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Alternative Action Formulation

The Alternative Action Formulation is a CBT case conceptualization (formulation) worksheet. Formulations help a client and therapist come to a shared understanding of a problem. This tool encourages a focus on alternative (adaptive) behavior.


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Full resource pack (PDF)

Everything you could need: a PDF of the resource, therapist instructions, and description with theoretical context and references. Where appropriate, case examples and annotations are also included.


Worksheet only (PDF)

A copy of the worksheet in PDF format.


Fillable version (PDF)

A fillable version of the resource. This can be edited and saved in Adobe Acrobat, or other PDF editing software.


Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.


Translation Template

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The Alternative Action Formulation is a CBT case conceptualization (formulation) worksheet. The purpose of a formulation is for the client and therapist to come to a shared understanding of a problem. This formulation template follows a Problem > Coping strategy > Unintended consequence format and is designed to encourage a focus on alternative (more adaptive) behavioral strategies.


Start by identifying the client’s current difficulties and the strategies that they use to cope with these. The consequences of the current coping strategies are then explored (look out for short-term gains and long-term costs). Clients are then encouraged to consider alternate coping strategies.


  • Eells, T. D. (Ed.). (2011). Handbook of psychotherapy case formulation. Guilford Press.
  • Johnstone, L., & Dallos, R. (2013). Formulation in psychology and psychotherapy: Making sense of people’s problems. Routledge.
  • Kuyken, W., Padesky, C. A., & Dudley, R. (2008). Collaborative case conceptualization: Working effectively with clients in cognitive-behavioral therapy. Guilford Press.
  • Persons, J. B. (2012). The case formulation approach to cognitive-behavior therapy. Guilford Press.
  • Tarrier, N., & Johnson, J. (Eds.). (2015). Case formulation in cognitive behaviour therapy: The treatment of challenging and complex cases. Routledge.