Cognitive restructuring worksheet
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If you’re a therapist looking for cognitive restructuring worksheets, these CBT worksheets include cognitive restructuring examples and a Socratic questioning worksheet.
Cognitive behavioral therapy (CBT) offers therapists practical strategies to support clients who are stuck in unhelpful thought patterns.
This article explores using cognitive restructuring and Socratic questioning worksheets to help clients overcome cognitive distortions. You can also download a free cognitive restructuring worksheet to save to your electronic health record (EHR) for repeated use with clients.
What is cognitive restructuring?
Cognitive restructuring is a technique used in CBT to help clients challenge unhelpful thoughts.
CBT works on the principle that our core beliefs influence our thoughts and behaviors.
Through the lens of CBT, when individuals repeatedly have unhelpful thoughts, they may experience a skewed view of themselves, others, and the world around them. These inaccurate thought patterns are called cognitive distortions.
Some examples of common thought distortions include:
- Catastrophizing: An exaggerated response in which a person assumes the worst possible outcome of a situation.
- All-or-nothing thinking: A form of 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.
- Minimizing or magnification: Minimizing or over-exaggerating the importance of a person, situation, or behavior.
- “Should” statements: Using “should” statements like things should or ought to be done a certain way.
Through the use of cognitive restructuring worksheets, clients can begin the process of noticing thought distortions, challenging them, and finding new and more helpful thoughts.
The steps of the cognitive restructuring worksheet include:
1. Identify the upsetting situation: This may relate to their interpretation of themselves, others, or the world.
2. Note the associated feelings and emotions: These feelings may also present as symptoms of anxiety and depression.
3. Identify the thoughts underlying the feelings and consider if this is a cognitive distortion.
4. Evaluate the unhelpful thoughts, whether they are accurate, and try to find another way to think about the situation.
5. Decide the accuracy of the thought, the evidence to support it, and if there is an alternative way to think about the person/situation/event.
What is Socratic questioning?
The Socratic method is a component of CBT that involves dialogue and inquiry.
Socratic questioning worksheets consist of asking questions to stimulate critical thinking, reflection, and problem-solving, allowing clients to reach more adaptive thoughts.
Socratic questioning worksheets enhance learning by asking open-ended questions so clients consider new sources of information and gain a broader perspective.
Typically, Socratic questioning involves four stages:
1. Asking informational questions, such as:
- "When was the first time this happened?”
- “What did you do?”
- “What would your friends say about this?”
2. Listening to the client.
3. Summarizing information. Prompts may include “What do you think is causing the problem?”
4. Synthesizing the new information to address the client’s original concern by asking questions like, “What would you say to a friend in this situation?” or “How would you approach changing this situation with this new information?”
Socratic questioning worksheets are also used in other types of psychotherapy, such as motivational interviewing.
Other types of cognitive distortion worksheets
There are various types of cognitive restructuring worksheets, including:
- Core beliefs worksheet: Our cognitive behavioral therapy worksheets help therapists support clients to uncover the underlying beliefs that fuel cognitive distortions.
- CBT for anxiety: This CBT worksheet provides practical tips and strategies to support clients in overcoming anxiety.
- Thought stopping worksheet: This CBT thought record worksheet helps clients notice, acknowledge, and work through unhelpful thoughts.
- Cognitive distortions worksheet: This free worksheet highlights common unhelpful thoughts to support clients in achieving more adaptive thoughts.
How to use the cognitive restructuring worksheet
Therapists can use the cognitive restructuring worksheet in several ways:
- To provide psychoeducation about cognitive distortions during client sessions
- To illustrate the process of cognitive restructuring during the session
- A handout to remind clients of cognitive distortions and to practice cognitive restructuring at home
Sources
- Braun, J. D., Strunk, D. R., Sasso, K. E., & Cooper, A. A. (2015). Therapist use of Socratic questioning predicts session-to-session symptom change in cognitive therapy for depression. Behaviour research and therapy, 70, 32–37.
- Carona C, Handford C, Fonseca A. Socratic questioning put into clinical practice. BJPsych Advances. 2021;27(6):424-426.
- Clark G, et al. (2018). Clarifying the role of the socratic method in CBT: A survey of expert opinion.
- Crum J. Understanding Mental Health and Cognitive Restructuring With Ecological Neuroscience. Front Psychiatry. 2021 Jun 18;12:697095.
- American Psychological Association. (n.d). Handout 27.5 steps of cognitive restructuring instructions.
- American Psychological Association. (2017). What is cognitive behavioral therapy?
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