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Cognitive Restructuring

At the core of the cognitive model is the assumption that a patient’s appraisals of an event determine their feelings and reactions to it. Cognitive restructuring is an umbrella term that refers to any methods that help people to think differently about an event (which might include any stimulus, thought, memory, or belief). In a broad sense the term ‘cognitive restructuring’ could apply to anything done in (or outside of) a therapy session that promotes cognitive change. In a narrower sense, therapists deliberately use a range of therapeutic approaches designed to promote cognitive restructuring. Leahy and Rego (2012) give a narrow definition of cognitive restructuring as:
“a multistep process that involves: (1) eliciting problematic cognitions known as automatic thoughts or negative automatic thoughts of the self, world, or future, (2) formulating rational responses to these negative automatic thoughts by (3) identifying and removing cognitive distortions found in the automatic thoughts and (4) correcting false beliefs, assumptions, predictions and so on, using a Socratic dialogue.”
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Problem

Therapy tool

Language

Anger Thought Challenging Record

Disputing thoughts is a critical skill in cognitive therapy. The Anger Thought Monitoring Record helps clients to identify and challenge their angry t ... https://www.psychologytools.com/resource/anger-thought-challenging-record/

Worksheet

Barriers Abusers Overcome In Order To Abuse

Individuals who have experienced abuse often focus on their own actions (or inactions) and blame themselves for their own abuse. This client informati ... https://www.psychologytools.com/resource/barriers-abusers-overcome-in-order-to-abuse/

Exercise

Before I Blame Myself And Feel Guilty

Guilt is a common post-traumatic reaction and is often the result of cognitive bias. This CBT worksheet explores common cognitive biases that have bee ... https://www.psychologytools.com/resource/before-i-blame-myself-and-feel-guilty/

Exercise

Behavioral Experiment

Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ... https://www.psychologytools.com/resource/behavioral-experiment/

Worksheet

Belief-O-Meter (CYP)

The Belief-O-Meter is an engaging way of helping children and adolescents to relate to their thoughts differently. It is a form of cognitive restructu ... https://www.psychologytools.com/resource/belief-o-meter-cyp/

Worksheet

Catching Your Thoughts (CYP)

Before thoughts can be examined or challenged they must be ‘caught’ – they must be noticed and distinguished from events and feelings. The Catch ... https://www.psychologytools.com/resource/catching-your-thoughts-cyp/

Worksheet

CBT Thought Record

The CBT Thought Record is an essential tool in cognitive behavioral therapy. Thought challenging records help people to evaluate their negative automa ... https://www.psychologytools.com/resource/cbt-thought-record/

Worksheet

CBT Thought Record Portrait

The CBT Thought Record is an essential tool in cognitive behavioral therapy. Thought challenging records help people to evaluate their negative automa ... https://www.psychologytools.com/resource/cbt-thought-record-portrait/

Worksheet

Challenging Your Negative Thinking

A cornerstone of cognitive behavioral therapy is that an individual’s interpretation of an event determines how they feel and behave. We all experie ... https://www.psychologytools.com/resource/challenging-your-negative-thinking/

Guide

Compassionate Thought Challenging Record

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. This Compassi ... https://www.psychologytools.com/resource/compassionate-thought-challenging-record/

Worksheet

Court Trial Thought Challenging Record

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. This Thought ... https://www.psychologytools.com/resource/court-trial-thought-challenging-record/

Worksheet

Daily Record of Dysfunctional Thoughts

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. The Daily Rec ... https://www.psychologytools.com/resource/daily-record-of-dysfunctional-thoughts/

Worksheet

Decatastrophizing

Catastrophic thinking (magnification) is characteristic of many anxiety problems. This CBT worksheet for decatastrophizing is a tool for cognitive res ... https://www.psychologytools.com/resource/decatastrophizing/

Exercise

Dysfunctional Thought Record

The Dysfunctional Thought Record is a Rational Emotive Behavior Therapy (REBT) tool to record and challenge dysfunctional thoughts. ... https://www.psychologytools.com/resource/dysfunctional-thought-record/

Worksheet

Fact Or Opinion

One cognitive error which commonly results in distress is to act on our opinions as though they were facts. This CBT exercise helps clients to practic ... https://www.psychologytools.com/resource/fact-or-opinion/

Exercise

Health Anxiety Thought Record

Individuals with health anxiety experience clinically significant distress associated with health concerns. This thought-challenging record enables cl ... https://www.psychologytools.com/resource/health-anxiety-thought-record/

Worksheet

Hindsight Bias

Survivors of loss or trauma often think “If only …”. Hindsight Bias is a cognitive bias / cognitive illusion which makes events seem mor ... https://www.psychologytools.com/resource/hindsight-bias/

Information Handout

Hotspot Record

Enhanced ‘reliving’ in trauma-focused CBT for PTSD involves addressing the meaning associated with ‘hot spots’ of traumatic me ... https://www.psychologytools.com/resource/hotspot-record/

Worksheet

Interoceptive Exposure

Misappraisals of body sensations trigger emotional and physiological reactions of fear and heightened arousal. These feelings motivate behavioral resp ... https://www.psychologytools.com/resource/interoceptive-exposure/

Exercise

Intrusive Thoughts Images And Impulses

Intrusive Thoughts, Images, And Impulses that are experienced as distressing are a feature of obsessive compulsive disorder (OCD). They are also a com ... https://www.psychologytools.com/resource/intrusive-thoughts-images-and-impulses/

Exercise

Modifying Rules And Assumptions

Assumptions are often considered dysfunctional if they are inflexible, rigid, or lead to counterproductive behaviors. Modifying Rules And Assumptions ... https://www.psychologytools.com/resource/modifying-rules-and-assumptions/

Worksheet

Nightmare Exposure And Rescripting

Imagery rescripting is an effective treatment for intrusive and unwanted memories. Nightmare Exposure And Rescripting employs similar techniques and c ... https://www.psychologytools.com/resource/nightmare-exposure-and-rescripting/

Exercise

Nightmare Rescripting (Audio)

Nightmare rescripting is an evidence based treatment for nightmares, with medium to large effect sizes on nightmare frequency, distress, intensity, an ... https://www.psychologytools.com/resource/nightmare-rescripting-audio/

Audio

Perspective-Taking

Cognitive restructuring techniques in CBT teach clients ways of analyzing situations in ways that might initially be unfamiliar. A simple way of intro ... https://www.psychologytools.com/resource/perspective-taking/

Exercise

Pie Charts

A common cognitive bias is to take an egocentric approach to events. When applied to negative events this can result in an exaggerated sense of respon ... https://www.psychologytools.com/resource/pie-charts/

Exercise

Positive Belief Record

Some cognitive change can happen quickly – for example challenging negative automatic thoughts. Other cognitive structures such as schemas are m ... https://www.psychologytools.com/resource/positive-belief-record/

Worksheet

Prompts For Challenging Negative Thinking

The CBT model proposes that how we think affects the way we feel. Challenging our unhelpful thoughts (cognitive restructuring) is an essential skill w ... https://www.psychologytools.com/resource/prompts-for-challenging-negative-thinking/

Information Handout

REBT Consequences Analysis Form

The REBT Consequences Analysis Form is a form of ‘functional/pragmatic disputing’ and can be used to challenge and restructure irrational ... https://www.psychologytools.com/resource/rebt-consequences-analysis-form/

Worksheet

Schema Bias

Core beliefs (schemas) are self-sustaining. They act to ‘attract’ confirmatory evidence and ‘repel’ or ‘distort’ d ... https://www.psychologytools.com/resource/schema-bias/

Information Handout

Self Critical Thought Challenging Record

Disputing thoughts is a critical skill in cognitive therapy. The Self-Critical Thought Challenging Record helps clients to identify and challenge thei ... https://www.psychologytools.com/resource/self-critical-thought-challenging-record/

Worksheet

Simple Thought Challenging Record

Disputing thoughts is a critical skill in cognitive therapy. The Simple Thought Challenging Record encourages clients to identify alternative perspect ... https://www.psychologytools.com/resource/simple-thought-challenging-record/

Worksheet

Stimulus Discrimination

Stimulus discrimination is a component of cognitive behavioral treatment for post-traumatic stress disorder (PTSD). Clients are guided to deliberately ... https://www.psychologytools.com/resource/stimulus-discrimination/

Exercise

Stimulus Discrimination (Audio)

Stimulus Discrimination is designed to help people with post-traumatic stress disorder (PTSD) to ‘retrain their brain’ in order to attend automat ... https://www.psychologytools.com/resource/stimulus-discrimination-audio/

Audio

Taking Panic Out Of The Body

A critical driver of panic reactions is catastrophic misinterpretation of body sensations. This worksheet helps therapists to teach clients about the ... https://www.psychologytools.com/resource/taking-panic-out-of-the-body/

Exercise

Testing Anxious And Panicky Predictions (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter introduces beh ... https://www.psychologytools.com/resource/testing-anxious-and-panicky-predictions-psychology-tools-for-overcoming-panic/

Chapter

Theory A Theory B

“The most effective way of changing a misinterpretation … is to help the person come up with an alternative, less threatening interpretation o ... https://www.psychologytools.com/resource/theorya-theoryb/

Exercise

Thought Challenging Record 7 Column

The thought record is an essential tool in cognitive behavioral therapy (CBT). Thought challenging records help people to evaluate their negative auto ... https://www.psychologytools.com/resource/thought-challenging-record-7-column/

Worksheet

Thought Distortion Monitoring Record

Thinking is often biased in particular ways and individuals often have their own characteristic patterns of bias. The Thought Distortion Monitoring Re ... https://www.psychologytools.com/resource/thought-distortion-monitoring-record/

Worksheet

Thoughts In CBT (Psychology Tools For Living Well)

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/thoughts-in-cbt-psychology-tools-for-living-well/

Chapter

Unhelpful Thinking Styles

Human thinking is subject to a number of characteristic biases. Cognitive restructuring is the process of helping individuals to overcome their biases ... https://www.psychologytools.com/resource/unhelpful-thinking-styles/

Information Handout

Vertical Arrow Down Arrow Vertical Descent

Vertical Arrow / Downward Arrow / Vertical Descent is a form of Socratic questioning in which the therapist asks a succession of questions to uncover ... https://www.psychologytools.com/resource/vertical-arrow-down-arrow-vertical-descent/

Exercise

Vicious Flower Formulation

Case conceptualizations (formulations) are designed to help clients and therapists come to a shared understanding of a problem. The ‘vicious flo ... https://www.psychologytools.com/resource/vicious-flower-formulation/

Exercise

What If

“What if…?” questions are a powerful way in which anxious individuals generate or maintain anxious states, particularly in generaliz ... https://www.psychologytools.com/resource/what-if/

Exercise

Working With Anxious Thoughts And Predictions (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter introduces the ... https://www.psychologytools.com/resource/working-with-anxious-thoughts-and-predictions-psychology-tools-for-overcoming-panic/

Chapter

Worry Thought Record

Anxiety stems from negative predictions about the future (and also from assumptions that one will not be able to cope with the magnitude of the threat ... https://www.psychologytools.com/resource/worry-thought-record/

Worksheet

Types

Intervention

Recommended Reading

What Is Cognitive Restructuring?

Techniques for Cognitive Restructuring

  • Behavioral experiments (including hypothesis testing and surveys) have been a fundamental CBT technique since the publication of the first treatment manual: “a powerful method with which to investigate the validity of a specific assumption consists of designing an experiment or task to test the assumption empirically” (Beck et al., 1979). Bennett-Levy et al. (2004) define behavioral experiments as:

“planned experiential activities, based on experimentation or observation, which are undertaken by patients in or between cognitive therapy sessions … their primary purpose is to obtain new information which may help to: test the validity of the patients’ existing beliefs …; construct and/or test new, more adaptive beliefs; contribute to the development and verification of the cognitive formulation.”

  • Examining and reality-testing automatic thoughts and images, popularly known as ‘thought challenging’ or ‘disputing thoughts’ is a technique by which patients are encouraged to examine the accuracy of and validity of their negative automatic thoughts and images.
  • Psychoeducation in therapy refers to information-giving. Many patients experience psychological distress because they lack critical information. Information can be given directly in the form of handouts or reading, or indirectly in the form of information-gathering exercises.
  • Socratic dialogue is “a method of guided discovery in which the therapist asks a series of carefully sequenced questions to help define problems, assist in the identification of thoughts and beliefs, examine the meaning of events, or assess the ramifications of particular thoughts or behaviors” (Beck & Dozois, 2011). The Socratic method can help patients to reflect upon how they think and the assumptions they make, and can promote cognitive change.

References

  • Beck, A. T., & Dozois, D. J. (2011). Cognitive therapy: Current status and future directions. Annual Review of Medicine, 62, 397–409.
  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
  • Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M., & Westbrook, D. (2004). Oxford guide to behaviouralexperiments in cognitive therapy. New York: Oxford University Press.
  • Leahy, R. L., & Rego, S. A. (2012). Cognitive restructuring. In W. T. O’Donohue & J. E. Fisher (Eds.), Cognitive behavior therapy: Core principles for practice(pp. 113–158). Hoboken, NJ: Wiley.