DBT Treatment Plan for Borderline Personality Disorder

​This DBT treatment planning worksheet is designed to help clinicians structure effective interventions for Borderline Personality Disorder. It integrates symptom severity, behavior chain analysis, and evidence-based DBT skills to support emotional regulation, relationship stability, and long-term behavioral change.

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DBT Treatment Plan for Borderline Personality Patterns

Mark Zauss, LMHC, LPC, CCMHC, NBCC, BC-TMC, ASDCS, NATC, CCTP, CCTP II, ADHD-CCSP, C-DBT, C-PD

Double Board Certified Counseling Services, Inc.

Scoreable treatment-planning worksheet with AI-style clinical summary

Clinical use note: This DBT treatment worksheet is a clinical support tool for treatment planning, psychoeducation, progress monitoring, and documentation. It does not replace formal diagnosis, risk assessment, safety planning, crisis evaluation, or clinical judgment. If suicidal ideation, self-harm, violence risk, abuse, psychosis, or acute crisis is present, complete appropriate risk assessment and crisis procedures.

Client / Session Information

Client Name

Date

Primary treatment targetSelect oneEmotional dysregulationRelationship instabilityFear of abandonmentImpulsivitySelf-harm / crisis urgesIdentity disturbance / unstable self-imageAnger dysregulationDissociation / stress-related suspiciousnessChronic emptiness

Treatment phaseStabilization and safetySkills acquisitionBehavioral pattern changeTrauma-informed integrationMaintenance and relapse prevention

Brief presenting problem

DBT Treatment Priorities

DBT treatment often prioritizes safety first, then therapy-interfering behaviors, quality-of-life interfering behaviors, and skill acquisition. This worksheet organizes symptom intensity, behavioral targets, DBT skills, and a practical next-step plan.

MindfulnessDistress ToleranceEmotion RegulationInterpersonal EffectivenessBehavior Chain AnalysisRepair Plan

Part 1: Current Severity Ratings

Rate the past week or current treatment period. 0 = none, 1 = mild, 2 = moderate, 3 = high, 4 = severe.

1. Emotional intensity / affective instability

0
None1
Mild2
Moderate3
High4
Severe

2. Fear of abandonment / rejection sensitivity

0
None1
Mild2
Moderate3
High4
Severe

3. Relationship instability / conflict cycles

0
None1
Mild2
Moderate3
High4
Severe

4. Impulsivity / urgent behavior

0
None1
Mild2
Moderate3
High4
Severe

5. Self-harm / suicidal ideation / crisis urges

0
None1
Mild2
Moderate3
High4
Severe

6. Identity disturbance / unstable self-image

0
None1
Mild2
Moderate3
High4
Severe

7. Anger dysregulation

0
None1
Mild2
Moderate3
High4
Severe

8. Dissociation / stress-related suspiciousness

0
None1
Mild2
Moderate3
High4
Severe

9. Chronic emptiness / disconnection

0
None1
Mild2
Moderate3
High4
Severe

Part 2: DBT Skills Selection

Select the skills that will be used as primary interventions.

Mindfulness: Observe, Describe, Participate Wise Mind decision-making STOP skill TIP skills Paced breathing / box breathing Opposite Action Check the Facts PLEASE skills DEAR MAN GIVE FAST Radical Acceptance Self-soothing Behavior Chain Analysis Repair plan after conflict Crisis/safety plan review

Part 3: Behavior Chain Analysis

Vulnerability factors before the eventPrompting event / triggerLinks in the chainProblem behavior or target behaviorSkillful replacement behavior

Part 4: Weekly Treatment Goals

Goal 1: Reduce crisis or emotion-driven behavior

Goal 2: Improve relationship effectiveness

Goal 3: Build identity stability and self-respect

Homework / practice plan

Part 5: Score + AI-Style Treatment Summary

Score + Generate SummaryDownload / Print as PDF

Your score and AI-style clinical summary will appear here.