points!)

If I have not got round to rehearsing solutions by the time there is only 20 minutes left I will STOP my chain analysis and start rehearsing.

I am weaving in the following DBT techniques:

 Highlighting secondary targets as patterns of behaviour
 Using different levels of validation strategically
 Use of metaphor
 Looking for what is missed out
 Using a mix of reverent and irreverent strategies
 Highlighting dialectical tensions and finding syntheses