Thought Records in Cognitive Behavioral Therapy (CBT)

The idea that our thoughts determine how we feel and behave is the cornerstone of Cognitive-Behavioral Therapy (CBT).

The good news is that by viewing our experiences differently and changing how we think, we can alter how we react. This shift in perception can offer the opportunity to gain control and handle situations more effectively.

But first, it is vital to capture negative and unhelpful thinking accurately. In this article, we’ll explore how to do that using Thought Records.

***LINK TO THOUGHT RECORD FORM***

WHAT IS A THOUGHT RECORD AND DOES IT WORK?

Unlike some forms of therapy, Cognitive-Behavioral Therapy does not focus on the past. Instead, while acknowledging the importance of earlier experiences, CBT recognizes that our current thinking shapes how events are perceived (Wilding, 2015).

“Perceptions are often more crucial than actual events.”

Traditionally, CBT is thought to addresses our current irrational, illogical, and incorrect thinking. I prefer to think of it as addressing unhelpful thinking. It offers a well-researched and widely validated tool for treating anxiety, depression, stress, attention-deficit/hyperactivity disorder (ADHD), and many other mental health issues (Widnall, Price, Trompetter, & Dunn, 2019).

The strength of CBT comes from it being both short term and solution-focused. People also get the commonsense approach of CBT. This is essential as, according to the American Psychological Association (2017), CBT “emphasizes helping individuals learn to be their own therapists.”

While CBT can be understood by the untrained, complex and persistent problems typically require a professional’s support to make negative automatic thoughts visible and learn better ways of coping.

How do we recognize negative thinking?

Negative (and illogical or unhelpful) thinking is likely to stop us from reaching short-term and life goals.

CBT does not suggest we try to block such thoughts, but rather identify them before considering their accuracy and effectiveness. Unhelpful ones can be reevaluated and replaced with thoughts that are rational and open minded.

Negative thoughts can take many forms yet often arise from specific types of thinking, for example (Wilding, 2015):

  • You believe you know what others are thinking
  • You expect disaster
  • You tend to personalize general comments
  • You generalize specific incidents
  • You blame others for your thoughts and actions

As opposed to positive or even neutral thinking, such thought patterns lead us to interpret events negatively; in the long term, they can lead to burnout, depression, and anxiety.

Such cognitive distortions are often automatic; they pop into our heads, unannounced and unwanted, and linger. They profoundly affect how we feel, with thoughts such as “I can’t cope” or “I feel awful,” and how we behave by avoiding opportunities and situations.

How do we capture negative thinking?

It can be useful to check in and ask ourselves if our thoughts are positive and constructive or negative and damaging throughout the day.

A simple example is given below:

Event: What happened? I procrastinated making progress on a project and am regretting it.
Thoughts: What went wrong? I’m lazy.
Feelings/physical sensations: How do you feel? Are there any physical sensations? Worthless, angry, heaviness

Does it work?

Once identified, Thought Records provide a practical way to capture unhelpful thinking for functional analysis and review (Beck, 2011).

Indeed, Thought Records are potent tools for evaluating automatic thoughts at times of distress and remain a popular choice for therapists.

Research has confirmed that Thought Records are highly successful at effecting belief change and are recommended for CBT practitioners working with a client (McManus, Van Doorn, & Yiend, 2012).

HOW ARE THOUGHT RECORDS USED IN COGNITIVE BEHAVIORAL THERAPY (CBT)?

Writing down thoughts in a structured manner is a fantastic way to capture and work through existing thinking patterns.

The more often we practice completing Thought Records, the greater our awareness of negative, unhelpful, or dysfunctional thinking.

A good time to complete a Thought Record is shortly after noticing a change in how we feel.

Begin by asking yourself to consider the following questions regarding the thinking behind a recent emotional upset, difficult situation, or concern (adapted from Beck, 2011):

  • Is there any evidence to support this idea?
  • What is the evidence for and against it?
  • Are there other explanations or viewpoints?
  • What is the worst that could happen, and how would I cope?
  • What is the best that could happen?
  • What outcome is most realistic?
  • What is the result of such automatic thinking?

The following questions encourage us to start considering how we can challenge our thinking:

  • What would happen if I changed my thinking?
  • What would I tell a close friend if they were in this situation?
  • What should I do next?

While automatic thoughts may have some supporting evidence, that evidence is typically inadequate and inaccurate and ignores evidence to the contrary.

In a Thought Record you’re asked to describe:

  • A situation that led to unpleasant feelings (e.g., being turned down for a job)
  • The negative thoughts that arose (e.g., I’m useless)
  • The emotions running through your mind (e.g., I’m ashamed)
  • Your response (e.g., blame interviewer, stop applying for jobs)
  • A better, more adaptive response (e.g., ask for feedback from the interviewer)

Thought challenging

Our thinking style is influenced by inherited personality traits, upbringing, and meaningful events and interprets what we experience. Two people can have precisely the same encounter yet respond very differently.

CBT is a practical way to identify and challenge unhelpful thought patterns.

Thought challenging begins with focusing on the most powerful, negative thoughts captured in the Thought Record Worksheet.

After completing the first few columns in the Thought Record Worksheet, describing the situation in question. Here again is an example:

Event: What happened? I procrastinated making progress on a project and am regretting it.
Thoughts: What went wrong? I’m lazy.
Feelings/physical sensations: How do you feel? Are there any physical sensations? Worthless, angry, heaviness

You may ask yourself, “What could I do differently in the future?” For example, rather than jumping to conclusions, we may begin to challenge our thinking with questions.

Is there any other way to look at this? I’m upset because this project is important to me and it would mean a lot for me to do well.
How do I feel now? Calmer and more forgiving 

With practice, such a change in thinking can become second nature. And the act of challenging thoughts will increasingly become internalized, with no need to write them down.

You don’t need to remove all negative thinking; instead, you are trying to find a more balanced outlook.

When stressed or having a bad day, we are more likely to reject the positives and only see the negatives.

 

3 TIPS FOR CATCHING YOUR THOUGHTS

1. Complete the Thought Records in stages

Most people find that Thought Records are incredibly useful for organizing their thoughts and considering their responses.

However, if less daunting or confusing, start by only completing the first four columns (date and time, situation, automatic thoughts, and emotions). As you feel more comfortable, you may add the last last two columns (adaptive response, outcome).

2. Thought Record alternative

Thought Records aren’t the only way to capture thoughts. The following questions can be used to replace the worksheet and more easily guide you to challenging a thought (adapted from Beck, 2011):

  • What is the situation? I procrastinated making progress on a project and am regretting it.
  • What am I thinking? I’m lazy.
  • Why do I think this is true? I keep procrastinating despite regretting doing so in the past
  • Why might this not be true? I’ve completely many hard projects before.
  • What’s another way to look at this? I was just having a bad brain day and felt overwhelmed
  • What’s the worst outcome? I get reprimanded, shamed, or chastised
  • What’s the best outcome? That me getting the project done later wasn’t a big deal
  • What will probably happen? I’ll likely get corrective feedback after finishing the project late
  • What will happen if I keep reacting in this way? I will keep beating myself up and make myself feel less confident in finishing projects in the future
  • What could happen if I changed my thinking? I could feel better and better problem solve what to do next.
  • What would I tell a friend if this happened to them? Give the person extra time to call, or call to see if everything is okay.

3. Positive and negative event Thought Records

We don’t have to limit our focus to negative Thought Records; it can be useful to explore positive ones too (Wilding, 2015):

Choose a recent event and complete a Thought Record that also includes:

  • Positive thoughts – I’m excited about my new job.
  • Neutral thoughts – What am I going to have for dinner?
  • Evaluative thoughts – I wonder where I will sit in my new job?
  • Rational thoughts – If it’s not the right job, I can always take another.
  • Action-oriented thoughts – I’m determined to be good in my new job; if I need to do some extra hours to catch up, then that’s okay.

It’s useful to understand multiple categories of thoughts. It is then easier to spot the negative ones; for example, I will be useless in the job, and they only gave it to me because no one else showed up.

Negative thoughts are the ones that will leave you feeling upset, unhappy, and anxious.


A TAKE-HOME MESSAGE

Cognitive-Behavioral Therapy (CBT) provides a practical way to identify and challenge illogical, unhelpful, and incorrect thought patterns.

To address our unhelpful and often untrue beliefs, we must first capture our thoughts accurately and in sufficient detail. Thought Records are an invaluable and proven aid in capturing automatic thinking that can plague us and appear believable, despite being unreliable (McManus et al., 2012).

Paying attention to what is running through our minds – thoughts and images – when feelings and situations change can become a positive habit, helped by writing them down.

Capturing the situation, thought, and emotion to check its accuracy begins the process of changing the way we think.

Is there a more helpful way to think about myself and what has happened? Most likely, yes.

We can use Thought Records to collect data about our specific thoughts, emotions, and behaviors, and plan a strategy for overcoming their difficulties. We can use problem solving and changes to thinking and behavior to help build a better life.


The Science

American Psychological Association (2017). What is cognitive behavioral therapy? Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder. Retrieved from https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press.

McManus, F., Van Doorn, K., & Yiend, J. (2012). Examining the effects of thought records and behavioral experiments in instigating belief change. Journal of Behavior Therapy and Experimental Psychiatry, 43(1), 540–547.

Widnall, E., Price, A., Trompetter, H., & Dunn, B. D. (2019). Routine cognitive behavioural therapy for anxiety and depression is more effective at repairing symptoms of psychopathology than enhancing wellbeing. Cognitive Therapy and Research, 44, 28–39.

Wilding, C. (2015). Cognitive behavioural therapy: Techniques to improve your life. Quercus.