Behavioral analysis and recording tools

Daily monitoring as a clinical compass

The fundamental tool for data collection in DBT is the diary card.

The client should fill out this record daily, documenting emotions, impulses, problem behaviors and use of skills.

This card is not a mere administrative formality; it dictates the agenda of the individual therapy session.

At the beginning of each encounter, the therapist reviews the card to identify if any high priority behaviors (life-threatening or interfering with therapy) have occurred during the week.

If the client arrives without the card, the session is devoted to completing it on the spot, stressing its importance.

This prevents the therapy from being based on the "crisis of the moment" or the patient's current mood, and ensures that the objective behavioral patterns recorded during the week are addressed.

Dissecting the behavior: Chain analysis

When a problem behavior is identified on the daily card, the behavioral chain analysis technique is applied.

This tool is a step-by-step eva luation, similar to a slow-motion replay, of all the events that led to the behavior.

It starts by identifying the specific behavior (e.g., a binge eating episode).

Then, you trace backward to find the triggering event (a job criticism), the vulnerability factors (having had little sleep, skipping breakfast), and the chain of thoughts ("I am a failure"), emotions (shame, anxiety), and physical sensations that followed link by link until culminating in the dysfunctional behavior.

The goal is to understand the micro-sequence of events to identify where to intervene in the future.

Solution analysis and relapse prevention

Behavioral analysis does not end with understanding the problem; it must lead to solution analysis.

Once the chain of events has been mapped, therapist and client collaborate to identify at which "links" different coping skills could have been inserted to change the outcome.

For example, in the link where the emotion of shame arose, an emotional regulation technique could have been applied instead of resorting to food.

In addition, repair strategies are planned for the negative consequences of the behavior and prevention plans are developed to reduce vulnerability to similar future triggers.

This process transforms errors into practical learning opportunities, integrating the new skills into the individual's behavioral repertoire.

Summary

The diary card records emotions and behaviors on a daily basis to collect data. This document dictates the session agenda, prioritizing objective patterns over the momentary mood to intervene.

Chain analysis breaks down specific problem behaviors step-by-step. Triggering events, thoughts and emotions are traced link by link to understand the micro-sequence that led to the crisis.

The process culminates with the analysis of solutions to prevent future relapses. Therapist and patient identify where to insert coping skills in the chain and plan effective repair strategies.