CBT Thought Record
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A CBT thought record can help both clients and therapists in the process of cognitive restructuring.
This article explains CBT thought records, the benefits of using a CBT thought log, and examples of journal prompts for managing anxiety or depression. In addition, download a free automatic thought record PDF to use with clients and save to your electronic health record (EHR) for future use.
What is a cognitive behavioral therapy (CBT) thought record?
Cognitive behavioral therapy (CBT) works on the premise that how we think impacts how we feel and behave.
Using the CBT model, therapists can support clients in changing their thoughts and how they perceive situations, empowering them to respond more effectively.
Most of our thoughts are automatic, and we may not even realize we are having them. A cognitive behavioral thought record is like a structured journal to increase awareness of automatic thoughts and challenge their accuracy.
For example, a client who was stood up on a date may experience automatic thoughts about being rejected when they plan for or attend future dates. This could lead to a cascade of unhelpful thoughts and emotions, which may prevent them from dating.
A CBT thought record provides clients with a practical opportunity to examine their automatic thoughts, challenge their accuracy, and restructure their thoughts to more adaptive responses.
Benefits of using a CBT thought log
A thought log is an accessible and impactful CBT tool that only takes a few minutes to complete.
Benefits of using a CBT thought record include:
- Increases awareness of unhelpful automatic thoughts
- Seeks evidence to support or reject these thoughts
- Highlights how thoughts impact emotions and behavior
- Identifies thought distortions which fuel anxiety, depression, and contribute towards low self-esteem, like catastrophizing or black-and-white thinking
- Creates an opportunity to reframe thoughts for different outcomes
- Enhances emotional regulation and distress tolerance skills
- Reminds clients that thoughts are not always true, and they can be biased
Aside from the positive outcomes from using a thought journal, CBT is one of the most researched and evidence-based interventions and can help to alleviate symptoms of anxiety and depression.
Examples of using a CBT thought journal
Using an anxiety CBT thought record is a great way to empower clients to overcome the automatic thoughts that may contribute to their anxiety.
Some examples of using a CBT thought record for anxiety include:
Journaling when feeling anxious
Suggest to the client that they take five to 10 minutes to use a CBT thought log (such as the one you can download above), or write in a journal, when they notice feelings of anxiety.
Ask clients to record the following:
- What they are worried or feeling anxious about. For instance, is it something happening in their life at that moment, or are they worried about something that they think is about to happen?
- Emotions associated with their anxiety. (This List of Emotions PDF may be helpful to share with clients as well.)
- Automatic thoughts about the situation, or perceived event, and what they believe. For example, if the client is getting ready to go on a date and is feeling anxious, their automatic thoughts might include “dates are always a disaster,” “they won’t like me,” or perhaps “they never show up.”
- Evidence they have to support or reject those thoughts.
- Ideas for how they can reframe their thoughts by considering the best outcome, other possible outcomes, and more realistic outcomes.
CBT thought log for cognitive distortions
Another option is to work through a template of thought distortions with the client, so they have a list of common thoughts or phrases that could be contributing to their anxiety.
When the client feels anxious, encourage them to journal about the situation, while referencing their list of thought distortions to identify any coming up in the anxiety they’re experiencing.
Some common thought distortions include:
- Mind reading: Assuming you know what others are thinking.
- Catastrophizing (or fortune telling): Dreading the worst or predicting a disaster. This distortion is considered an exaggerated response, with accompanying escalating anxiety and worry, and may include questions like “what if?”
- All-or-nothing thinking: Extreme thinking, like believing you are doomed to fail, or that everybody hates you.
- Emotional reasoning: Believing that feeling a certain way must mean the thoughts associated with the feeling are true. For example, there may be no conflict in the relationship, but you still think the relationship is failing.
For a full list of cognitive distortions, share this Cognitive Distortions Worksheet with clients to help them recognize their automatic thoughts.
How to use the CBT thought record PDF with clients
The free downloadable CBT thought log can be used with clients in several ways:
- In session to illustrate cognitive distortions
- As a tool to describe how the client can work through their anxiety or other thought distortions to a more adaptive response
- As a thought diary/CBT log to measure progress between sessions, or to discuss observations in the next session
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