Current Clients

Your Information

Update your information

• address and phone numbers
• other therapists and doctors
• emergency contact information

Telemedecine Consent Form for remote video psychotherapy

Authorize your other mental health providers to send us your information:

Release of Information (former) - records from your former therapist or hospital
Release of Information (current) - records from your current psychiatrist

Authorize DBTCSD to send your information to another mental health provider:

Release of Information (send)


Completing these questionnaires will enable us to effectively assess your progress. If you prefer, you may instead print out these questionnaires and bring them to your session, or fill them out before or after your session.

Once per month - Please complete the following questionnaires every month:


Once every three months - In addition to the monthly questionnaires, please complete any of the following questionnaires that your therapist has told you are relevant for you:

PTSD Checklist
PTSD Symptom Scale (for teens)

Treatment Forms

Diary Card instructions
Diary Card - Depression (adult)
Diary Card - Depression (adult)
Diary Card - Adolescent
Diary Card - Parents
Behavior Contract for parents
Severe Behavior Contract
Reward Plan for Aggression/Curfew/School ( RTF format)
Behavior Contract for Accepting No (aggression) ( RTF format)
Activities Log
Thought Log - Standard
Thought Log - Worry
Pros and Cons

DBT Paced Breathing Skill

Breathing Training videos:
Short version (for clients)
Full version (for therapists)
10 Breath Pace Test

Biofeedback Devices & Software:
Heartmath (recommended)(software, handheld device, phone app)
My Calm Beat (software, phone app)
Somatic Vision (biofeedback video games)
Breath Sync (phone app)
Belly Bio Interactive Breathing (phone app)

Educational Videos and Books

Skills training overview (emotion diagram)
DEAR MAN assertiveness (27 minutes)
DBT diary cards
Wise Mind
Radical Acceptance
Mindfulness of Thoughts
Paced Breathing long version / Short version
DBT YouTube Videos
Reading and Video List


Psychiatrists who treat BPD patients

Web sites:
Project Borderline - nonprofit BPD organization by NFL star Brandon Marshall
Healing from BPD - BPD/DBT resources and blog

Mental health apps and software:
DBT Diary Card - DBT diary card and skills reference app
MY3 - suicide prevention app
Operation Reach Out - suicide prevention app geared toward military personnel
NAMI air - support and connection for mental health issues
Lumosity - Brain fitness games for improved cognition (online and app)
Mindfulness clock

Parental Controls for electronic devices:
Web site 1
Web site 2
Video 1
Video 2
Video 3