Which sequence correctly describes a typical DBT session structure when combining individual therapy and skills?

• A. Begin with crisis intervention; end with diary card review; no individual therapy.
• B. Begin with group discussion; skip diary card review; do skills first; finish with crisis assessment.
• C. Start diary card review; address crisis; conduct target-focused individual therapy; end with skills practice or homework.
• D. Start with skills training; end with diary card review; ignore crises.

Answer: (C)

In DBT, sessions are built to be data-driven, safety-focused, and skills-focused. The typical flow starts with diary card review to ground the session in the client’s week of emotions, urges, and behaviors, so the discussion targets real patterns. Next, any crises or urgent issues are addressed to ensure safety and stabilize the moment. Then the session moves to targeted individual therapy, focusing on the client’s top problem behaviors and applying problem-solving and validation to promote change. The session finishes with skills practice or homework to reinforce what was learned and help transfer those skills to daily life before the next session.

Choosing a sequence that skips diary card review, ignores crises, or fronts skills practice before reviewing data disrupts this structured, data-driven, safety-oriented approach.