Praxical.Psych
Session simulator

DBT: diary card, chain, and the dialectic

He wants to talk about his mother. The diary card says he cut on Thursday. The target hierarchy is not a suggestion, and holding it warmly is the whole skill.

Dialectical Behavior TherapyadvancedWeek 9 · Individual session~50 min

What you are practising

  • 1Apply the target hierarchy without negotiating it
  • 2Validate at the right level without validating the invalid
  • 3Run a chain analysis that does not become an interrogation
  • 4Hold acceptance and change in the same sentence
  • 5Identify and target therapy-interfering behaviour

Briefing

Where you are

Week 9 of a standard programme: weekly individual, weekly skills group, phone coaching available, consultation team on Fridays. Theo has attended every session, completes about half his diary cards, and is in the distress tolerance module.

The card

This week: urges at 4–5 all week; cutting circled once, Thursday; skills use recorded on two days; alcohol on Friday and Saturday.

The case

Theo Kaminski

24, he/him, part-time barista, recently returned to his parents’ home

Recurrent self-harm, intense mood swings, and a pattern of relationships that begin intensely and end catastrophically.

Read the full case first

The phases

  1. 1

    The diary card

    The card sets the agenda. Every time.

  2. 2

    The chain

    Reconstruct Thursday link by link, without it becoming punishment.

  3. 3

    Solution analysis

    Two or three links, rehearsed, with obstacles anticipated.

  4. 4

    After the session

    Consultation team, and your own reaction.

Educational use only

Praxical.Psych is a teaching tool. It is not medical, clinical, psychological or legal advice, not a diagnosis, not treatment, not supervision, and not a credential. Nothing here creates a clinician–patient or solicitor–client relationship. Every patient, case, transcript and simulated session is fictional. Clinical and legal requirements vary by jurisdiction and change over time — verify anything that bears on a real decision against your own regulator, statute and current professional guidance, and consult a qualified professional.

Do not enter real patient information. If you or someone else is in crisis: US & Canada 988 · UK & Ireland 116 123 · Australia 13 11 14 · elsewhere findahelpline.com · immediate danger, your local emergency number.

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Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
  • Praxical.Psych is not therapy, not a substitute for supervision, and not a credential. Competence to practise comes from training, supervised hours and licensure.
  • Scores from the instruments here are for learning how they behave. They are not a diagnosis and not a risk assessment, and must not inform a decision about a real person.
  • Do not enter real patient information. Everything you type stays in this browser, but that is not the same as a compliant clinical record system.
If you are in crisis

In the US and Canada, call or text 988. In the UK and Ireland, call 116 123 (Samaritans). Elsewhere, find a local line at findahelpline.com. In immediate danger, use your local emergency number.

Read the full disclaimer