CBT Model - Here And Now

The CBT Model - Here And Now worksheet introduces clients to the cognitive behavioral model, detailing how thoughts, feelings, and behaviors interact and influence clients' difficulties.

Download or send

Language

Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Overview

Formulation is a key component of cognitive behavioral therapy (CBT) and essential to effective practice. The CBT Model - Here And Now worksheet is a simple, descriptive formulation that aims to introduce clients to the cognitive behavioral model, and illustrates the role that thoughts, feelings, and behaviors play in their difficulties. It can be used to familiarize clients with the cognitive behavioral model and its key concepts by illustrating how these concepts (e.g., thoughts, emotions, and behavior) are related; explaining connections between problem areas (e.g., anxiety and insomnia); breaking complex or distressing experiences down into smaller parts; identifying steps towards change.

Why Use This Resource?

This descriptive formulation can be used in various capacities:

Introduces the cognitive behavioral model.
Clarifies the role that thoughts, feelings, and behaviors play in clients' difficulties.
Explains how and why problem areas are linked.
Guides treatment planning.

Key Benefits

Structure

Offers a clear framework for developing preliminary formulations.

Clarity

Illuminates how problems relate to specific thoughts, feelings, behaviors, and their connections.

Engagement

Helps develop a mutual understanding of clients' challenges.

Who is this for?

Depression

Interactions between hopeless or self-critical thoughts, low mood, and withdrawal behaviors.

Anxiety

Identifies how anxious thoughts perpetuate distress and avoidance.

Eating disorders

Describes how food-related concerns influence disordered eating behaviors like binge-eating and restriction.

Integrating it into your practice

Explore

Identify a specific event that triggered the client’s difficulty.

Identify

Elicit the client's automatic thoughts.

Explore

Discuss the client's emotional and physiological responses.

Clarify

Identify the client's behavioral responses, including overt actions and internal strategies.

Connect

Help clients see the relationship between their thoughts, feelings, and behaviors.

Reflect

Encourage clients to reflect on and provide feedback on the formulation.

Theoretical Background & Therapist Guidance

Formulation in cognitive behavioral therapy (CBT) is a dynamic and ongoing process. It involves creating hypotheses based on cognitive behavioral theories to develop a coherent understanding of the client's difficulties. CBT formulations can be categorized into three types: descriptive, cross-sectional, and longitudinal, with each serving specific therapeutic functions. As emphasized by Kennerley and colleagues, formulation integrates the client's ongoing feedback and new insights, resulting in an evolving narrative that supports effective therapy. Collaboration also ensures that clients play an active role in the formulation process, which enhances its validity and relevance.

What's inside

A detailed overview of case conceptualization in CBT.
Guidance for developing descriptive formulations.
Tips for maximizing client engagement and feedback.
A structured framework for mapping the connections between thoughts, emotions, and behaviors.

Get access to this resource

FAQs

A formulation helps make sense of a client's issues and guides treatment planning by linking theory to practice.

Descriptive formulations focus on understanding clients' current experiences in cognitive and behavioral terms, particularly useful in early therapy stages.

Collaboration ensures formulations are meaningful and personalized, incorporating the client's firsthand experiences and perspectives.

How This Resource Improves Clinical Outcomes

Utilizing the CBT Model - Here And Now enhances therapy by:

Increasing therapist-client collaboration.
Simplifying complex problems.
Providing insight into the nature of clients' difficulties.
Supporting alliance formation and treatment planning.

Therapists gain a an easy-to-use formulation framework hat can be used with a wide-range of clients.

Clinicians Who Use This Resource Also Use

References And Further Reading

Bakker, G. M. (2008). Problem-maintaining circles: Case illustrations of formulations that truly guide therapy. Clinical Psychologist, 12, 30-39. DOI:10.1080/13284200802069050 (https://doi.org/10.1080/13284200802069050).
Beck, A. T. (1976). Cognitive therapy and the emotional disorders. International Universities Press.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford.
Butler, G. (1998). Clinical formulation. In: A. S. Bellack and M. Hersen (Eds.), Comprehensive Clinical Psychology (pp.1-23). Oxford.
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461-470. DOI: 10.1016/0005-7967(86)90011-2.
Division of Clinical Psychology [DCP] (2010). The core purpose and philosophy of the profession. The British Psychological Society.
Dudley, R., & Kuyken, W. (2014). Case formulation in cognitive behavioural therapy: A principle-driven approach. In: L. Johnstone & R. Dallos (Eds.), Formulation in psychology and psychotherapy: Making sense of people's problems (2nd ed.), (pp.18-44). Routledge.
Hayes, S. C., & Follette, W. C. (1992). Can functional analysis provide a substitute for syndromal classification? Behavioral Assessment, 14, 345-365.
Hsu, L. G., & Holder, D. (1986). Bulimia nervosa: Treatment and short-term outcome. Psychological Medicine, 16, 65-70. DOI: 10.1017/S0033291700002543.
Johnstone, L., & Dallos, R. (2014). Introduction to formulation. In: L. Johnstone & R. Dallos (Eds.), Formulation in psychology and psychotherapy: Making sense of peopleâs problems (2nd ed.), (pp.1-17). Routledge.
Kennerley, H., Kirk, J., & Westbrook, D. (2017). An introduction to cognitive behaviour therapy (3rd ed.). Sage.
Kuyken, W. (2006). Evidence-based case formulation: Is the emperor clothed? In: N. Tarrier (Ed.), Case formulation in cognitive behaviour therapy: The treatment of challenging and complex cases (pp.12-35). Routledge.
Kuyken, W., Padesky, C. A., & Dudley, R. (2009). Collaborative case conceptualisation: Working effectively with clients in cognitive-behavioral therapy. Guilford Press.
Moorey, S. (2010). The six cycles maintenance model: Growing a "vicious flower" for depression. Behavioural and Cognitive Psychotherapy, 38, 173-184. DOI: 10.1017/S1352465809990580.
Muse, K., McManus, F., Rakovshik, S., & Thwaites, R. (2017). Development and psychometric evaluation of the Assessment of Core CBT Skills (ACCS): An observation-based tool for assessing cognitive behavioral therapy competence. Psychological Assessment, 29, 542-555. DOI: 10.1037/pas0000372.
Padesky, C. A. (2020). Collaborative case conceptualization: Client knows best. Cognitive and Behavioral Practice, 27, 392-404.
Padesky, C. A., & Mooney, K. A. (1990). Presenting the cognitive model to clients. International Cognitive Therapy Newsletter, 6, 13-14.
Persons, J. B. (2008). The case formulation approach to cognitive-behavior therapy. Guilford Press.
Persons, J. B., & Hong, J. J. (2016). Case formulation and the outcome of cognitive behavior therapy. In: N. Tarrier and J. Johnson (Eds.), Case formulation in cognitive behaviour therapy: The treatment of challenging and complex cases (2nd ed.), (pp. 14-37). Routledge.
Royal College of Psychiatrists [RCP] (2017). Using formulation in general psychiatric care: Good practice. Royal College of Psychiatrists.
Salkovskis, P. M., Clark, D. M., & Gelder, M. G. (1996). Cognition-behaviour links in the persistence of panic. Behaviour Research and Therapy, 34(5-6), 453-458.
Salkovskis, P. M., Warwick, H. M., & Deale, A. C. (2003). Cognitive-behavioral treatment for severe and persistent health anxiety (hypochondriasis). Brief Treatment and Crisis Intervention, 3, 353-367. DOI: 10.1093/brief-treatment/mhg026.
Spencer, H. M., Dudley, R., Johnston, L., Freeston, M. H., Turkington, D., & Tully, S. (2023). Case formulation - A vehicle for change? Exploring the impact of cognitive behavioural therapy formulation in first episode psychosis: A reflexive thematic analysis. Psychology and Psychotherapy: Theory, Research and Practice, 96, 328-346. DOI: 10.1111/papt.12442.
Sperry, L., & Sperry, J. (2012). Case conceptualization: Mastering this competency with ease confidence. Routledge.