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Cognitive Behavioural Therapy Worksheets and Exercises

The following Cognitive Behavioural Therapy – CBT worksheets and exercises can be downloaded free of charge for use by individuals undertaking NHS therapy or by NHS practitioners providing CBT in primary or secondary care settings. These worksheets form part of the Think CBT Workbook, which can also be downloaded as a static PDF at the bottom of this page. Please share or link back to our page to help promote access to our free CBT resources. 

The Think CBT workbook and worksheets are also available as an interactive/dynamic document that can be completed using mobile devices, tablets and computers. The interactive version of the workbook can be purchased for single use only for £25. All Think CBT clients receive a free interactive/dynamic copy of the workbook and worksheets free of charge.

Whilst these worksheets can be used to support self-help or work with other therapists, Cognitive Behavioural Therapy is best delivered with the support of a BABCP accredited CBT specialist. If you want to book an appointment with a professionally accredited CBT expert, call (01732) 808626, complete the simple contact form on the right side of this page or email [email protected]  

Please note: if you are a private business or practitioner and wish to use our resources, please email [email protected]  to purchase a registered copy. This material is protected by UK copyright law. Please respect copyright ownership.

Exercise 1 - Problem Statements

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Exercise 2 - Goals for Therapy

Exercise 3 - personal strengths / resources, exercise 4 - costs / benefits of change, exercise 5 - personal values, exercise 6 - the cbt junction model, exercise 7 - the cross-sectional cbt model, exercise 8 - the longitudinal assessment, exercise 9 - layers of cognition, exercise 10 - cognitive distortions, exercise 11 - theory a-b exercise, exercise 12 - the cbt thought record, exercise 13 - cognitive disputation "putting your thoughts on trial", exercise 14 - the cbt continuum, exercise 15 - the self-perception continuum, exercise 16 - the cbt responsibility pie chart, exercise 17 - noticing the thought, exercise 18 - four layers of abstraction, exercise 19 - semantic satiation, exercise 20 - the characterisation game, exercise 21 - speed up / slow down, exercise 22 - word translation, exercise 23 - the time-traveller's log, exercise 23a -the time-traveller's log continued, exercise 24 - leaves on a stream, exercise 25 - the traffic, exercise 26 - clouds in the sky, exercise 27 - taming the ape - an anchoring exercise, exercise 28 - the abc form in functional analysis, exercise 29 - pace activity exercise, exercise 30 - graded hierachy of anxiety provoking situations, exercise 31 - the behavioural experiment, exercise 32 - act exposures exercise, exercise 33 - worry - thinking time, exercise 34 - submissive, assertive & aggressive communication, exercise 35 - sleep hygiene factors, exercises 36 - 38.

(Abdominal Breathing, Aware Breathing & The Five-Minute Daily Recharge Practice)

Exercise 39 - Wheel of Emotions

Exercise 40 - linking feelings and appraisals, exercise 41 - personal resilience plan, exercise 42 - cbt learning log, act with choice exercise, angels and devils worksheet, transdiagnostic model of ocd worksheet, tuning in exercise, penguin-based therapy (pbt), big picture exercise, post-therapy journal, catch it-check it-change it exercise.

A brief cognitive change exercise for identifying and altering negative thinking

Download here

Download The Think CBT Workbook Here

To get a free copy of the 90 page Think CBT Workbook and Skills Primer, click on the download button and save the PDF document to your personal drive or device. The free version of the Think CBT Workbook is presented as a static PDF, so that you can read the document on your device and print worksheets to complete by hand.

In return for a free copy of the workbook, please help us to promote best practice in CBT by sharing this page or linking back to your website or social media profile.

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CBT Worksheets, Handouts, And Skills-Development Audio: Therapy Resources for Mental Health Professionals

CBT Worksheets, Handouts, And Skills-Development Audio: Therapy Resources for Mental Health Professionals

Resource type

Therapy tool.

cbt worksheet questions

"Should" Statements

Information handouts.

A Guide To Emotions (Psychology Tools For Living Well)

A Guide To Emotions (Psychology Tools For Living Well)

Books & Chapters

A Memory Of Caring For Others

A Memory Of Caring For Others

A Memory Of Feeling Cared For

A Memory Of Feeling Cared For



ABC Model

Activity Diary (Hourly Time Intervals)

Activity Diary (No Time Intervals)

Activity Diary (No Time Intervals)

Activity Menu

Activity Menu

Activity Planning

Activity Planning

Activity Selection

Activity Selection

All-Or-Nothing Thinking

All-Or-Nothing Thinking

Alternative Action Formulation

Alternative Action Formulation

Am I Experiencing Anorexia?

Am I Experiencing Anorexia?

Am I Experiencing Body Dysmorphic Disorder (BDD)?

Am I Experiencing Body Dysmorphic Disorder (BDD)?

Am I Experiencing Bulimia?

Am I Experiencing Bulimia?

Am I Experiencing Burnout?

Am I Experiencing Burnout?

Am I Experiencing Death Anxiety?

Am I Experiencing Death Anxiety?

Am I Experiencing Depersonalization And Derealization?

Am I Experiencing Depersonalization And Derealization?

Am I Experiencing Depression?

Am I Experiencing Depression?

Am I Experiencing Generalized Anxiety Disorder (GAD)?

Am I Experiencing Generalized Anxiety Disorder (GAD)?

Am I Experiencing Health Anxiety?

Am I Experiencing Health Anxiety?

Am I Experiencing Low Self-Esteem?

Am I Experiencing Low Self-Esteem?

Am I Experiencing Obsessive Compulsive Disorder (OCD)?

Am I Experiencing Obsessive Compulsive Disorder (OCD)?

Am I Experiencing Panic Attacks?

Am I Experiencing Panic Attacks?

Am I Experiencing Panic Disorder?

Am I Experiencing Panic Disorder?

Am I Experiencing Perfectionism?

Am I Experiencing Perfectionism?

Am I Experiencing Post-Traumatic Stress Disorder (PTSD)?

Am I Experiencing Post-Traumatic Stress Disorder (PTSD)?

Am I Experiencing Psychosis?

Am I Experiencing Psychosis?

Am I Experiencing Social Anxiety?

Am I Experiencing Social Anxiety?

An Introduction To CBT (Psychology Tools For Living Well)

An Introduction To CBT (Psychology Tools For Living Well)

Anger - Self-Monitoring Record

Anger - Self-Monitoring Record

Anger Decision Sheet

Anger Decision Sheet

Anger Diary (Archived)

Anger Diary (Archived)

Anger Self-Monitoring Record (Archived)

Anger Self-Monitoring Record (Archived)

Anger Thought Challenging Record

Anger Thought Challenging Record

Anxiety - Self-Monitoring Record

Anxiety - Self-Monitoring Record

Anxiety Self-Monitoring Record (Archived)

Anxiety Self-Monitoring Record (Archived)

Approach Instead Of Avoiding (Psychology Tools For Overcoming Panic)

Approach Instead Of Avoiding (Psychology Tools For Overcoming Panic)



Arbitrary Inference

Arbitrary Inference

Assertive Communication

Assertive Communication

Assertive Responses

Assertive Responses

Attention - Self-Monitoring Record

Attention - Self-Monitoring Record

Attention Training Experiment

Attention Training Experiment

Attention Training Practice Record

Attention Training Practice Record

Audio Collection: Psychology Tools For Developing Self-Compassion

Audio Collection: Psychology Tools For Developing Self-Compassion

Audio Collection: Psychology Tools For Mindfulness

Audio Collection: Psychology Tools For Mindfulness

Audio Collection: Psychology Tools For Overcoming PTSD

Audio Collection: Psychology Tools For Overcoming PTSD

Audio Collection: Psychology Tools For Relaxation

Audio Collection: Psychology Tools For Relaxation

Autonomic Nervous System

Autonomic Nervous System

Avoidance Hierarchy (Archived)

Avoidance Hierarchy (Archived)


Barriers Abusers Overcome In Order To Abuse

Before I Blame Myself And Feel Guilty

Before I Blame Myself And Feel Guilty

Behavioral Activation Activity Diary

Behavioral Activation Activity Diary

Behavioral Activation Activity Planning Diary

Behavioral Activation Activity Planning Diary

Behavioral Experiment

Behavioral Experiment

Behavioral Experiment (Portrait Format)

Behavioral Experiment (Portrait Format)

Behaviors In Panic (Psychology Tools For Overcoming Panic)

Behaviors In Panic (Psychology Tools For Overcoming Panic)

Being A Compassionate Person

Being A Compassionate Person

Being With Difficulty (Audio)

Being With Difficulty (Audio)

Belief Driven Formulation

Belief Driven Formulation

Belief-O-Meter (CYP)

Belief-O-Meter (CYP)

Body Posture

Body Posture

Body Scan (Audio)

Body Scan (Audio)

Body Sensations In Panic (Psychology Tools For Overcoming Panic)

Body Sensations In Panic (Psychology Tools For Overcoming Panic)

Boundaries - Self-Monitoring Record

Boundaries - Self-Monitoring Record

Breathing To Activate Your Soothing System

Breathing To Activate Your Soothing System

Breathing To Calm The Body Sensations Of Panic (Psychology Tools For Overcoming Panic)

Breathing To Calm The Body Sensations Of Panic (Psychology Tools For Overcoming Panic)

Broadening Your Perspective

Broadening Your Perspective



Catching Your Thoughts (CYP)

Catching Your Thoughts (CYP)

CBT Appraisal Model

CBT Appraisal Model

CBT Daily Activity Diary With Enjoyment And Mastery Ratings

CBT Daily Activity Diary With Enjoyment And Mastery Ratings

CBT Thought Record Portrait

CBT Thought Record Portrait

CFT Calm Place

CFT Calm Place

Challenging Your Negative Thinking (Archived)

Challenging Your Negative Thinking (Archived)

Changing Avoidance (Behavioral Activation)

Changing Avoidance (Behavioral Activation)

Checking Certainty And Doubt

Checking Certainty And Doubt

Checklist For Better Sleep

Checklist For Better Sleep

Classical Conditioning

Classical Conditioning

Coercive Methods For Enforcing Compliance

Coercive Methods For Enforcing Compliance

Cognitive Behavioral Model Of Anorexia Nervosa (Fairburn, Cooper, Shafran, 2003)

Cognitive Behavioral Model Of Anorexia Nervosa (Fairburn, Cooper, Shafran, 2003)

Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD: Veale, 2004)

Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD: Veale, 2004)

Cognitive Behavioral Model Of Bulimia Nervosa (Fairburn, Cooper, Shafran, 2003)

Cognitive Behavioral Model Of Bulimia Nervosa (Fairburn, Cooper, Shafran, 2003)

Cognitive Behavioral Model Of Clinical Perfectionism (Shafran, Cooper, Fairburn, 2002)

Cognitive Behavioral Model Of Clinical Perfectionism (Shafran, Cooper, Fairburn, 2002)

Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)

Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)

Cognitive Behavioral Model Of Fear Of Body Sensations

Cognitive Behavioral Model Of Fear Of Body Sensations

Cognitive Behavioral Model Of Generalized Anxiety Disorder (GAD: Dugas, Gagnon, Ladouceur, Freeston, 1998)

Cognitive Behavioral Model Of Generalized Anxiety Disorder (GAD: Dugas, Gagnon, Ladouceur, Freeston, 1998)

Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Cognitive Behavioral Model Of Insomnia (Harvey, 2002)

Cognitive Behavioral Model Of Insomnia (Harvey, 2002)

Cognitive Behavioral Model Of Intolerance Of Uncertainty And Generalized Anxiety Disorder Symptoms (Hebert, Dugas, 2019)

Cognitive Behavioral Model Of Intolerance Of Uncertainty And Generalized Anxiety Disorder Symptoms (Hebert, Dugas, 2019)

Cognitive Behavioral Model Of Panic (Clark, 1986)

Cognitive Behavioral Model Of Panic (Clark, 1986)

Cognitive Behavioral Model Of Persistent Postural-Perceptual Dizziness (PPPD: Whalley, Cane, 2017)

Cognitive Behavioral Model Of Persistent Postural-Perceptual Dizziness (PPPD: Whalley, Cane, 2017)

Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)

Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)

Cognitive Behavioral Model Of Social Phobia (Clark, Wells, 1995)

Cognitive Behavioral Model Of Social Phobia (Clark, Wells, 1995)

Cognitive Behavioral Model Of The Relapse Process (Marlatt & Gordon, 1985)

Cognitive Behavioral Model Of The Relapse Process (Marlatt & Gordon, 1985)

Cognitive Behavioral Model Of Tinnitus (McKenna, Handscombe, Hoare, Hall, 2014)

Cognitive Behavioral Model Of Tinnitus (McKenna, Handscombe, Hoare, Hall, 2014)

Cognitive Behavioral Treatment Of Childhood OCD: It's Only A False Alarm: Therapist Guide

Cognitive Behavioral Treatment Of Childhood OCD: It's Only A False Alarm: Therapist Guide

Treatments That Work™

What is Psychology Tools?

Psychology Tools develops and publishes evidence-based psychotherapy resources and tools for mental health professionals. Our online library gives you access to everything you need to deliver more effective therapy and support your practice. With a wide range of topics and resource types covered, you can feel confident knowing you’ll always have a range of accessible and effective materials to support your clients, whatever challenges they are facing, whatever stage you are at, and however you work.

Choose from assessment and case formulations to psychoeducation, interventions and skills development, CBT worksheets, exercises, and much more. Our resources include detailed therapist guidance, references and instructions, so they are equally suitable for those with less experience but who want to expand their practice. Each resource explains how to work with the material most effectively, and how to use it with clients.

Are these resources suitable for you?

Psychology Tools is used by thousands of professionals all over the world as a key part of their practice and preparation, and our resources are designed to be used with clients who experience psychological difficulties or distress. Professionals who use our resources include:

  • Clinical, Counseling, and Practitioner Psychologists
  • Family Doctors / General Practitioners
  • Licensed Clinical Social Workers
  • Mental Health Nurses
  • Psychiatrists
  • Psychological Wellbeing Practitioners
  • Psychotherapists
  • Therapists (CBT Therapists, ACT Therapists, DBT Therapists)

Psychology Tools resources are perfect for individuals, teams and students, whatever their preferred modality, or career stage.

What kinds of resources are available at Psychology Tools?

Psychology Tools offers a range of relatable, engaging, and evidence-based resources to ensure that your clients get the most out of therapy or counseling. Each resource has been carefully designed with accessibility in mind and is informed by best practice guidelines and the latest scientific research.

Therapeutic exercises are used in many evidence-based psychotherapies including cognitive behavioral therapy, rational emotive behavior therapy, compassion-focused therapy, schema therapy, emotion-focused therapy, systemic family-based therapies, and several others.

Therapists and counselors benefit from incorporating exercises into their work. They can be used to:

  • Introduce and explain key concepts.
  • Collect information about clients’ difficulties.
  • Bring therapeutic ideas to life.
  • Keep therapy active and engaging.
  • Alleviate distress and/or reduce problematic symptoms.
  • Practice new skills and coping strategies.
  • Develop new insights and self-awareness.
  • Give clients a sense of accomplishment and progress.

Psychology Tools offers a variety of exercises that you can use with your clients as a part of therapy or counseling. These interventions can be incorporated into your sessions, assigned as homework tasks, or used stand-alone interventions. Many of our exercises are either evidence-based (meaning they have been shown to effectively treat certain difficulties) or evidence-derived (meaning they form part of a treatment program that has been shown to effectively treat certain difficulties).

The exercises available at Psychology Tools have a variety of applications. You can use them to:

  • Develop case conceptualizations , formulations, and treatment plans.
  • Address specific difficulties, such as worry, insomnia, and self-focused attention.
  • Introduce clients to new skills, such as grounding , problem-solving, relaxation, and assertiveness .
  • Support key interventions, such as exposure and response prevention, safety planning with high-risk clients, and perspective-taking.
  • Plan treatments and prepare for supervision.

Psychology Tools exercises have been developed with practicality and convenience in mind. Most exercises include simple step-by-step instructions so that clients can use them independently or with the support of their therapist or counselor. In addition, therapist guidance is available for each exercise, which includes a detailed description of the task, relevant background information, an overview of its aims and potential uses in therapy, and simple instructions for its delivery. A comprehensive list of references is also provided so that you can access key studies and further your understanding of each exercise’s applications in psychotherapy.

Did you know that 40 – 80% of medical information is immediately forgotten by patients (Kessels, 2003)? The same is probably true of therapy and counseling, so clients will almost always benefit from having access to additional written information.

Psychology Tools information handouts provide clear, concise, and reliable information, which will empower your clients to take an active role in their treatment. Learning about their mental health, helpful strategies and techniques, and other psychoeducation topics helps clients better understand and overcome their difficulties. Moreover, clients who understand the process and content of therapy are more likely to invest in the process and commit to making positive changes.

Psychology Tools information handouts can help your clients:

  • Understand their difficulties and what keeps them going.
  • Learn what therapy is and how it works.
  • Understand what they are doing in therapy and why.
  • Remember and build upon what has been discussed during sessions.
  • Create a personalized collection of resources that can used between appointments.

Our illustrated information handouts cover a wide variety topics. Each has been informed by scientific evidence, best practice guidelines, and expert opinion, ensuring they are both credible and consistent with evidence-based therapies. Topics featured among these resources include:

  • ‘ What is… ’ handouts. These one-page resources provide a concise summary of common mental health problems (e.g., anxiety , depression , low self-esteem ), key therapeutic approaches (such as cognitive behavioral therapy, eye movement desensitisation and reprocessing , and compassion-focused therapy), and psychological mechanisms which maintain the problem (such as worry and rumination ).
  • ‘ What keeps it going… ’ handouts. These handouts explain the key mechanisms that maintain difficulties such as burnout, panic disorder, PTSD, and perfectionism. You can use them to inform your case conceptualization or as a roadmap in therapy.
  • ‘ Recognizing… ’ handouts. These guides can help you identify and assess specific disorders, comparing key diagnostic criteria taken from leading diagnostic manuals.
  • Simple explanations of key psychological concepts, such as safety behaviors , psychological flexibility, thought suppression, and unhelpful thinking styles .
  • Overviews of important psychological theories, such as operant conditioning and exposure.

Each information handout comes with guidance written specifically for therapists and counselors. It provides suggestions for introducing psychoeducation topics, facilitating helpful discussions related to the handout, and ensuring the content is relevant to your clients.

Worksheets are a core ingredient of many evidence-based therapies such as CBT. Our worksheets take many forms (e.g., diaries, diagrams, activity planners, records, and questionnaires) and can be used throughout the course of therapy.

How you incorporate worksheets into therapy or counselling depends on each client’s difficulties, goals, and stage of recovery. You can use them to:

  • Assess and monitor clients’ difficulties.
  • Inform treatment plans and guide decision-making.
  • Teach clients new skills such as ‘self-monitoring’ or ‘thought challenging’.
  • Ensure that clients apply their learning in the real world.
  • Track their progress over time.
  • Help clients to take an active role in their recovery.

Clients also benefit from using worksheets. These tools can help them:

  • Become more aware of their difficulties.
  • Identify when, how, and why these problems occur.
  • Practice using new skills and techniques.
  • Express and explore difficult feelings.
  • Process difficult events.
  • Consolidate and integrate insights from therapy.
  • Support their self-reflection.
  • Feel empowered and build self-efficacy.

Psychology Tools offers a wide variety of worksheets. They include general forms that are widely applicable, disorder-specific worksheets, and logs that are used in specific therapies such as CBT , schema therapy, and compassion-focused therapy . These resources are typically available in editable or fillable formats, so that they can be tailored to your client’s needs and used in a flexible manner.

Guides & self-help

People want clear guidance on mental health, whether for themselves or a loved one.

Our ‘ Understanding… ’ series is designed to introduce common mental health difficulties such as depression, PTSD, or social anxiety. Each of these guides uses a clear and accessible structure so that readers can understand them without any prior therapy knowledge. Topics addressed in each guide include:

  • What the problem is.
  • How it arises.
  • Where it might come from.
  • What keeps it going.
  • How the problem can be treated.

Other guides address important topics such as trauma and dissociation, or the effects of perfectionism. They usually contain a mixture of psychoeducation, practical exercises and skills development. They promote knowledge, optimism, and positive action related to these difficulties, and have been informed by current research and evidence-based treatments, ensuring they are consistent with best practices.

Therapists can use Psychology Tools guides in several ways:

  • As a screening tool. Clients can read the guide to see if the difficulty or topic is relevant to them.
  • As psychoeducation. Each guide provides essential information related to the difficulty or topic so that client can develop a better understanding of it.
  • As self-help. Each guide describes key skills and techniques that can be used to overcome the difficulty.

Each guide contains informative illustrations, practical examples, and simple instructions so that clients can easily relate to the content and apply it to their difficulties.

Therapy audio

Audio exercises are a particularly convenient and engaging way help your clients and can add variety to your therapeutic toolkit. Psychology Tools audio resources can help your clients:

  • Augment and consolidate their learning in therapy.
  • Practice new techniques.
  • Integrate skills and practices into their daily lives.
  • Access additional support when they need it.
  • Create a sense a continuity between your meetings.

A variety of audio resources are available at Psychology Tools. Each one has been developed and recorded by highly experienced clinical psychologists and can be easily integrated into your therapeutic practice. Audio collections include:

  • Psychology Tools for Developing Self-Compassion
  • Psychology Tools for Relaxation
  • Psychology Tools for Mindfulness
  • Psychology Tools for Overcoming PTSD

Many of these audio resources are widely applicable (e.g., mindfulness-based tools), although problem-specific resources are also available (e.g., tools for overcoming PTSD). You can use these tools:

  • During your therapy sessions.
  • As a homework task for clients to complete.
  • As a stand-alone intervention or ongoing part of therapy.

Treatments That Work®

Authored by leading psychologists including David Barlow, Michelle Craske, and Edna Foa,  Treatments That Work ® is a series of workbooks based on the principles of cognitive behavioral therapy (CBT). Each pair of books in the series – therapist guide and workbook – contains step by step procedures for delivering evidence-based psychological interventions. Clinical illustrations and worksheets are provided throughout.

You can use these workbooks:

  • To plan treatment for a range of specific difficulties including depression, obsessive compulsive disorder (OCD), social anxiety, and substance use.
  • As a self-help intervention that you guide the client through during sessions.
  • As a supplement to therapy, which clients work through independently.
  • To consolidate the content of your sessions.
  • As an ongoing intervention at the end of treatment (e.g., for difficulties that haven’t been fully addressed).

Each book is available to download chapter-by-chapter, and Psychology Tools members with a currently active subscription to our ‘Complete’ plan are licensed to share copies with their clients.

Archived resources

We work hard to keep all resources up to date, so we regularly review and update our library. However, we understand that you might get used to a certain version of a resource as part of your workflow. Instead of removing older versions, we keep them in our archive so that you can still access them if you want to. We also clearly explain if an improved version is available, so you can choose which you prefer.

Series and ranges

As well as many topic-specific resources, we also publish a variety of ranges and series.    

  • The ‘What is…’ series. These one-page resources cover a range of common mental health problems. In client friendly language they provide a concise summary of the problem, what it can feel like, what maintains it and an overview of key evidence-based therapeutic approaches (e.g., CBT, EMDR, and compassion-focused therapy) to treatment.
  • The ‘What keeps it going…’ series . These are one-page diagrams that explain what tends to maintain common mental health conditions such as burnout, panic disorder, PTSD, and perfectionism. You can use them to inform your case conceptualization or as a roadmap in therapy. They provide a quick and easy way for clients to understand why their disorder persists and how it might be interrupted.
  • The ‘Recognizing…’ series can help you identify and assess specific disorders, comparing key diagnostic criteria from leading diagnostic manuals.
  • The ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are comprehensive sources of information for your clients. Concepts are explained in an easily digestible way with plenty of case examples and diagrams. Each guide covers symptoms, treatments and some key maintenance factors .
  • The ‘Guide to…’ resources give clients a deep dive into a condition or treatment approach. They cover a mixture of information, psychoeducation, practical exercises and skills development to help clients learn to manage their condition. Each of these guides offers psychoeducation about the topic alongside a range of practical exercises with clear instructions to help clients identify, monitor, and address their symptoms.
  • The ‘ Self-monitoring’ collection provides problem-specific records designed to help you and your clients get the most from this essential but often overlooked technique. Covering a broad range of conditions, these worksheets allow you to give clients a tool that is targeted to their experience, with relevant language and prompts.
  • The ‘Formulation’ series provides a client-friendly adaptation of cognitive behavioral models for disorders including panic, PTSD, and social anxiety. These useful tools can help you and your clients come to a shared understanding of their difficulties, and can help you to develop a roadmap for therapy.  

Multilingual library of translations

Did you know that Psychology Tools has the largest online, searchable library of multilingual therapy resources? We aim to make our resources accessible to everyone. With over 3500 resources across 70 languages, you can give clients resources in their native language, enabling a deeper understanding and engagement with the treatment process. Translations are carried out by specially selected professional translators with experience of psychology, and our pool of volunteer mental health professionals. We also make sure that the resource design is the same for each translated resource so that you can be confident you know what section you are looking at, even if you don’t speak the language.

Simply find the resource you want to use, then explore which languages that resource is available in, or you can see all the resources available in a particular language by using our search filters.  

What formats are the resources available in, and how can I use them?

People work in different ways. Our formats are designed to reflect that, so you can choose the style that suits how you and your client want to work. Psychology Tools resources are perfectly formatted to work whether you practice face to face, remotely, or use a blended approach.

  • Professional version. Designed for clinicians, this comprehensive option includes everything you need to use the resource confidently. As well as the resource, each PDF contains useful information, including therapist guidance explaining how to use the resource most effectively, descriptions that provide theoretical context, instructions, therapist prompts, and references. Some resources also include case examples and annotations where appropriate.
  • Client version.  This is a blank PDF of the resource, with client-friendly instructions where appropriate, but without the theoretical description. These are ideal for printing and using in-session, or giving to a client.
  • Fillable PDFs are great for clients who want to work with resources online instead of on paper. Your client can fill in and save the resource on a computer, before sending it back to you without the need for a printer. This format is also useful if you have remote sessions with clients and want to work through a resource on screen together.
  • Editable PowerPoint documents are useful if you want to make any changes to the resource structure, or personalize it for your client.
  • Editable Word documents are also useful if you want to make changes to the resource, and are more suited to printing.

How do we design our resources to support your practice?

Our resources are informed by evidence-based treatments, best practice guidelines, and the latest published research. They are written by highly experienced therapists and experts in mental health, ensuring they are effective and as up to date as possible. In addition, every resource goes through a rigorous peer review process to confirm they are accurate and easy to use.

Each resource is designed with both clients’ and therapists’ needs in mind. For clients, that means using clear, user-friendly language, as well as plenty of visual and case examples, illustrations, diagrams and vignettes that readers can relate to. They include information on how the resource can help them, how they should use it, and other useful tips.

We also include useful information and descriptions for clinicians to help them use the resource most effectively. The therapist versions of each resource contain therapist guidance, prompts, instructions, and full references. They outline how the resource can be used and what types of problems it could be helpful for.

  • Designed to make strong theory-practice links . We pay close attention to the theory underpinning our resources, which provides therapists with useful context and helps them make theory-practice links. Having a greater understanding of each tool ensures best practice.
  • One concept per page. Wherever possible, we create resources using the principle of one therapeutic concept per page, as this ensures that we have distilled the idea down to its essence. This makes each tool simple for therapists to communicate and easy for clients to grasp. We also pay close attention to visual layout and design, to make our resources as accessible as possible. Every resource aims to maximize clinical benefit and engagement, without overwhelming readers.
  • Action focused. Resources are designed to be interactive, collaborative and goal-focused, with prompts to facilitate self-monitoring of progress and goals.

How can I use this page?

This page is where you can explore all the resources in the Psychology Tools library. The different search filters on the left-hand side enable you to customize your search, depending on what you need. Materials are organized by resource type, problem, and therapy tool, though you can also filter by language or use the search box. You can find more detailed instructions for how to find resources here .  

Can I share resources directly with my clients?

If you have a paid Psychology Tools membership, you are licensed to share resources with clients in the course of your professional work. You can even email resources (even large audio collections) directly to your clients from our website. All emails are secure and encrypted, so it is a quick and easy way to save you time and facilitate clients’ self-practice.

What if I need more help?

We have a wide range of ‘ How-to’ guides and an FAQ in our help centre , which answers questions on how to use the library and tools, such as ‘ How do I download resources? ’ or ‘ How do I email resources to my clients directly from the website? ’.

Kessels, R. P. C. (2003). Patients’ memory for medical information . Journal of the Royal Society of Medicine, 96 , 219-222.

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Mental health activities to help you and your clients thrive, 1. purchase  2. download  3. print or share with clients, 7 super cbt activity sheets, games, and exercises.

Updated: May 3

These cognitive behavioral therapy activities help teach and reinforce CBT techniques.

CBT activity sheets, games, and exercises help with teaching CBT skills such as cognitive restructuring and coping skills.

Cognitive behavioral therapy can seem a bit complicated at first. Fortunately, CBT activity sheets, games, and other exercises can make techniques easier and even fun. With that in mind, let’s jump right into activities you can view and download, including PDFs you can use as soon as today. 

1. CBT Activity Sheets for Anxiety and PTSD

This packet of CBT worksheets can be downloaded, printed, or even shared via email with clients. It’s available as 8 separate worksheets, or as one PDF workbook. The pages include cognitive restructuring sheets and build upon each other, if you choose to use them that way.  

Topics covered include: 

Coping with anxiety

Understanding post-traumatic stress (PTSD)

Emotional regulation

Introduction to Cognitive restructuring

Creating an Anxiety Hierarchy

Restructuring trauma stuck-points

Writing a trauma narrative

Reflecting on post-traumatic growth

These worksheets are best for problems like general anxiety, phobias, and post-traumatic stress disorder (PTSD). You can use them along with your therapy or share them with clients. Download them now. 

2. CBT Jeopardy-Style Game

The CBT Game Show is Jeopardy-inspired with a set of interactive categories and prompts. It’s available as a PowerPoint and PDF version. The PowerPoint version includes clickable links so you can move around the game and screens, similar to a real game show. Example prompts include: 

Describe a way to safely express a difficult feeling such as fear or anger. 

Give an example of a less helpful coping skill and a more helpful one. Why do you think people use less helpful skills sometimes? 

What’s a fun think you’ve never tried but would like to do?

The prompts are kid-friendly but have also been used with teen and adult groups. Since the game is in PowerPoint you can edit the prompts as well. Learn more.

3. Cognitive Behavioral Triangle Activity Sheet

The CBT triangle is a more basic activity sheet that covers the cognitive triangle. It reviews the three points of the triangle including thoughts, feelings, and behaviors, providing instruction and examples. The second part of the worksheet includes open space for you to walk through your own example and help restructure a common thought or belief. Check it out. 

4. Printable Therapy Dice

This set of printable dice includes prompts based on CBT, DBT, and coping skills. Since they’re in PDF form you can reprint them as much as needed. There are prompts and ideas to play the dice as a game, or you can simply share and discuss the dice in an individual session or in groups. Example prompts include: 

Name or describe a cognitive distortion.

Describe or show a mindfulness activity that can help with stress. 

Name a feeling you’ve had before and how it shows up in the body

The dice set also includes feelings themselves, such as dice with “anger” or “happy” printed on them, to use along with other prompts. Download the PDF. 

5. CBT Island Quest Board Game

CBT Island Quest is a printable therapy game that includes prompts to discuss ideas and skills relating to cognitive behavioral therapy. Categories include CBT and relaxation/mindfulness topics. Here are some example prompts: 

Describe a calming breathing skill

What are the corners of the CBT triangle? 

Give an example of challenging a negative thought

The game moves around an “island” as players roll dice and answer questions. There are also wild cards to make the game more interesting. Check it out.

6. CBT Lingo (Bingo Inspired)

CBT Lingo is a playable game with multiple Bingo-type cards including prompts based on cognitive behavioral therapy. Unlike other therapy Bingo-style games, there are multiple different cards included with 50 total prompts, and you can play it similar to a real Bingo game. 

The cards are even saved separately so you can send individual cards for playing over telehealth. Example prompts are: 

How do behaviors connect to feelings? 

What is emotional reasoning? 

What does it mean to challenge a thought

This is a great game for groups learning and practicing CBT. Learn more.

7. Coping Skills Cards

This set of coping skills cards includes skills from several categories, including CBT. Although created for kids, many adults also find them helpful. Categories, along with CBT, include mindfulness, creativity, movement, and distraction. Example skills written on cards are: 

Visit Nature

The cards include fun “magical” creatures including dragons and unicorns for a kid-friendly feel. They are helpful to print and keep a deck handy or send them home with clients. Check them out.

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9 CBT Worksheets and Tools for Anxiety and Depression

cbt worksheets

CBT is one of the most effective psychological treatments when it comes to managing anxiety and depression, and can be a highly useful approach to apply in online therapy.

If you help clients tackle cognitive distortions and unhelpful thinking styles, we’ve compiled a list of essential worksheets that should be part of your therapy toolbox.

How To Use CBT Worksheets in Therapy

Cognitive-behavioral therapy (CBT) is based on the idea that thoughts, feelings, physical sensations and behaviors are interlinked, and that changing negative thought patterns can enhance the way we act and feel.

It encompasses a variety of techniques and interventions that have been proven effective in the treatment of many mental disorders.

Besides anxiety and depression, a few examples include: [1]

  • Panic disorder
  • Bipolar disorder
  • Borderline personality disorder, and
  • Obsessive-compulsive disorder.

With the advent of online therapy, guided online CBT has become an increasingly popular way for mental health professionals to help clients manage behavioral health conditions without the need to meet in person as often.

CBT worksheets, exercises, and activities play a large role in these treatments to encourage further progress between sessions, in the same way that face-to-face CBT involves between-session practice. [2]

5 Example Tools For Treating Anxiety

So what types of online CBT worksheets can be used to help clients cope better with symptoms of anxiety ?

There is a wide spectrum of therapeutic approaches that range from self-help activities to guided interventions, and all of them focus on identifying and changing unhelpful thoughts, feelings, and behaviors.

Here are a few of the best-known techniques that can be applied with the right tools.

Identifying cognitive distortions

Recognizing and identifying maladaptive automatic thoughts is a main goal of CBT.

Recognizing and identifying maladaptive automatic thoughts is a main goal of CBT. Cognitive distortions describe inaccurate or exaggerated perceptions, beliefs, and thoughts that can contribute to or increase anxiety, so increasing a client’s awareness of these is the first step to unraveling them and feeling better.

Quenza’s  Unhelpful Thinking Styles – “Shoulding” and “Musting” worksheet, shown below, is an example exercise that can help clients recognize the damaging impacts of using “should” and “must” statements to place unreasonable demands or unnecessary pressure on themselves.

example cbt worksheet for anxiety identifying cognitive distortions

Cognitive restructuring

Cognitive restructuring involves disputing the distortions that underpin a client’s challenges. Various techniques that can be helpful here include Socratic questioning, decatastrophizing, and disputing troublesome thoughts with facts.

One example CBT exercise is the Cognitive Restructuring Expansion shown below, which can help clients identify automatic thoughts and substitute them with more fair, rational ways of thinking.

Screenshot of Cognitive Restructuring Exercise in Quenza

Journaling and thought records

Journaling is a form of self-monitoring that helps clients identify their thought patterns and emotional tendencies, as shown by the Stress Diary Expansion below.

Quenza Stress Diary Expansion Pathway preview with steps

Journals can involve logging negative thoughts or feelings as homework, with the aim of positioning clients to manage them successfully.

Stress Reduction Techniques

Stress reduction exercises such as deep breathing, meditation, and progressive muscle relaxation can all be effective CBT tools for managing anxiety.

The example below is Quenza’s Progressive Muscle Relaxation exercise, which clients can practice to increase their sense of control and calm when stressed or anxious.

Progressive Muscle Relaxation Expansion activity prevew

Breathing Exercises

Diaphragmatic breathing is another useful relaxation exercise often used in CBT for anxiety.

With this mindfulness practice, clients learn to regulate their breath and activate their body’s relaxation response, as shown in Quenza’s audio  Diaphragmatic Breathing  exercise below.

Quenza Belly Breathing Expansion preview desktop view

CBT Worksheets for Depression (PDF)

CBT worksheets are useful resources for therapists helping clients manage depression, because they can be used to encourage your clients’ progress between sessions.

If you are a mental health professional, the following worksheets can be shared as homework. Each is available as a customizable Quenza Expansion for easy sharing with clients with a $1, 30-day Quenza trial .

The ABC Model of Helpful Behavior

ABC is an acronym for Antecedents, Behavior, and Consequences, and the ABC model proposes that behavior can be learned and unlearned based on association, reward, and punishment.

This CBT worksheet allows clients to reflect on adaptive behavior, thus building their awareness of the triggers for and consequences of this behavior.

After introducing the ABC Model of Behavior and the ABC Model of Helpful Behavior, the exercise asks clients to try it out themselves by:

  • Describing a recent personal problem
  • Recalling a helpful behavior that they carried out that contributed to the problem in a positive way.
  • Recalling the Antecedents of the helpful Behavior – where they were, who they were with, and what they were doing, thinking, and feeling
  • Considering the short- and long-term Consequences of that behavior – how they felt, what happened, and what others said or did.

Unhelpful Thinking Styles – Emotional Reasoning

This worksheet invites clients to identify and decrease the negative impact of a specific cognitive bias known as “Emotional Reasoning,” which can be common in clients with depression.

As an introduction, clients learn about the negative impacts of regarding emotions as evidence of the truth, or basing one’s view of situations, yourself, or others on how they feel at a certain moment.

They are then invited to reflect on a time when they used emotional reasoning and describe the situation as well as their thoughts and emotions at the time.

Through self-reflection, this therapy exercise aims to help the user separate their feelings from their thoughts so that they can reduce the negative effect of emotional reasoning on their wellbeing.


As we’ve seen, patients with symptoms of depression often experience negative thoughts that result from faulty thinking rather than accurate experiences of reality.

Catastrophizing is amplifying the importance of adverse events and situations while minimizing their positive aspects or outcomes. The Decatastrophizing Expansion can be an impactful cognitive restructuring technique to help with this cognitive distortion when it is practiced over time.

Clients are asked to describe the situation that they are currently catastrophizing about before answering a series of questions to challenge their thinking:

  • What is the worst that can happen?
  • What three events would have to take place for the worst to happen?
  • How likely is it that  all three  of these events will take place?
  • What is a more likely outcome, given what you know about the situation?

Here’s an example of the PDF copy that you or your clients can download of these exercises:  Decatastrophizing CBT worksheet

To customize these CBT worksheets for depression and browse more, take a look at the $1, 30-day Quenza trial .

Can CBT Help Build Self Esteem?

Studies have shown CBT to be useful in developing a client’s self-esteem so that they start to perceive themselves as more worthy and deserving. [3]

Cognitive restructuring is particularly can equip them with the skills to challenge or refute negative self-talk. This involves:

  • Helping clients explore repetitive negative self-talk can be damaging to their sense of self-worth
  • Challenging harmful cognitive distortions
  • Supporting in the development of a more balanced, positive self-perspective.

Preview of Quenza Challenging Unhelpful Thoughts Expansion with intro

Quenza’s Challenging Unhelpful Thoughts , pictured above, is an example CBT worksheet for self-esteem with the following prompts and questions:

  • Describe a negative thought that keeps coming back.
  • On a scale of 1 to 10, how strongly do you believe this thought to be true?
  • What evidence supports this thought?
  • What evidence do you have against the thought?
  • What would you tell a friend (to help them) who would have the same thought?

CBT Toolbox for Online Therapists

Once you’ve found the most useful tools for your programs and are ready to start treating clients, it’s time to organize them for easy, convenient delivery.

Without a centralized library of digital materials – and the ability to quickly personalize and share them – it’s easy to spend more time than is necessary on the admin side of helping others.

With the right CBT app , you should have an entire toolbox of CBT worksheets plus the tools you need to deliver them:

  • Activity design tools: for efficiently creating online CBT interventions
  • Customizable templates: e.g., Quenza Expansions that include personalizable science-based exercises and activities
  • Documentation tools: e.g., Quenza Notes – A secure, convenient way to create and store session notes and collaborate with clients
  • Pathway builder tools: which help you assemble separate worksheets and tools into programs and mental health treatment plans
  • Real-time results tracking:  to securely collect and store client responses and results
  • A free client app:  so that clients can easily receive, complete, and return your CBT resources and assemble a library of their finished activities.

Whether you’re new to the world of online therapy or coaching or simply looking to increase your impact, our free 30-page guide is a great place to start.

This PDF will give you an easy-to-understand introduction to the essentials of digital practice: how to create and share your own CBT interventions, keep clients engaged in their treatment, and improve your clients’ results while growing and scaling your business.

Click here to download your copy of  Coach, This Changes Everything .

blue cover image of online life coaching guide pdf

Final Thoughts

Practicing CBT online for the first time may take some adapting, but the ability to help more clients with less work is always worth the payoff.

Hopefully, these worksheets and resources give you a solid starting point for building your CBT toolkit. Let your fellow practitioners know how you use them – leave a comment and join in the conversation below!

  • ^ NHS. (2022). Overview - Cognitive behavioural therapy (CBT). Retrieved from https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/
  • ^ Harvard Health Publishing. (2015). Online cognitive-behavioral therapy: The latest trend in mental health care. Retrieved from https://www.health.harvard.edu/blog/online-cognitive-behavioral-therapy-the-latest-trend-in-mental-health-care-201511048551
  • ^ McKay, M., & Fanning, P. (2016). Self-esteem. New Harbinger.

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Common CBT Exercise, Questions & Worksheets Found in PDFs

cbt worksheet questions

Cognitive Behavioral Therapy (CBT) is a widely used form of psychotherapy that helps people identify and change negative thought patterns and behaviors contributing to mental health issues such as depression, anxiety, and trauma. 

One of CBT's key components is using worksheets and exercises to help clients develop skills and strategies for managing their thoughts and emotions. In this article, we will discuss some common CBT questions, worksheets, and exercises you may find in PDFs that therapists use to help their clients.

Common Exercise Questions

CBT exercises typically involve questions that help clients identify and challenge negative thoughts and behaviors. Some common exercise questions found in CBT include:

What is the evidence for and against this thought or belief? 

This question is often used in thought records to help clients identify the evidence that supports or contradicts a negative thought or belief. By examining the evidence, clients can develop a more balanced and realistic perspective.

What is the worst that could happen? What is the best that could happen?

This question is often used in exposure exercises to help clients confront their fears and anxieties. By exploring the potential outcomes of a situation, clients can develop a more realistic understanding of the risks and benefits.

What would you say to a friend who was thinking this way? 

This question is often used to help clients develop self-compassion and empathy. By imagining how they would respond to a friend struggling with negative thoughts, clients can learn to be more supportive and understanding of themselves.

What can you do differently in this situation? 

This question is often used in behavioral activation exercises to help clients identify positive activities they can engage in to improve their mood and reduce negative thinking. Clients can feel more empowered and motivated to make changes by identifying specific actions they can take.

What are some alternative explanations or interpretations of this situation? 

This question is often used to help clients challenge negative thinking patterns and develop more positive and balanced perspectives. Clients can learn to recognize and challenge their automatic negative thoughts by exploring alternative explanations or interpretations.

What would happen if you did nothing?

This question is often used to help clients evaluate the consequences of their actions (or lack of action). Clients can make more informed and intentional decisions by considering the potential outcomes of different choices.

These are just a few examples of the types of exercise questions that are commonly found in CBT. Depending on the specific needs and goals of the client, therapists may use various questions and exercises to help clients develop skills and strategies for managing their thoughts and emotions.

Common Worksheets and Exercises in PDF

Thought Records

Thought records are a staple of CBT and help clients identify and challenge negative thoughts and beliefs. A thought record is a worksheet that helps clients identify a negative thought or belief, examine the evidence for and against it, and develop a more balanced and realistic alternative view. Completing a thought record helps clients learn to recognize and challenge negative thinking patterns, which can help reduce symptoms of depression and anxiety.

Exposure Exercises

Exposure exercises are used in CBT to help clients overcome fear and anxiety related to specific situations or objects. Exposure exercises gradually expose clients to the feared situation or object in a safe and controlled environment. For example, a client who fears flying might begin by imagining a plane taking off, then progress to looking at pictures of planes, and eventually work up to taking a short flight. Exposure exercises can be challenging but are highly effective in treating phobias and anxiety disorders.

Behavioral Activation

Behavioral activation is a technique used in CBT to help clients overcome depression and improve their mood by increasing positive activities in their lives. Behavioral activation worksheets help clients identify enjoyable activities and develop a plan to incorporate them into their daily routines. By increasing positive experiences, clients can reduce negative thinking and improve their overall mood.

Gratitude Exercises

Gratitude exercises are used in CBT to help clients focus on positive aspects of their lives, which can help improve mood and reduce symptoms of depression and anxiety. Gratitude exercises involve reflecting on what clients are grateful for and expressing gratitude verbally or in writing. Therapists may provide worksheets or prompt to help clients identify things they are thankful for and develop gratitude practice.

Problem-Solving Worksheets

Problem-solving worksheets are used in CBT to help clients develop skills for solving problems and making decisions. These worksheets typically involve identifying a problem, generating possible solutions, evaluating the pros and cons of each solution, and choosing the best course of action. By developing problem-solving skills, clients can reduce stress and improve their ability to cope with challenging situations.

CBT is a highly effective form of psychotherapy that utilizes a variety of worksheets and exercises to help clients develop skills and strategies for managing their thoughts and emotions. These exercises range from thought records and exposure exercises to gratitude and problem-solving worksheets. By working with a therapist and practicing these exercises, clients can improve their mental health and quality of life.

Grouport offers CBT online group therapy sessions

Grouport Therapy  provides online cognitive behavioral therapy (CBT) groups to assist individuals struggling with  anxiety ,  depression ,  PTSD, and trauma . Our online group therapy sessions teach members how to integrate CBT techniques into their daily lives. Incorporating these skill sets enables them to recognize triggers, counteract negative thought patterns, and adopt more positive behaviors to recover from and manage their symptoms.

Our licensed therapists lead weekly group sessions conducted remotely in the comfort of members' homes. According to participant feedback, 70% experienced significant improvements within 8 weeks.

You don't have to face these challenges alone. Join our community and work together towards a brighter future. Sign up for one of our groups today and begin your journey towards meaningful, lasting change and renewed hope. We also offer skills groups, such as our dialectical behavior therapy skills group . Our DBT Skills Group, is a therapist-led module driven group that will provide you new skills to replace behaviors and emotions causing friction in your daily life and relationships. It is excellent for interpersonal connections, building social skills concerning relationship issues, improving emotion regulation & distress tolerance, and developing deeper mindfulness.

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cbt worksheet questions

49 Questions to ask Clients in CBT Therapy Sessions

Cognitive Behavioral Therapy focuses on the belief that our thinking impacts our feelings and actions. Because of this, CBT treatment focuses on changing how a person thinks with the goal of impacting how they feel and subsequently, how they behave. These changes can lead to a reduction in challenges and negative symptoms. As one of the most widely used therapeutic approaches, CBT can be applied to a variety of presenting concerns and populations. Keep reading to learn 49 CBT questions you can ask clients in therapy sessions.

Cognitive Behavioral Therapy can be used with clients who are living with a variety of mental health concerns including anxiety , depression , PTSD , and Axis I disorders. CBT can also be used in the treatment of children who are living with symptoms associated with ADHD , behavioral disorders, anxiety, depression, and eating disorders.

cbt worksheet questions

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CBT Worksheets Bundle PDF Templates (Editable, Fillable, Printable)

View all of our CBT Therapy Worksheets

Getting Ready for Your First CBT Therapy Session with a New Client

While CBT can be used with clients who are living with a range of mental health concerns, you likely work within a particular niche or field of counseling. CBT can be used in inpatient treatment centers, partial hospitalization programs, and outpatient treatment programs. The clinical setting that you work in will have a direct impact on how you prepare for your first session and the CBT questions that you utilize.

Being knowledgeable about the paperwork you are expected to complete during your first session will impact how you prepare for your session as well. Using your knowledge and experience from your clinical work will help develop a routine that works best for you.

If possible, take time to review any documentation that has been provided to you before you begin your session. This can help you develop a game plan for your session and help you better understand where your focus should be during your new session. 

Common Questions to Ask CBT Clients

CBT questions can be used during various stages of treatment and during a variety of therapeutic interventions. This includes rating questions, exploring the validity of their thoughts, labeling cognitive distortion, Socratic questions , and working to change automatic thoughts. 

Rating Questions

Rating Questions can be used to rate the intensity of the emotion that your client is experiencing. Rating questions can be helpful in revising personal beliefs and automatic thoughts to work towards healthy cognitions.

An example of rating questions include:

  • On a scale of 1 to 5, with one being a mild impact to 5 as severe, how would you rate your experience?

Determining the Validity of Cognitions

Exploring the validity of a clients cognitions is an example of a phase of counseling where CBT questions can be used. Working with our clients to see where their thoughts are not fully valid, can help them see where changes can be made to make clinical gains.

Examples of CBT questions that could be asked include:

  • Ask your client what they would encourage a loved one to do if they were in their shoes
  • Encourage your client to take their concern to an extreme, and explore their thoughts afterwards
  • Encourage your client to imagine the worst possible result and explore ways in which they could respond to, or cope with the worst-case scenario

Cognitive Distortions and Automatic Thoughts

Cognitive distortions and automatic thoughts that anyone can have. For some, these automatic thoughts can have a significant impact on feelings and behaviors. Before you can work to change your thoughts, it is important to understand which thoughts are troubling your client. CBT questions can be used to guide exploration into the presence of different cognitive distortions and explore their impact. 

  • Are you confusing a thought with a fact?
  • Are you jumping to conclusions?
  • Are you assuming that your view of things is the only possible way?
  • What is the effect of thinking the way you do? Advantages? Disadvantages?
  • Are you asking questions that have no answers?
  • Are you using ultimatum words in your thinking?
  • Are you condemning yourself as a total person or just for 1 event that occurred?
  • Are you focusing on your weaknesses rather than your strengths?
  • Are you blaming yourself for something that is not your fault?
  • Are you taking something personally that has little or nothing do with you?
  • Are you expecting yourself to be perfect?
  • Are you using a double standard?
  • Are you paying attention only to the negative things?
  • Are you overestimating your chances of disaster?
  • Are you exaggerating the importance of an event(s)?
  • Are you predicting the future before it happens (instead of waiting to see how it unfolds)?
  • Are you assuming nothing can change your situation?
  • Are you worrying about the way you think things should be instead of facing things as they are?

Socratic Questions

The questions you ask will be impacted by the specific distortion that you are looking to explore. Using a list of Socratic Questions with CBT can be used to guide an exploration of a thought pattern that your client has been experiencing. Socratic Questions can be defined differently, so using a worksheet like the one provided by TherapyByPro can be helpful. It is important to keep in mind that CBT takes a non-confrontational approach, and counselors work to guide their clients as they develop new perceptions of their challenges and concerns.  

Here are some Socratic question examples you can ask:

Clarification Questions

  • What is a thought you’d like to question?
  • Why do you say that?
  • What do you mean by that?
  • What do you think is the main problem?
  • Could you discuss this point further?

Assumption Questions

  • Are you making any assumptions in your thought?
  • Why would you make this assumption?
  • What else could you assume instead?
  • Can you verify this assumption?
  • Can you disprove this assumption?

Probing Questions

  • Could you tell me about an example?
  • What do you think causes this to happen?
  • Could you be reading the evidence incorrectly?
  • Are you looking at all the evidence or just evidence that supports your thought?
  • Are you basing your thought on facts or your feelings?
  • Are you having this thought out of habit or do the facts support it?

Consequences Questions

  • What are the short-term consequences of this thought / assumption?
  • What are the long-term consequences of this thought / assumption?
  • How does this thought / assumption affect you negatively?
  • How does this thought / assumption affect you positively?

Perspective Questions

  • What is evidence that agrees with this thought?
  • What is evidence that goes against this thought?
  • How would someone else think in your situation?
  • Did someone pass this thought or belief to you?
  • What could have been a better question to ask or thought to have?

Questioning the Question Questions

  • Why do you think I asked you this question?
  • Why is this question important?

Final Thoughts On Asking the Right Questions in CBT Therapy

CBT questions can be a powerful tool when working with our clients. When we keep the goals of CBT in mind, along with the importance of the therapeutic alliance, CBT can be an effective treatment approach for many individuals.

Once a client has reached the end of their therapeutic journey, they should be able to effectively apply the skills and knowledge that they have learned when they find themselves having challenges and difficulties.  

TherapyByPro is an online mental health directory that connects mental health pros with clients in need. If you’re a mental health professional, you can Join our community and add your practice listing here . We have assessments, practice forms, and worksheet templates mental health professionals can use to streamline their practice. View all of our mental health worksheets here .

To learn more about how you can apply Cognitive Behavioral Therapy, we encourage you to look for continuing education courses and other training opportunities. 

Kayla Loibl, MA, LMHC

Author: Kayla Loibl, MA, LMHC

Kayla is a Mental Health Counselor who earned her degree from Niagara University in Lewiston, New York. She has provided psychotherapy in a residential treatment program and an outpatient addiction treatment facility in New York as well as an inpatient addiction rehab in Ontario, Canada. She has experience working with individuals living with a variety of mental health concerns including depression, anxiety, bipolar disorder, borderline personality disorder , and trauma .

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Cognitive Restructuring Techniques for Reframing Thoughts

CBT's Cognitive Restructuring (CR) For Tackling Cognitive Distortions

I’m going to assume you answered affirmatively since you’re human! (If you’re not a human, feel free to skip this piece.)

It’s in our nature to come up with schemas, or thought patterns and assumptions, about how things work. Without them, we would have to approach every problem as a brand new one, with no pre-existing experiences, problem-solving techniques, or lessons learned to draw from.

The issue with these schemas is that they are not always accurate. We do not always come up with the best and most effective methods for solving problems, but these methods can get saved to our subconscious anyway.

Fortunately, all hope is not lost if you have internalized a faulty perspective! There is an effective, evidence-backed process of reframing or restructuring these faulty ways of thinking that can help you right the biased, skewed, or just plain inaccurate beliefs you hold.

Read on to learn about cognitive restructuring and how it can help you improve your thinking.

Before you read on, we thought you might like to download our three Positive CBT Exercises for free . These science-based exercises will provide you with a detailed insight into Positive CBT and will give you the tools to apply it in your therapy or coaching.

This Article Contains:

What is cognitive restructuring or cognitive reframing a definition, what role does cr play in cognitive behavioral therapy, magnification, overgeneralization, and other cognitive distortions, cognitive restructuring techniques: socratic questioning, guided imagery, and more.

  • 9 Cognitive Restructuring Worksheets (PDF)

A Take-Home Message

Cognitive restructuring, or cognitive reframing, is a therapeutic process that helps the client discover, challenge, and modify or replace their negative, irrational thoughts (or cognitive distortions ; Clark, 2013).

It is a staple of Cognitive Behavioral Therapy and a frequently used tool in a therapist’s toolbox because many of our problems are caused by faulty ways of thinking about ourselves and the world around us. Cognitive restructuring aims to help people reduce their stress through cultivating more positive and functional thought habits (Mills, Reiss, & Dombeck, 2008).

Although it may seem overwhelmingly difficult to change your own ways of thinking, it is actually comparable to any other skill – it is hard when you first begin, but with practice, you will find it easier and easier to challenge your own negative thoughts and beliefs.

Cognitive Behavioral Therapy , or CBT, is built on the idea that the way we think affects the way we feel. It is easy to see the logic behind this idea, and the implications of faulty ways of thinking.

Cognitive restructuring was first developed as a therapeutic tool of CBT and Rational Emotive Behavioral Therapy , or REBT (Mills, Reiss, & Dombeck, 2008). CBT practitioners quickly found that it was an adaptable and flexible tool that could help a wide range of people dealing with all kinds of problems, whether the problems were due to outside factors, internal issues, or both.

This method of addressing problems and promoting healing makes up the bulk of CBT sessions and offers dozens of techniques and exercises that can be applied to nearly any client scenario. Applied correctly, it will help the client learn to stop automatically trusting his or her thoughts as representative of reality and begin testing his or her thoughts for accuracy (Mills, Reiss, & Dombeck, 2008).

To learn more about how CBT uses cognitive restructuring techniques, watch this video of CBT founding father Aaron Beck discussing this method.

There are so many ways our thinking can play tricks on us that it’s almost surprising that we think in a more functional way most of the time! These tricks are known as “cognitive distortions” in psychology.

Cognitive distortions are faulty or biased ways of thinking about ourselves and/or our environment (Beck, 1976). They are beliefs and thought patterns that are irrational, false, or inaccurate, and they have the potential to cause serious damage to our sense of self, our confidence, and our ability to succeed.

One of the most common cognitive distortions is magnification or minimization, a damaging distortion that affects how we evaluate the things that happen to us (Yurica & DiTomasso, 2005). You can read more in our cognitive distortions article about magnification, overgeneralization, and other common cognitive distortions.

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Luckily, although cognitive distortions are stubborn and surprisingly insidious thought patterns, there are ways to combat them! Cognitive restructuring techniques have had great success in identifying, challenging, and replacing faulty ways of thinking with more accurate, helpful, and positive ways of thinking.

Increasing Awareness of Thoughts

The first step toward fixing faulty thinking is to identify your faulty thinking. Increasing your awareness of your own thoughts, particularly your overly negative or biased thoughts, is a vital piece of this process.

It will take time and effort to improve your awareness of your own thoughts. It’s not a natural practice for people to stop in the middle of experiencing an intense emotion and think about how they got to where they are! Although it is difficult, you will find that the outcome is worth the effort.

Begin looking for cognitive distortions by turning on your internal “radar” for negative emotions. Think about when your depression, anxiety, or anger symptoms are at their worst. If it’s too difficult to start with your emotions, start with behaviors instead. Ask yourself what behaviors you would like to change, then identify what triggers those behaviors.

You can think of these situations as “alarm” situations, or situations that alert you to the presence of one or more cognitive distortions.

Some example alarm situations include:

  • You notice a feeling of anxiety before going out with friends. Your heart races, and you sweat.
  • You start arguments with your partner after you’ve had a meeting with your boss. The arguments always start over something minor, like chores.
  • When a big assignment is due at school, you put it off until the last minute. Small assignments are no problem.
  • You feel depressed when you have to spend an evening alone. You feel so lonely that you can’t take it.

Consider these alarm situations and think about similar situations in your own life. Are there scenarios that frequently bring out uncomfortable or painful emotions? Do certain situations tend to have a larger than expected impact on your mood?

Do your best to identify as many triggering situations as you can, and the more specific they are, the better! It’s incredibly helpful to have a list of your most common or most significant triggers when beginning your cognitive restructuring work.

Socratic Questioning

Socratic questioning is a very effective cognitive restructuring technique that can help you or your clients to challenge irrational, illogical, or harmful thinking errors.

The basic outline for this technique is to ask the following questions:

  • Is this thought realistic?
  • Am I basing my thoughts on facts or on feelings?
  • What is the evidence for this thought?
  • Could I be misinterpreting the evidence?
  • Am I viewing the situation as black and white, when it’s really more complicated?
  • Am I having this thought out of habit, or do facts support it?

Thoughts are a running dialogue in our minds, and they can come and go so quickly that we can barely understand them, let alone have time to address them.

The first step is to identify the thoughts that you feel need to be questioned. Think of a specific thought that you suspect is destructive or irrational, especially one that pops into your head quite a lot.

Next, consider the evidence for and against this thought. What evidence is there that this thought is accurate? What evidence exists that calls it into question?

Once you have identified the evidence, you can make a judgment on this thought. Weigh the evidence for the thought and the evidence against the thought, and decide whether it is more likely to be accurate or false. Determine whether it is based on the facts or on your feelings.

Next, you answer a question on whether this thought is truly a black and white situation, or whether reality leaves room for shades of grey. This is where you think about whether you are using all-or-nothing thinking, or making things unreasonably simple when they are truly complex.

This detailed Cognitive Restructuring Worksheet uses “Socratic questions” to encourage a deep dive into thoughts that plague you, and offer an opportunity to analyze and evaluate them for truth. If you are having thoughts that do not come from a place of truth, this worksheet can be an excellent tool for identifying and defusing them.

Guided Imagery

Quenza Gentle Harmony

You may not have known that it can also be an extremely effective method of cognitive restructuring.

There are three main categories of guided imagery that a therapist can guide their client through cognitive restructuring:

  • Life Event Visualization
  • Reinstatement of a Dream or Daytime Image
  • Feeling Focusing

CBT therapists looking to support their clients using guided imagery might point them toward recordings they can purchase, many of which accompany CBT workbooks or come as guided audio meditations.

Alternatively, practitioners may wish to pre-record their own audio that guides their clients through cognitive restructuring exercises.

Using a digital psychotherapy platform such as Quenza (pictured here), these pre-recorded audio clips can be sent directly to the client’s smartphone or tablet, where they will be available to complete when needed, such as during moments of pain or anxiety.

The advantage of distributing these recordings via such a platform is that the therapist can then track the completion of the sessions from their own devices. This may provide useful content for exploration during in-person therapy sessions, such as regarding the timing and frequency with which clients choose to engage with cognitive restructuring exercises.

Let’s now look more closely at key types of guided imagery exercises for cognitive restructuring.

– Life Event Visualization

This technique involves having the client identify a specific event or theme that is the focus of the therapy sessions (Edwards, 1989). This event could be something recent and particularly salient, like an argument with a loved one, or something from the past that still has a strong impact on the client, like being bullied or a harsh rejection from childhood. If the focus is on a theme, the client will keep this theme in mind and let an image arise organically.

– Reinstatement of a Dream or Daytime Image

This imagery technique focuses on a specific image that the client has already had. The image could be one that the client encountered in a dream, daydream, fantasy or previous guided imagery session. Wherever it came from, it will hold some inherent meaning to the client and may cause the client to feel anxious, sad, upset, or another emotion intensely.

– Feeling Focusing

The final imagery type is characterized by the client focusing on a feeling he or she is experiencing in the session, and letting an image arise from the feeling. An image will usually arise spontaneously, but if not, a technique called multisensory evocation can help to clarify an image. For this technique, the therapist will direct the client through an exploration of the senses to help sharpen the image and identify more detail.

Once the client has an image in mind, the therapist will move on to assessing the meanings that the image hold for the client. There are several assessment techniques a therapist may use, including:

  • Prompted soliloquy – the therapist directs the client to identify as an object or entity from the image (e.g., a client who visualized a lake drying up was directed to “be the lake”), and speak from the position of this object or entity (e.g., the client would speak about how it felt to be the lake, and what its drying up meant).
  • Interview – in this technique, the client will once again take on the role of an object or entity from the image, and the therapist will ask specific questions of the client in this role.
  • Prompted dialogue – similar to the previous techniques, this technique involves the client taking on a role and addressing one of the other objects or people in the imagery (e.g., the client could identify as the lake and address the trees around the lake).
  • Prompted descriptions – this basic technique simply refers to the therapist’s use of frequent questions about what the client is seeing and feeling.
  • Prompted transformation – the therapist may suggest that the client shifts or changes the image; this can be especially helpful when the current image has reached the end of its usefulness as a discussion piece.

However a therapist and client work together to identify the meanings attached to the image, the next step will help them to begin challenging, restructuring, or replacing harmful assumptions and beliefs.

Some of the techniques a therapist may use to guide a client through restructuring include summary and reframing, directed dialogue, prompted dialogue, directed transformation, and prompted transformation.

– Summary and Reframing

This restructuring method refers to the therapist’s summarizing what he or she has learned from the client and suggesting alternate beliefs or assumptions based on the client’s image. This is generally a first step in restructuring, as it is a gentle introduction to the idea of changing what may be deeply or even unconsciously held beliefs.

– Directed Dialogue

In directed dialogue, the therapist instructs the client to take on the role of one of the objects or people from the imagery and deliver specified lines in that role. The client may direct their speech to another object or person in the imagery or simply make statements to no one in particular. This technique can help the client consider the possibility of new beliefs and begin to modulate their own assumptions.

– Prompted Dialogue

This technique is not as direct as the previous technique, but it can be just as powerful. Instead of telling the client exactly what to say in their role from the image, the therapist will direct them to come up with their own words to capture a specific idea.

– Directed Transformation

This technique also has the potential to be very powerful. In directed transformation, the therapist will direct the client to make a change to the image. The change may be to direct one of the individuals in the image to take a new action or to edit, enhance, or erase an object from the image.

– Prompted Transformation

Like prompted dialogue, this technique gives the client a bit more freedom to make their own changes to the image. Instead of directing the client in exactly how to change the image, the therapist will encourage the client to think of a way to change the image that will further a goal or help it become more positive (Edwards, 1989).

Thought Records

Keeping thought records is an excellent way to help you or your client become aware of any cognitive distortions that went previously unnoticed or unquestioned, which is the necessary first step to restructuring them (Myles & Shafran, 2015). There are several different ways to structure a thought record, but the main idea is to note what recurrent thoughts are coming to mind and the situations in which they come up.

A popular thought record (described in more detail later) instructs you to record the situation, thoughts, emotions, behaviors, and alternate thought.

As an example, you may fill this out with the following descriptions if you are having trouble being alone with depressive symptoms:

  • Situation: Everyone’s busy, so I’m spending an evening alone with no plans.
  • Thoughts: No one wants to hang out with me. I’m just wasting my life, sitting here alone.
  • Emotions: Depressed.
  • Behaviors: Stayed home all night and did nothing. Just sat around having bad thoughts.
  • Alternate Thought: I’m alone tonight, but everyone is alone from time to time. I can do whatever I want!

Alternatively, if you are struggling with procrastination, you might fill out the thought record as follows:

  • Situation: A difficult assignment is due at school.
  • Thoughts: This is so much work. I’m horrible at this stuff. I don’t think I can do it.
  • Emotions: Anxious.
  • Behaviors: Avoided the assignment until the last minute. Had to rush my work.
  • Alternate Thought: This is a difficult assignment, and it’ll take a lot of work. But I know I can do it if I break it into small pieces.

Writing this information down will give you or your client a way to consider what they may not have noticed before, and find patterns in their thinking that can point to specific distortions in their cognition.

In the next section, we’ll go over one such worksheet that can be used to record potentially distorted thoughts.

Decatastrophizing or “What If?” Technique

This technique is basically asking “what’s the worst that can happen?” and following a scenario logically through to completion (Dattilio & Freeman, 1992). We often suffer from assumptions or anxieties about the worst possible outcome that could happen, even if that outcome is (a) not very likely, and (b) not going to ruin our lives even if it does!

Decatastrophizing or asking yourself “what if?” will help you or your client determine what is likely to happen, reduce irrational or unreasonable anxiety, and see that even the worst-case scenario is manageable.

A worksheet covering this technique will also be included below.

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5 Cognitive Restructuring Worksheets (PDF)

If you’re hoping for some hands-on tools to help you with cognitive restructuring, you’ve come to the right place! A few of the best worksheets and handouts for cognitive restructuring exercises are described below.

Thought Record

This simple worksheet is very easy to use, but it can be extremely helpful for enhancing your awareness and identifying potentially damaging thoughts.

There are six columns in this thought record, with space for up to five separate instances.

In the second column, the user is instructed to describe the situation. This should include the five “W”s and one “H” (i.e., who, what, where, when, why, how), if applicable. Write down everything you can think of that contributed to the environment and to encouraging or promoting the thought that follows.

Write down this thought in the third column. It should be a thought that you identified as potentially harmful, illogical, or outright false. Be specific and write out the whole thought.

In the next column, think about the emotions that accompanied this thought. How did you feel when this thought popped up? What emotions did it seem to bring with it? What emotions did it cause? Anger, shame, sadness, guilt? Write down whatever emotions it engendered.

Use the fifth column to record an alternate thought, especially if the original thought is one that you find unenjoyable or unhelpful. The alternate thought should be something that you find plausible, but that is more positive and realistic than the original thought.

In the last column, note the outcome of this exercise.

Use this Thought Record Worksheet as much as needed, whether that is once every couple of days when a problematic thought pops up, or several times a day when a recurring thought returns to plague you. Keeping a log will help you identify patterns and discover the triggers and potential fixes for the negative, automatic thoughts you are suffering from.

ABC Belief Monitoring

9 Cognitive Restructuring Worksheets (PDF)

Similar to the Thought Record worksheet, this worksheet is a great way to help you or your client identify the link between situations, thoughts and beliefs, and the feelings and actions that follow.

Sometimes it is difficult for us to connect the triggers of our thoughts and beliefs with the outcomes of those thoughts and beliefs. Use this worksheet to help you or your clients discover these connections.

In the first portion of the worksheet, you will identify the antecedents or triggers (the “A” in ABC) of the belief or thought. Describe the situation as best you can.

In the second section, identify the belief or thought (the “B” in ABC) that you had about the situation. Make sure to note all thoughts or beliefs that arose if you had more than one. Be specific about them. After you have identified the thoughts and beliefs, rate how true you find them to be on a scale from 0% (not true at all) to 100% (absolutely true). Consider each thought or belief, and take some time to assign them an accurate rating.

In the third and final section, list the consequences (the “C” in ABC) of the thought or belief. Describe how you felt when this situation occurred, what you did in response, and how others reacted (if applicable). Do your best not to shy away from the truth, even if it’s difficult to admit how you responded to the situation or acknowledge how others reacted.

Use this ABC Functional Analysis worksheet  to keep tabs on any automatic beliefs or thoughts that tend to pop up for you, especially in times of stress or situations that don’t go your way. The first step to restructuring harmful or problematic beliefs is identifying them!

Behavioral Experiment

This worksheet is an excellent way to practice several helpful restructuring techniques and methods of reframing. It also allows you to use your imagination and think about how your current habits and behaviors could bring about future outcomes, whether positive or negative.

In the first section, labeled “Original Belief,” write down something you believe to be true. It should be related to something meaningful to you, and it should be tied to a potential cognitive distortion. Describe what you expect to happen, and how you would know if your belief came true. Next, rate how strongly you believe it will actually come true on a scale from 0% (not strong at all) to 100% (extremely strong).

In the next section, you will do a little experimenting. Think of an experiment that could test this prediction you have, and note the situation that would need to unfold (when, where, who, etc.). Identify which of your safety behaviors, or behaviors you use to protect yourself from anxiety, sadness, or disappointment, would need to be dropped to conduct the experiment.

Write this in the next circle if there is an alternate belief you may need to adopt. Again, rate in on a scale from 0% (not strong at all) to 100% (extremely strong). Note how you would know if your prediction came true or not.

The next step is the biggest one – go out and conduct the experiment.

Once you have completed the experiment, come back to the worksheet and answer the rest of the questions.

The section following the experiment covers the outcome of the experiment. Describe what happened, and don’t skimp on details! Once you have penned a good description of the outcome, determine whether your prediction was accurate.

Write down what you learned from your experiment, and determine how likely it is that your original belief will come true in the future. Finally, rate how strongly you agree with your original belief now that you have completed your experiment and examined the results.

The beauty of this worksheet is that it can be used for a wide variety of beliefs, predictions and behaviors, from big to small, positive to negative, meaningful to trivial, and everything in between.

Completing these Behavioral Experiments will help you challenge your assumptions about how things work, as well as your beliefs about how things should work. Use it as often as you like to keep track of any potentially damaging distortions and maintain awareness about your deeply held beliefs.

Positive Belief Record

This worksheet offers a surprisingly simple and straightforward, yet evidence-based method of challenging potentially harmful or inaccurate beliefs you may hold.

To dive into this worksheet, direct your attention to the top of the sheet. You will find two clouds – one where you can record the belief you would like to modify or replace, and a second space where you can come up with a new, more positive belief to replace it.

Underneath the two beliefs is a section where you can record some evidence for the new belief or against the current belief. This evidence can provide support for the new belief, call the current belief into question, or do both at once. It should be fairly easy to find this kind of evidence, especially if the current belief is one that you have identified as a belief that is likely to be inaccurate or illogical.

There is enough space on the worksheet to come up with ten pieces of evidence that support the new belief or cast doubt upon the current belief, but feel free to use another sheet of paper if you need more room! This evidence can include experiences you have had, something someone else has said to you, or anything else you can think of that supports the new belief or sheds doubt on the old belief.

Use this Logging Positive Beliefs worksheet whenever you identify a thought or belief that you realize is distorted, inaccurate, or biased. It will help you come up with ways to combat it and replace it with a new, more positive, more realistic thought or belief.

Theory A Theory B

However important, real, or pressing our problems seem to us, they are often a different kind of problem than we think. This exercise can help your client see many problems as problems of belief or worry instead of situation or fact.

Take a blank sheet of paper and split it into two columns, labeling them as “Theory A” and “Theory B.”

Under Theory A, describe your problem as one of fact. Under Theory B, describe your problem as one of worry.

First, identify your problem and describe it under Theory A. Finish the sentence prompt “The problem is…” with a description of the problem as you currently understand it.

Next, provide evidence that this problem is real, and that you are interpreting the situation correctly.

Finish up the Theory A column by answering the question: “What do I need to do if Theory A is true?” In other words, determine what you would need to do to solve your problem or, if it is unsolvable, address the issues that come with this problem.

When you have finished with the first column, move on to the second column and Theory B.

Describe the problem again, but this time from the perspective of the problem as one of worrying rather than fact. Consider the idea that the real problem is in fact the belief you have or the worry you carry.

Next, provide evidence for the problem as one of belief or worry instead of fact. Think of any evidence you can find that lends support to this interpretation.

Finally, answer the same question you did at the bottom of the first column: “What do I need to do if Theory B is true?” Consider what you would need to do to address your problem if it is interpreted as a problem of worry rather than fact.

Compare the two columns once you have finished. You will likely find that the second column describes a problem that is much more realistic and manageable, and that your “to-do list” at the bottom is much simpler and more straightforward in the second column.

Use this exercise whenever you want to reframe a problem to make it tamer and more manageable.

This last worksheet will help you change your perspective on some of the most common situations you encounter or think about. It is based on the natural human tendency to finish the thought “What if…?” with negative situations or events.

While we often veer toward the negative possibilities, there are usually an equal number of positive possibilities that we simply fail to recognize. The consequence of considering only negative outcomes is clearly not a happier and healthier you – a more balanced perspective will help you to approach life with a more positive and realistic attitude.

The worksheet juxtaposes two columns with two separate ways of looking at the world: one negative, and one positive.

On the left side, the column is labeled “Negative ‘What if…?’”

On the right side, the column is labeled “Positive ‘What if…?’”

As you have probably guessed, your instructions are to fill out the left column with “glass half empty” ways of completing a “What if…?” thought, and to fill out the right column with “ glass half full ” ways of completing such a thought.

There is plenty of room to write in each column, so do your best to fill them! At the least, you should try to make sure you come up with as many positive sentence completions as negative ones. Negative ones tend to come easier to us, but it’s important to consider the positive possibilities as well.

Once you are done, ask yourself these two questions:

  • How does each kind of “What if…?” make me feel?
  • Which is more likely than the other?

Consider your answers to these questions for each pair of “What if…?” scenarios. You will likely find that you feel much better thinking about the positive ones than the negative ones. If you are being honest with yourself, you will probably find that the positive outcome is more likely to occur than the negative one.

Pull out this What If Bias worksheet whenever you or your client is having trouble considering the positive along with the negative. This exercise can help you restructure your thinking to correct distortions like disqualifying the positive, mental filter, catastrophizing, minimizing, and overgeneralization.

Challenging Negative Automatic Thoughts

In this worksheet, the reader will be guided through questions challenging negative automatic thoughts (or cognitive distortions).

The questions are based on strategies which include:

  • Examining the evidence for and against
  • Exploring the idiosyncratic meanings of these thoughts
  • Exposing the bias and distortion in these thoughts
  • Expanding one’s perspective
  • Experimenting, both behaviorally and cognitively

Here are some of the questions:

  • What facts support this thought? What existing evidence contradicts it?
  • What would the worst possible outcome be, if this thought were true?
  • Am I using a past experience to overgeneralize?

Use these questions to guide your thinking about the evidence for negative automatic thoughts, the implications if they are correct (and if they are incorrect), and how they should be modified, restructured, or replaced.

In this piece, we covered the topic of cognitive restructuring. We defined cognitive restructuring (or cognitive reframing), identified some of the most common distortions that can be addressed through cognitive restructuring, covered several different techniques for modifying or replacing these distortions, and provided worksheets and handouts that can help you or your client on this journey to more positive and effective cognition.

I hope you come away from this piece with a new understanding of this valuable CBT tool, and an interest in learning more about the fascinating way that our minds work.

Have you tried any of these techniques, either as a therapist or as a client? How did they work for you? Are there any techniques you found effective that were not included here? Leave us a comment and let us know your thoughts on the subject!

Thanks for reading!

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free .

  • Beck, A. T. (1976). Cognitive therapy and emotional disorders . New York, NY: International Universities Press.
  • Clark, D. A. (2013). Cognitive restructuring. In S. G. Hoffman, D. J. A. Dozois, W. Rief, & J. Smits (Eds.), The Wiley handbook of cognitive behavioral therapy (pp. 1-22). Hoboken, NJ: John Wiley & Sons.
  • Dattilio, F. M., & Freeman, A. (1992). Introduction to cognitive therapy. In A. Freeman & F. M. Dattilio (Eds.), Comprehensive casebook of cognitive therapy (pp. 3-11). Boston, MA: Springer.
  • Edwards, D. (1989). Cognitive restructuring through guided imagery: Lessons from Gestalt Therapy. In A. Freeman, K. M. Simon, L. E. Beutler, & H. Akrowitz (Eds.), Comprehensive handbook of cognitive therapy. Boston, MA: Springer.
  • Mills, H., Reiss, N., & Dombeck, M. (2008). Cognitive restructuring. Mental Help Net. Retrieved from https://www.mentalhelp.net/articles/cognitive-restructuring-info/
  • Myles, P., & Shafran, R. (2015).  The CBT Handbook: A comprehensive guide to using Cognitive Behavioural Therapy to overcome depression, anxiety and anger . London, UK: Hachette.
  • Yurica, C. L., & DiTomasso, R. A. (2005). Cognitive distortions. In S. Felgoise, A. M. Nezu, C. M. Nezu, & M. A. Reinecke (Eds.), Encyclopedia of cognitive behavior therapy  (pp. 117-122). Springer, Boston, MA.

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These worksheets on thought restructuring are excellent tools for CBT therapy. Thank you!


I experienced CBT as a structured problem-solving method, assisting by getting to the problem, brainstorming solutions, and creating an action plan. It really helps to change behaviour using positive reinforcement and gain a fresh outlook on negative experiences. I found CBT to be realistic which really results in constructive outcomes. The resources have been very helpful for reflecting on myself and I’m confident to use them with my clients.

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12 Printable CBT Worksheets for Kids

Michael Vallejo, LCSW

It isn’t uncommon for a child to experience stress and anxiety at home or in school, but when emotions spiral, they can be difficult to control. Using CBT worksheets for kids can help curb self-destructive coping mechanisms and change negative thought patterns.

If your child struggles with anxiety, depression, and stress, this helpful guide is for you. Explore these ten simple, printable cognitive behavioral therapy worksheets for kids and discover how to use them.

What are CBT Worksheets for Kids?

CBT worksheets for kids aim to improve a child’s problem-solving skills when stress-related challenges arise. They can help children reframe their thought patterns and reactions to negative experiences, leading to improvements in self-control, coping skills, and emotional awareness.

What are the Benefits of Using CBT Worksheets for Kids?

Just as cognitive behavioral therapy is an effective treatment for psychological issues in teenagers and adults, it’s just as impactful for children. CBT for kids is effective in treating psychopathologies in children like anxiety, obsessive-compulsive disorder, eating disorders, self-harm, and school phobias [ * ].

Here are a few other benefits of using CBT worksheets for kids:

  • Improved self-control. Because CBT worksheets aim to help children recognize negative thought patterns , they can learn to refrain from engaging in self-destructive behavior in the future. They’ll regulate their emotions better in stressful situations.
  • Better social skills. Anxiety and depression can prevent a child from exercising their social skills. Through CBT worksheets, they can learn to express themselves more confidently in social situations and handle conflicts with more grace.
  • Simpler learning experience. Explaining CBT to children can be challenging, especially when they are very young. By using worksheets, your child can visualize concepts and grasp them in simpler, more manageable ways.
  • High success rate. According to meta-analyses, using CBT as the primary method for treating anxiety disorders in children has a 60% success rate [ * ]. Through continued CBT, children suffering from symptoms of PTSD, anxiety, and depression may no longer meet the criteria for diagnosis within four years.
  • Tailored treatment. There is no one “right” way to use CBT worksheets with a child. What doesn’t work for one may work for another. Ultimately, CBT is a highly customizable treatment you can tailor to suit your child’s specific needs.

Whether your child is new to CBT or is already undergoing therapy, these printable CBT worksheets for kids can supplement their healing journey.

1. Letting Go of Anxious Thoughts

Anxiety can be crippling for a young child and it’s essential to find healthy, relaxing ways to let go. Tap into your child’s visual thinking by using our Letting Go of Anxious Thoughts worksheet site.

When they are anxious, ask them to envision six balloons. Using our worksheet, write six of their negative thoughts or fears onto these balloons and visualize letting them go. As they drift away, encourage them to relax their minds.

Letting Go of Anxious Thoughts

2. Changing Negative Thoughts to Positive Thoughts

Changing negative thoughts into positive thoughts starts with identifying and acknowledging the former. With your child, list the persistent negative thoughts they have and reconfigure them into positive ones.

For instance, your child might write, “I failed my exam and I’m not smart enough.” You can turn this negative thought into a positive one by saying, “I failed my exam but I can study harder and do better next time.”

Changing Negative Thoughts to Positive Thoughts

3. Physical Symptoms of Anxiety

Most children won’t understand that anxiety can manifest physically. By studying the physical symptoms of anxiety and listing down other occurrences, your child can identify early warning signs of a panic attack or depressive state.

Physical Symptoms of Anxiety

4. Happy Place Worksheet

When in a depressive or anxious state, thinking of a happy place can help your child calm down. As your child pictures their happy place, ask them to describe it according to their senses—what do they see? Hear? Smell?

Once your child is calm, reflect on how they feel and how the activity helped.

Happy Place Worksheet

5. Anxiety Triggers Worksheet

Anxiety is often the result of a trigger. However, young children may struggle to identify what these triggers are. You can use our Anxiety Triggers Worksheet to identify these triggers and rate how anxious they make your child feel. Add triggers to the worksheet as necessary to help your child identify warning signs of anxiety or panic.

Anxiety Triggers Worksheet

6. Worry Jar

Children should know that worrying is normal, but that spending too much time doing so can be detrimental to their mental health. With a worry jar , your child can reflect on their worries and dedicate enough time to sit with their negative feelings.

When their “worry time” is up, encourage your child to focus on letting go of their painful thoughts and focus on moving on.

Worry Jar

7. Coping Statements for Anger

Anger is often considered a secondary emotion to more vulnerable feelings like hurt, betrayal, or disappointment [ * ]. When children learn to address and soothe their anger, they become better at identifying their true feelings underneath the rage.

Coping statements for anger can help a child return to a calmer state and reflect on why they are angry.

Coping Statements for Anger

8. Positive Self-Talk for Depression

Children may think negatively for many reasons, one of them being depression. Encourage them to engage in positive self-talk for depression with phrases like, “I’m feeling down but can focus on feeling better,” and “My sadness makes me feel worthless, but I am not.”

Your child will learn to self-motivate and take the necessary steps to improve their depression.

Positive Self-Talk for Depression

9. Anger Firework

Anger can quickly spiral out of control, especially in children who haven’t learned to regulate their emotions. By using an anger firework to visualize the stages of anger, children can learn to manage outbursts before they lead to bigger problems.

Anger Firework

10. Trauma Coping Statements

Trauma can have a lasting impact on young children that is challenging to reverse. Thankfully, through trauma coping statements and consistent work, children can learn to be at peace with their negative thoughts and develop the mindset of a hardworking survivor.

Use our worksheet to reinforce positive coping mechanisms and create helpful daily mantras for your child.

Trauma Coping Statements

11. Exploring Emotions Worksheet

Children may feel discouraged from sharing how they feel when no one checks in on them. Use our exploring emotions worksheet to see where your child’s head is at and get to the bottom of why they feel a certain way.

Once your child identifies the core emotion, consider where in their body they feel this emotion, recognizing any physical manifestations of anxiety. Then, reflect on how they act when they feel this particular emotion. This worksheet uses a version of the CBT triangle to allow kids to explore the connection between their thoughts, feelings, and actions.

Exploring Emotions Worksheet

12. Anxious Thoughts Breakdown

Anxiety can seemingly appear out of nowhere and be challenging to control. By using our anxious thoughts breakdown worksheet , your child can better prepare themselves for this rollercoaster of emotions.

When writing down their anxious thoughts, your child can reflect on the situation at hand and consider their truthful thoughts. Then, you can help break down these worried thoughts by finding ways to challenge them and turn them into positive ones. This worksheet provides kids with three different ways to work through their anxious thoughts.

Anxious Thoughts Breakdown

Help Your Kids Explore Their Feelings with These CBT Worksheets

It can be challenging to explain CBT to a child, but using CBT worksheets for kids can break it down into simpler, more manageable concepts.

Whether your child struggles with depression or anxiety or could simply use a helping hand in their development, we encourage you to explore our collection of CBT worksheets .

  • Seligman LD, Ollendick TH. “Cognitive-Behavioral Therapy for Anxiety Disorders in Youth.” Child and Adolescent Psychiatric Clinics of North America, 2011.
  • Arne Kodal, Krister Fjermestad, Bjelland I, et al. “Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders.” Journal of Anxiety Disorders, 2017.
  • Sukhodolsky D, Smith S, McCauley S, et al. “Behavioral Interventions for Anger, Irritability, and Aggression in Children and Adolescents.” Journal of Child and Adolescent Psychopharmacology, 2021.

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Mental Illness in Children: Signs, Diagnosis, and Treatment

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  • Legionella Control
  • Guidance for Legionella Control
  • Legionella Training
  • Research Summary
  • WMP Overview
  • Hospitality and Recreational Water Facilities
  • Healthcare Facilities
  • Legionella (Legionnaires' Disease and Pontiac Fever)
  • Investigating Legionella Cases

Identify Buildings with Increased Legionella Risk

  • Quickly assess the need for a water management program (WMP).
  • Answer the first 4 questions for buildings and the last 4 questions for devices.
  • Effective WMPs can reduce the risk of Legionella growing and spreading.
  • This worksheet supplements CDC's Legionella WMP toolkit.

Picture of the worksheet to identify buildings at increased risk of Legionella growth and spread.

Worksheet questions

Building questions 1–4.

  • Is your building a healthcare facility where patients stay overnight or does your building house or treat people who have chronic and acute medical problems A or weakened immune systems?  Yes  No
  • Does your building primarily house people older than 65 years (like a retirement home or assisted-living facility)?  Yes  No
  • Does your building have multiple housing units and a centralized hot water system (like a hotel or high-rise apartment complex)?  Yes  No
  • Does your building have more than 10 stories (including basement levels)?  Yes  No

Device Questions 5–8

  • Does your building have a cooling tower ?  Yes  No
  • Does your building have a hot tub (also known as a spa) that is not drained between each use?  Yes  No
  • Does your building have a decorative fountain?  Yes  No
  • Does your building have a centrally-installed mister, atomizer, air washer, or humidifier?  Yes  No


Printable worksheet‎

Additional information.

The building standards discussed in CDC's Legionella WMP toolkit don't apply to

  • Single-family residences
  • Small multiple-family residences (e.g., duplexes)

It doesn't apply to those buildings even if they include the devices in questions 6 through 8.

Take steps to prevent waterborne diseases

Residents need to take steps to protect themselves from waterborne diseases even if they live in single-family or small multiple-family residences. Homeowners should follow local and state guidelines for household water use. Owners of the devices in questions 6 through 8 should follow the manufacturer's instructions regarding cleaning, disinfecting, and maintenance.

Infographic : How Legionella affects building water systems and people

Toolkit : Developing a water management program to reduce Legionella growth and spread in buildings

Toolkit : Controlling Legionella in common sources of exposure

Training : Preventing Legionnaires' disease: A training on Legionella water management programs

  • Burns, cancer, solid organ or bone marrow transplant, kidney disease, diabetes, or chronic lung disease
  • ASHRAE Standard 188: Legionellosis: Risk management for building water systems
  • ASHRAE Guideline 12: Managing the risk of legionellosis associated with building water systems

Control Legionella

An effective water management program is the primary strategy to control Legionella growth and spread to prevent Legionnaires' disease.

For Everyone

Public health.


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