A fundamental tenet of the cognitive behavioral model is that emotional disorders are the result of inaccurate or unhelpful appraisals. These appraisals lead to emotional distress and to behavioral reactions which are accompanied by unintended consequences. These reactions frequently serve to reinforce the appraisal. Cognitive behavioral interventions typically aim to:
- Identify the way in which a client is appraising a triggering event
- Evaluate and update the relevant appraisal
- Re-evaluate the appraisal so that it is more helpful and balanced
- Experiment with alternative behaviors
- Re-evaluate beliefs and assumptions which predispose the individual appraising situations in unhelpful ways
The CBT Appraisal Model worksheet is a transdiagnostic formulation tool. The centrality of appraisals underpins all of the disorder-specific cognitive behavioral models and this format can be helpfully used to explore the contribution of meaning to the client’s experience. In particular, this formulation tool can be used to:
- Socialize clients to CBT
- Explore specific situations in a cross-sectional manner
- Prompt clients to consider alternative ways that they could have interpreted a situation (and how this might have influenced their feelings and behaviors)
- Explore longitudinal contributions to a cross-sectional situation. The CBT Appraisal Model is positioned as a halfway house between longitudinal and cross-sectional formulation approaches: it allows the client and therapist to acknowledge the impact of past experiences while maintaining a focus on the here-and-now.
- By using multiple copies, therapists can look for patterns in appraisals.
The CBT Appraisal Model worksheet pack includes:
- Blank worksheets (cross sectional version)
- Blank worksheets (longitudinal version)
- Annotated versions with therapist prompts
- Worked examples to illustrate the formulation of different problems.
“The cognitive model says that it is not events which bother us, but rather that it is the way we interpret events that really matters. Could we use this cognitive appraisal model worksheet to explore some of the experiences that you have had, and the sense that you have made of them?”
Clinicians should ask the client to describe a recent time when they felt distressed. The key intervention for therapists is to elicit and explore the client’s appraisals of a triggering event. Helpful questions include:
- “When that event happened, what did you make of it?”
- “How did you interpret that event?”
- “What was your fear about that?”
- “What did that say about you, other people, or your future?”
- “What do you think led you to interpret it in that way?”
- Beck, A. T., Rush, A. J., Shaw, B. F., Emery, G. (1979). Cognitive therapy of depression. Guilford press.
- Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer publishing company.
- Salkovskis, P. M., Forrester, E., & Richards, C. (1998). Cognitive–behavioural approach to understanding obsessional thinking. The British Journal of Psychiatry, 173(S35), 53-63.