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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