Individual Therapy

Client reports interpersonal conflict with coworker that triggered urge to self-harm. States 'I used my skills this time. I did opposite action and went for a walk instead.' Reports one episode of dissociation during the week, managed with grounding. No self-harm behavior.

Client appropriately dressed. Affect labile but within functional range. Demonstrated understanding of DBT skills when discussing crisis situation. Speech normal. Client reports no new self-harm. DAST sheet reviewed showing use of distress tolerance skills 4/7 days.

Client demonstrates growing capacity for distress tolerance, evidenced by successful use of opposite action during interpersonal crisis. The shift from reactive self-harm to skills use represents significant clinical progress. BPD treatment on positive trajectory.

Continue weekly individual therapy with DBT skills focus. Review interpersonal effectiveness module for workplace relationships. Practice DEAR MAN for assertive communication. Continue DAST tracking. Safety plan remains in effect. Next session: 03/07/2026.