Dialectical Behavior Therapy for Binge Eating and Bulimia (21 page)

Adapted from Marsha M. Linehan. Copyright 1996–2009. Adapted with permission in Dialectical Behavior Ther—
apy for Binge Eating and Bulimia
by Debra L. Safer, Christy F. Telch, and Eunice Y. Chen (2009). Permission
to photocopy this appendix is granted to purchasers of this book for personal use only (see copyright page for
details).

APPENDIx
3.8

Chain Analysis

Behavioral Chain Analysis of Problem Behavior: Page 1

Name:

Date flled out:

Date of problem behavior:

VULNERABILITY

PROBLEM BEHAVIOR

PROMPTING

EVENT

LINKS

CONSEQUENCES

WHAT EXACTLY IS THE MAJOR
PROBLEM BEHAVIOR
THAT I AM ANALYZING?

WHAT PROMPTING EVENT
IN THE ENVIRONMENT
PROBLEM BEHAVIOR? Start Day:

STARTED ME ON THE CHAIN TO MY

WHAT THINGS IN MYSELF AND MY ENVIRONMENT MADE ME
VULNERABLE?
Start Day:

Adapted from Marsha M. Linehan. Copyright 1996–2009. Adapted with permission in Dialectical Behavior Ther—
apy for Binge Eating and Bulimia
by Debra L. Safer, Christy F. Telch, and Eunice Y. Chen (2009). Permission
to photocopy this appendix is granted to purchasers of this book for personal use only (see copyright page for
details).

Date flled out:
Behavioral Chain Analysis of Problem Behavior: Page 2

OF BEHAVIOR (actions; body sensations; cognitions; feelings) and EVENTS

LINKS

sensations

Feelings

A – Actions

B – Body

C – Cognitions

E – Events

F –

Name:

Adapted from Marsha M. Linehan. Copyright 1996–2009. Adapted with permission in
Dialectical Behavior Therapy for Binge Eating and Bulimia
by Debra L. Safer, Christy
F. Telch, and Eunice Y. Chen (2009). Permission to photocopy this appendix is granted to purchasers of this book for personal use only (see copyright page for details).

80

Behavioral Chain Analysis of Problem Behavior: Page 3

Name:

Date flled out:

WHAT EXACTLY WERE THE
1.

CONSEQUENCESIN THE ENVIRONMENT?

AND IN MYSELF?
1.

WAYS TO REDUCE MY
VULNERABILITYIN THE FUTURE

WAYS TO PREVENT
PRECIPITATING EVENT
FROM HAPPENING AGAIN

WHAT
HARM
DID MY PROBLEM BEHAVIOR CAUSE?

PLANS TO
REPAIR, CORRECT,
AND
OVERCORRECT
THE HARM

MY DEEPEST THOUGHTS AND FEELINGS ABOUT THIS (THAT I WANT TO SHARE)

Adapted from Marsha M. Linehan. Copyright 1996–2009. Adapted with permission in Dialectical Behavior Ther—
apy for Binge Eating and Bulimia
by Debra L. Safer, Christy F. Telch, and Eunice Y. Chen (2009). Permission
to photocopy this appendix is granted to purchasers of this book for personal use only (see copyright page for
details).

81

Urge to quit therapy (0–6):

Before therapy session

After therapy session

2–3 times

each day

4–6 times

once

This week I flled out this side of the diary card

Diary Card

Front Side of Diary Card

Please write in your user

ID or

initials

4 = Tried, could use them, but they didn’t help

5 = Tried, could use them, helped

6 = Used skills without trying, didn’t help

7 = Used skills without trying, helped

(circle one)

Sun

Sat

Fri

Thur

Wed

Tue

Dialectical Behavior Therapy for Binge Eating and Bulimia

by Debra L. Safer, Christy F. Telch, and Eunice Y. Chen. Copyright 2009 by The Guilford Press.

DIARY CARD

For week beginning:

Mon

On date:

/

/

Day

Describe AIBs.

USED SKILL

APPENDIX 3.9

Date Weighed

/

/

Weight

*Please rate from 0 to 6 the highest rating for the day (0 = did not experience the urge/thought/feeling, to 6 = experienced the urge/thought/feeling intensely)

†

‡

0 = Not thought about or used

1 = Thought about, not used, didn’t want to

2 = Thought about, not used, wanted to

3 = Tried but couldn’t use them

From

Permission to photocopy this appendix is granted to purchasers of this book for personal use only (see copyright page for details).