A practical CBT worksheet that helps clients understand and explore the interplay between their thoughts, feelings, body sensations, and behaviors.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
The Cognitive Behavioral Model worksheet provides a clear, descriptive formulation tool designed to introduce clients to core CBT concepts. Based on Beck’s cognitive theory, it focuses on the ‘here and now’ by helping clients identify and link triggering events to their cognitive, emotional, physiological, and behavioral responses.
This ‘here and now’ formulation supports early-stage therapeutic work by helping clients make sense of their experiences, understand maintaining processes, and identify potential areas for change. It facilitates collaborative exploration while providing a clear structure for guiding case conceptualization and intervention planning.
Formulation is a fundamental component of cognitive behavioral therapy (CBT), providing a bridge between theory and practice. This worksheet enables both therapist and client to map experiences in a way that feels personal, structured, and psychologically grounded.
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Supports clients in understanding and breaking patterns of negative thinking, low mood, and inactivity.
Allows highlighting of bodily responses and catastrophic misinterpretations linked to panic.
Helps identify worry patterns, somatic symptoms, and avoidance behaviours.
Facilitates exploration of trauma triggers, emotional responses, and protective behaviors.
Supports mapping of intrusive thoughts and compulsive behavioral cycles.
Encourages reflection on beliefs about social evaluation and associated avoidance.
Supports examination of how interpretations of bodily sensations affect reassurance-seeking behavior.
Clarifies the link between thoughts, feelings, and disordered eating behaviors.
Enables clients to visualise the impact of self-critical thoughts.
Applicable in broader work with distress, anger, or impulsivity even without a formal diagnosis.
Encourage clients to identify a recent emotionally-triggering event to explore.
Help the client describe their thoughts, emotions, body sensations, and behaviors triggered by the event.
Draw connections between components of the model to highlight hypothesized temporal or causal relationships, and to illustrate reinforcing cycles
Reflect collaboratively and discuss where therapeutic change might begin.
The Cognitive Behavioral Model worksheet is grounded in cognitive behavioral theory. In CBT, formulation is widely recognized as a core skill and an essential component of effective practice (Beck, 2011; Dudley & Kuyken, 2014; Muse et al., 2016). The resource supports therapists in developing descriptive formulations with clients – a collaborative process through which psychological difficulties are explored and understood in terms of cognitive, emotional, physiological, and behavioral responses to triggering events. Although simple in structure, this type of formulation plays an important role in early therapeutic engagement and in laying the groundwork for more complex conceptualizations as therapy progresses.
Formulation in CBT is more than a diagnostic alternative or case summary – it is a hypothesis-driven method for integrating psychological theory with a client’s lived experience (Butler, 1998; Johnstone & Dallos, 2014). According to Sperry and Sperry (2012), formulation provides clinicians with a clinical strategy for understanding maladaptive patterns, guiding treatment, and preparing for potential obstacles. Importantly, it also offers clients an opportunity to make sense of their difficulties in a psychologically coherent way, helping to understand the components of their distress and increase their hope that something can be done about it. As such, formulation serves both explanatory and strategic functions, shaping the direction of therapy. Formulation is also dynamic process that evolves over time. In the early stages of therapy, descriptive formulations can help clients see their experiences as understandable and manageable, rather than as overwhelming or inexplicable. As therapy continues, the therapist may return to the model to revise it in light of new experiences or therapeutic insights. For example, a client may notice recurring patterns across different situations, suggesting the presence of deeper beliefs or maintaining processes. This may lead to the development of more complex, cross-sectional formulations, such as functional analyses (Hayes & Follette, 1992) or problem-maintaining cycles (Bakker, 2008), or even longitudinal models that explore developmental antecedents and core beliefs (Beck, 2011; Kuyken et al., 2009).
The specific model introduced in this worksheet is a descriptive formulation – the simplest of three levels of formulation described by Kuyken and colleagues, 2009. Descriptive formulations capture how clients are responding to distressing events in the present moment. These formulations center on the interaction of five elements: the triggering situation or event, automatic thoughts, emotional responses, bodily sensations, and behaviors. As clients come to recognise how these domains are interconnected and reinforced, they can begin to understand the mechanisms that maintain their distress and identify points for change.
The value of a descriptive formulation lies not only in its theoretical coherence but in its practical accessibility. For clients unfamiliar with psychological models, it offers an immediate and intuitive way to begin thinking about their problems in structured terms. Rather than requiring historical exploration, the worksheet invites clients to focus on what they were thinking, feeling, and doing in response to a specific event. This here-and-now focus is particularly well suited to the early stages of therapy, where rapport is still being established and the emphasis is on building engagement and insight (Kuyken et al., 2009; Dudley & Kuyken, 2014).
This approach draws directly on Beck’s cognitive theory (Beck, 1976; Beck et al., 1979), which proposes that emotional distress arises not simply from external events but from the way individuals interpret those events. These interpretations known as automatic thoughts are often rapid and habitual, occurring outside of conscious awareness but shaping emotional and physiological responses. When individuals interpret situations in distorted or threatening ways, they are more likely to experience anxiety, sadness, anger, or shame, and to engage in unhelpful behaviors such as avoidance, withdrawal, or safety-seeking. Over time, these responses may form self-reinforcing cycles that maintain psychological difficulties (Persons, 2008; Salkovskis et al., 1996).
The Cognitive Behavioral Model worksheet is designed to make these patterns visible. Through guided reflection, clients are supported to identify a recent triggering event – such as a social interaction, intrusive thought, or bodily sensation – and to describe the thoughts, emotions, sensations, and behaviors that followed. In addition to mapping out individual responses, the worksheet prompts therapists and clients to consider how these responses influence one another. A common goal of this stage is to identify escalating patterns – for example, how a fleeting thought may trigger intense emotion, which then leads to physiological arousal and impulsive action. These insights are not merely descriptive but therapeutic: they open the door to intervention by revealing how change in one domain – such as thought, action, or body response – might lead to change across the entire system.
