Cognitive Distortions Worksheet
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A cognitive distortions worksheet can be a useful tool for therapists to use to empower clients in therapy.
Through cognitive behavioral therapy (CBT) and teaching clients about CBT thought distortions, clients can better understand themselves and their behavior. Using a cognitive distortions worksheet, like the cognitive distortions PDF in this article, can enhance clients’ coping strategies by learning to recognize common thought distortions and cognitive restructuring techniques.
In this article, we provide an overview of key cognitive errors, how to use a cognitive distortion worksheet with clients, and we provide a free, downloadable cognitive distortions PDF to save to your electronic health record (EHR) for future use.
What are cognitive distortions?
First introduced by psychiatrist Aaron Beck, MD, (who developed CBT) in the 1960s and 1970s, cognitive distortions are types of negative thoughts, or skewed perspectives of reality.
Beck found that these thought errors, or distortions, create negative biases to a person's interpretation of events. Thought distortions can happen to anyone, but when they are repeated and become automatic thoughts, they become maladaptive—inciting or influencing anxiety, depression, dysphoria, or other emotional and behavioral responses.
For example, let’s look at a client with depression. Typically, depression presents with biased thought patterns in three main core belief areas:
- Negative view of self: Thinking of themselves as worthless
- Negative view of the future: Thinking there is nothing to look forward to, or that things will not improve
- Negative view of the world: Thinking that no one cares about them
In addition to depression, cognitive distortions can occur in anxiety disorders and dysphoria.
Clients may or may not know that these distortions are irrational, but may experience their effects, which may include low self-esteem, worsening mental health conditions, and increasing maladaptive coping strategies, like substance use.
15 types of cognitive distortions
The thought distortions that were originally introduced by Beck have been expanded over the years, but these are some of the most well-known thought errors:
1. Mind reading
In this distortion, the person assumes they know what others are thinking. It’s most common in children and teens.
2. Catastrophizing
This type of distortion may involve dreading the worst outcome or predicting a disaster, despite facts to the contrary or assurances from others.. People may ask a lot of “what if?” questions. This distortion is considered an exaggerated response, accompanied by escalating anxiety and worry.
3. All-or-nothing thinking
Also called “polarized thinking” or “black-and-white thinking,” this type of distortion involves predicting extreme or detrimental outcomes—like believing you are doomed to fail, or that everybody hates you.
4. Emotional reasoning
This thought error involves the belief that feeling a certain way must mean the thoughts associated with the feeling are true. For example, feeling lonely validates the thought that you’re unlovable.
5. Labeling
This distortion involves thinking an isolated event or behavior shapes your view of a person or yourself—both in that instance and in all future interactions.
6. Mental filtering
This includes focusing on failures and refusing to acknowledge personal successes. It may also include focusing on just the negative parts of a situation and filtering out anything else. This distortion may also be referred to as “disqualifying the positive.”
7. Overgeneralization
This is the belief that one negative experience is indicative of a pattern bound to repeat itself. Words like “always” and “never” may commonly appear in this type of distortion.
8. Minimizing or magnification
This distortion involves either minimizing or over-exaggerating the importance of a person, event, or action. For example, minimizing can look like refusing to take credit for a successful outcome you were responsible for. On the magnifying end, thinking that a manager is the most important person in an organization and believing your success hinges on your every interaction with them.
9. Personalization
This common thought error takes the form of taking things personally even if they are not remotely connected to the person, such as taking the blame for something outside your control.
10. “Should” statements
This distortion is often rooted in familial expectations and plays out with statements like things should or ought to be done a certain way. When they’re not, the person may assume negative outcomes will follow, which can increase anxiety.
11. Jumping to conclusions
This may involve assuming you know another person’s thoughts, can predict their actions, or behavior. It may also involve making a negative prediction about the future.
12. Blaming
This distortion involves blaming others instead of taking responsibility for your actions. It may also involve playing the victim.
13. Fallacy of fairness
In this thought error, the person measures behavior or actions on a scale of fairness, and if something isn’t deemed to be fair, then they’re beyond reproach and don’t have to take accountability.
14. Control fallacies or fallacies of change
In this distortion, a person believes that if they pressure, control, or manipulate someone in a way that suits them, then they’ll feel satisfied or get what they want.
15. Magical thinking
This distortion assumes that if a person had behaved a certain way, something wouldn’t have happened, even though their actions or behavior are unrelated to the situation.
Cognitive distortion examples
The list of cognitive distortions below includes examples of scenarios you may encounter with clients. These examples can also be found in the cognitive distortions PDF that you can download at the top of this article.
Mental filtering
Your client reports that during a meeting with their supervisor, they were criticized for their use of the computer system. However, when you ask for a play-by-play of the meeting, you find out that the client was complimented for their hard work with a particular case and told that their performance exceeded expectations.
Just before the end of the meeting, the manager suggested one administrative adjustment for managerial reporting.
Overgeneralization
During a neighborhood community meeting, your client makes a suggestion for improving green spaces in the area. However, the community decided to proceed with a different approach.
Your client says that their contribution was a waste of time because no one ever listens to their ideas.
Jumping to conclusions
During a couples therapy session, one client observes their partner is being quiet. The client assumes it is because they are angry.
All-or-nothing thinking
Your client says that they might want to apply to graduate school when you asked them about their career aspirations.
However, they then say, “It’s pointless, actually. I was a failure at college, so I won’t get into the program.”
How to use the cognitive distortions worksheet in your practice
We’ve provided a cognitive distortions PDF that you can download and use as a worksheet with your clients in session. You can also provide clients with the cognitive distortions worksheet to take home and use on their own, in between sessions.
The cognitive distortions worksheet includes five common distortions and examples. Then, clients are provided with space for them to include ways in which they may experience thought distortions.
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