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The CBT Thought Record

Alexander Draghici ∙ Updated: 10/26/2020 Medically Reviewed 

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Over the last decades, cognitive-behavioral therapy (CBT) has rapidly grown in popularity, becoming one of the most sought-after therapeutic approaches.

A growing body of scientific literature indicates that CBT is an effective intervention for numerous emotional problems like depression, anxiety, and stress.

But its most significant contribution to counseling and psychotherapy is the thought record.

The CBT thought record is a simple and accessible tool that allows clients to become their own therapists by keeping track of their dysfunctional thinking patterns and challenging their irrational beliefs.

With enough practice, clients who use the thought record develop self-awareness and adopt a rational thinking style to keep unpleasant emotions in check.

 

What is a Thought Record in CBT?

In essence, the CBT thought record is a worksheet that clients must complete between sessions to monitor their negative thoughts and dysfunctional thinking styles.

Once clients have a good grasp of the principle behind this therapeutic tool, they can move to dispute the irrational or negative beliefs that generate depression, anxiety, guilt, shame, regret, and other unpleasant emotional reactions.

In time, clients learn to use the thought record as a go-to strategy to readjust their perspective and achieve a well-balanced outlook on life.

The ultimate goal of the thought record is to cultivate a rational and robust mindset that doesn’t waver in the face of adversity and misfortune.

 

The principle behind thought records

One of the fundamental principles of cognitive-behavioral therapy is that people experience unpleasant feelings not because of the situations that life throws down their path but because of how they interpret them.

Ten people can react in ten different ways to the same event. That is because each has its own set of ideas, opinions, and beliefs that influence their perspective.

Unfortunately, not everyone is aware of how thoughts give rise to emotions. Not everyone understands that each of us is responsible for how we feel, behave, and decide, regardless of the circumstances.

When life throws us a curveball, we often tend to pass on responsibility to others, God, the Universe, and pretty much anyone or anything outside our control.

In a way, it is comforting and liberating to blame someone or something else for our misery and misfortune.

However, when we perpetuate this mindset, we lose our personal power. Just like driftwood floating aimlessly on the ocean, so can we drift through life without ever feeling in control.

And this is where the CBT thought record comes into play, cultivating self-awareness and putting us in charge of our own lives.

In other words, the ‘philosophy’ embodied by the thought record encourages us to make the switch from passive individuals who assign blame and feel powerless to responsible adults who understand that behind every emotion, behavior, or decision is a subjective interpretation (belief) of reality.

It may sound complicated, but you will have a basic understanding of how the thought record works by the end of the article.

 

How Effective is the CBT Thought Record?

The thought record was developed on the theories and works of Aaron T. Beck and Albert Ellis, two of the most influential psychologists of the 20th century.

Throughout the years, numerous studies have confirmed its effectiveness, not only as a therapeutic strategy but also as a valuable self-help tool.

Even today, researchers are still discovering new ways in which the practice of putting thoughts and emotions on paper can change the way our brain works.

For example, a recent study revealed that using the thought record can influence our hormonal and neuroendocrine responses to stress. [1] Furthermore, this tool has proven highly effective in changing the core beliefs associated with social phobia. [2]

Given that the primary purpose of the thought record is to help clients identify and dispute their irrational beliefs, many experts have shown a keen interest in how this strategy can change our thinking style and, ultimately, the way we interpret reality.

As it turns out, the process of monitoring and disputing thoughts can alter the negative core beliefs responsible for unpleasant emotions. [3]

To achieve further cognitive restructuring, experts suggest a combination of thought records and behavioral experiments to help clients adjust their beliefs and gain a realistic (rather than negative) outlook on life. [4]

Overall, the CBT thought record is a scientifically valid tool that has proven its effectiveness repeatedly.

 

How Do I Complete a CBT Thought Record?

If we feel excited and happy, chances are this emotion was triggered by a positive thought (more or less conscious). On the other hand, if we feel sad, depressed, or anxious, there’s probably a negative thought that has crossed our minds.

Experts call them maladaptive or dysfunctional thoughts because they fuel unpleasant emotions, poor decisions, or maladaptive actions.

But emotions can be just as maladaptive or dysfunctional as the thoughts that triggered them. These emotions trigger strong physiological reactions in our bodies.

For example, an increase in blood pressure, coupled with restlessness, sweaty palms, and nausea, may indicate the presence of anxiety.

Emotional experiences such as anger, fear, guilt, shame, and sadness can also lead to avoidance or even destructive behaviors toward ourselves or others.

Such attitudes prevent us from adopting appropriate coping and problem-solving strategies. In the long run, maladaptive emotions can cause severe psychological and medical problems that affect the overall quality of life.

The first step in dealing with them (and preventing further problems) is understanding how thoughts, emotions, and behaviors influence each other.

 

The three essential elements of thought records

The most basic CBT thought record focuses on three fundamental elements: activating events, beliefs, and consequences.

Let’s take a closer look at each one.

A – Activating event

In essence, activating events are any stimuli that trigger our senses. The event can be internal (thoughts, emotions, physiological reactions) or external (situations, contexts, life events).

Think of a situation in which you experienced a negative emotion such as anger, fear, or jealousy. Describe the situation as objectively and accurately as possible using only the facts, without adding your interpretations.

B – Beliefs

Beliefs or cognitions give rise to the subjective interpretations that we attribute to activating events (situations). They represent the filter through which we perceive our reality.

Thoughts and beliefs are best described as ‘internal monologues,’ the inner voice that gives meaning to situations and life events (A’s).

If you find it challenging to identify the thoughts that went through your head, use the following questions to gain clarity:

  • What was going through my mind when the event took place?
  • What does it say about me?
  • What conclusions did I draw about myself or others in this situation?

C – Consequences

Consequences are emotions, behaviors, or physical reactions that result from your interpretations (B’s).

Physiological reactions accompany most dysfunctional emotions (especially those with high intensity). Write them down to get a better sense of how you reacted in a particular situation (A).

Furthermore, emotions elicit decisions, and actions. Take a moment to think about your behavior. Some examples of behavioral consequences are yelling, cursing, crying, running, or avoiding.

Here is a basic example of a CBT thought record:

Remember, consequences (C’s) result from beliefs (B’s), not activating events (A’s).

cbt table 1

The full version

Identifying the irrational or negative beliefs that trigger our emotional and behavioral consequences is what builds clarity and self-awareness

Next, we need to add two more elements to the ABC model.

D – Disputing

Disputing is the process through which we dismantle our dysfunctional beliefs by questioning their validity and usefulness.

In other words, we cope with problematic emotions and behaviors by changing the way we interpret situations and events (A’s).

Imagine you’re a prosecutor whose goal is to bring your irrational thoughts to trial and expose their dysfunctional nature.

To determine if your thoughts are valid, you need to examine the facts. That means looking for evidence that supports and does not support your beliefs.

 

E – Effect

This is the final step, the moment when you need to ask yourself one question – “Is there another way I can look at the situation, so I don’t end up feeling …. or doing …… ?”

After taking all evidence into account, write down an alternative explanation that sounds rational and reasonable.

Once you find an alternative way to interpret the situation (A), take a moment to think about how you feel. Most likely, you will notice that your emotions (C’s) are less disturbing.

Here’s how the full version of the thought record looks like:

cbt table 2

Is CBT Just Positive Thinking?

In cognitive-behavioral therapy, you learn to identify, challenge, and change the beliefs, thoughts, and assumptions behind the emotional and behavioral problems that you are dealing with.

By monitoring and recording the thoughts you have in various contexts, you realize that the way you think and how you choose to interpret reality contributes significantly to problems like anxiety or depression.

The therapeutic process is designed to help you reduce emotional discomfort by identifying cognitive distortions; to see thoughts as mere impressions rather than facts.

Given that one of the main goals of CBT is to reduce negative thinking and ‘tear down’ dysfunctional beliefs, some might believe this approach is mainly about cultivating positive thinking.

Indeed, CBT therapists and counselors will sometimes encourage clients to see the glass half full.

Research suggests that incorporating imagery (positive scenarios) into thought records helps clients cultivate positive thinking, diminishing negative beliefs. [5]

But the purpose isn’t to turn negative thinkers into positive thinkers but help clients adopt a balanced outlook on life.

In short, the principles and strategies employed by cognitive-behavioral therapists and counselors promote rational thinking and an objective outlook on life.

 

Can You Perform CBT On Yourself?

Having clear intervention protocols comprised of step-by-step instructions and specific strategies for every emotional or behavioral problem, cognitive-behavioral therapy is an easy-to-follow approach that promotes mental health and personal development.

Since clients cannot remain in therapy forever, one of counselor’s and therapists’ main goals is to ‘arm’ clients with all the tools and techniques they need to manage unpleasant emotions and keep their mental health in tip-top shape.

To a certain extent, people can learn and implement the principles of cognitive-behavioral therapy by themselves. The thought record is an excellent example of a CBT tool that people can use without the guidance of a licensed professional.

But the extent to which you can perform CBT on yourself depends on numerous factors such as educational background, access to resources, the nature or severity of your problem, and so on.

Ideally, you should consult a licensed therapist or counselor who can evaluate your condition and recommend a set of strategies tailored to your needs and goals. From there on out, you can focus on gradually building autonomy.

If you wish to identify dysfunctional thinking patterns, challenge negative core beliefs, and adopt a rational perspective on life, the CBT thought record is the ideal tool to start with.

 

References

[1] D. C. Rozek, N. B. Smith and A. D. Simons, “Experimentally unpacking cognitive behavioral therapy: The effects of completing a thought record on affect and neuroendocrine responses to stress,” Biological Psychology, vol. 138, pp. 104-109, 2018.
[2] I. R. de Oliviera, V. B. Powell, A. Wenzel, M. Caldas, C. Seixas, C. Almeida, T. Bonfim, M. C. Grangeon, M. Castro, A. Gavao, R. de Oliviera Moraes and D. Sudak, “Efficacy of the trial‐based thought record, a new cognitive therapy strategy designed to change core beliefs, in social phobia,” Journal of Clinical Pharmacy and Therapeutics, vol. 37, no. 3, pp. 328-334, 2012.
[3] T. R. Delavechia, M. L. Velasquez, É. P. Duran, L. S. Matsumoto and I. R. de Oliviera, “Changing negative core beliefs with trial-based thought record,” Archives of Clinical Psychiatry, vol. 43, no. 2, 2016.
[4] F. McManus, K. Van Doorn and J. Yiend, “Examining the effects of thought records and behavioral experiments in instigating belief change,” Journal of Behavior Therapy and Experimental Psychiatry, vol. 43, no. 1, pp. 540-547, 2012.
[5] N. Josefowitz, “Incorporating Imagery Into Thought Records: Increasing Engagement in Balanced Thoughts,” Cognitive and Behavioral Practice, vol. 24, no. 1, pp. 90-100, 2017.

 

 

About the author 

Alexander Draghici

Alexander Draghici is a licensed Clinical Psychologist, CBT practitioner, and content writer for several mental health websites. His work focuses mainly on strategies designed to help people manage and prevent two of the most common emotional problems: anxiety disorders and depression.


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