What got you through the week? Not in the retrospective, feeling-based sense — but specifically: which DBT skills were you actually using, on which days, and were they working? The diary card doesn't exist to make you feel observed. It exists because the therapy session happens once a week and the clinician needs seven days of behavioral data, not a summary of how you generally felt.
Urge Tracking — The Honest Record
Urge 1, Urge 2, Urge 3, and Urge 4 with corresponding Acted Upon checkboxes track the primary target behaviors identified in the treatment plan. The acted-upon checkbox is the field that requires the most honesty to complete accurately. An urge without action is a different data point than an urge that was acted upon — both are clinically important, and collapsing them loses the distinction that tells the treating clinician whether skills are working as behavioral barriers or whether the urge-to-action gap is still too narrow.
Four urge fields accommodate the typical structure of a full DBT treatment target hierarchy — the primary self-harm or crisis behavior, secondary therapy-interfering behaviors, and tertiary quality-of-life behaviors. The specific urge content is defined collaboratively between client and clinician; the structure holds any combination.
Physical Reality and Behavioral Anchors
How did Depression Present?, Physical illness, and If other, specify capture the somatic and diagnostic context. Depression presenting as fatigue versus depression presenting as anhedonia versus depression presenting as increased irritability are functionally different states that require different skill deployment. The presentation field gives the weekly review something more nuanced than a mood number.
Balanced Eating, Appropriate hygiene, Balanced Sleep, Exercise, and Laughter are the PLEASE skill behavioral indicators — the evidence of whether the foundational self-regulation behaviors were present. A week where sleep was consistently poor, exercise was absent, and eating was dysregulated is a week where the emotional baseline was compromised before any interpersonal or emotional challenge occurred. Seeing those fields populated next to high urge ratings makes the connection visible in the data.
Intensity and Yes/No with If yes, how? handle the structured query fields for specific behavioral events — medication taken, intense emotional experiences, self-care completion at a threshold level. These Boolean anchors give the diary card the structured query capability that Describe the Day narrative alone can't support.
The Skills Inventory
Core Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance — the four DBT skill modules — as daily checklist fields create the skills utilization record across the week. A session review that shows high urges paired with zero distress tolerance skill entries is a different clinical picture than high urges with documented TIPP or ACCEPTS skill use. The diary card produces the data that distinguishes between "skills aren't working" and "skills aren't being used."
Describe the Day holds the qualitative context that the structured fields can't contain — the specific situation, the interpersonal conflict, the environmental trigger. It's the field that gives the numbers their story.