Examining Your Negative Thoughts

An exercise to guide clients through identifying, evaluating, and modifying negative automatic thoughts (NATs) using cognitive restructuring techniques.

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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.

Overview

The Examining Your Negative Thoughts exercise supports cognitive restructuring, a core intervention of cognitive behavioral therapy (CBT). This resource helps clients identify negative automatic thoughts (NATs) and provides a structured approach to evaluate and modify these cognitions. Drawing on Beck’s cognitive model, the exercise guides individuals through the process of evaluating their thoughts from different perspectives to generate balanced and adaptive responses.

Why Use This Resource?

This resource aids therapists in implementing a fundamental intervention in CBT – cognitive restructuring. It is designed to increase clients’ awareness of their negative thoughts and facilitate the re-evaluation of these cognitions.

  • Helps identify and re-evaluate maladaptive cognitions.
  • Encourages detailed examination of automatic thoughts from multiple perspectives.
  • Aids in developing more balanced and adaptive thinking patterns.
  • Supports clinical interventions across a range of mental health issues.

Key Benefits

Identification

Facilitates the recognition of negative automatic thoughts and underlying cognitive biases.

Evaluation

Presents helpful perspectives for assessing whether thoughts are accurate, helpful, or consistent with client goals.

Modification

Encourages development of balanced responses through structured re-evaluation and reflection.

Application

Versatile enough to be integrated into various therapeutic contexts and disorders.

Who is this for?

Depression

Reframing thoughts related to self-blame and self-devaluation.

Anxiety Disorders

Assisting in identifying and challenging catastrophic thinking.

Social Anxiety Disorder

Evaluating thoughts about social rejection.

Low Self-Esteem

Restructuring self-critical thoughts.

Integrating it into your practice

01

Identify

Select a recent automatic thought that is emotionally charged.

02

Record

Document the thought and explore its implications and associated emotions.

03

Evaluate

Use varied perspectives such as counter-evidence, helpfulness, and other viewpoints.

04

Balance

Help clients develop a new, adaptive thought incorporating all discussed information.

05

Reflect

Encourage reflection on the exercise and its application to broader contexts.

Theoretical Background & Therapist Guidance

Cognitive restructuring is grounded in the principle that changing thought patterns can alter emotional responses. Beck's cognitive model highlights the role of maladaptive cognitions in generating emotional distress. Cognitive restructuring involves identifying, evaluating, and altering these cognitions. The exercise leverages techniques such as reviewing the evidence and costs-benefits analysis to facilitate cognitive modification.

What's inside

  • Detailed instructions for identifying and evaluating automatic thoughts.
  • Prompt categories for re-evaluating thoughts by considering the counter-evidence, other perspectives, and the bigger picture.
  • Guidance that helps clients develop more balanced, adaptive thoughts.
  • A reflective component to help integrate these learnings into other life contexts.
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FAQs

Cognitive restructuring is a therapeutic strategy in CBT aimed at identifying and re-evaluating distressing cognitions that influence how people feel and behave.
It guides clients in recognizing negative automatic thoughts and evaluating these from different perspectives to encourage balanced thinking.
While highly adaptable, it is particularly effective for those experiencing frequent, highly distressing, or disruptive automatic thoughts.

How This Resource Improves Clinical Outcomes

By facilitating cognitive restructuring, this exercise aids in:

  • Reducing cognitive biases associated with various mental health issues.
  • Enhancing awareness of automatic thoughts and associated emotional responses.
  • Developing cognitive strategies that reduce distress and promote resilience.
  • mproving therapeutic outcomes.

References And Further Reading

  • Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9, 324-333. DOI: 10.1001/archpsyc.1963.01720160014002.
  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
  • Burns, D. D. (2022). Feeling great: The revolutionary new treatment for depression and anxiety. PESI.
  • Shafran, R., & Rachman, S. (2004). Thought-action fusion: A review. Journal of Behavior Therapy and Experimental Psychiatry, 35, 87-107. DOI: 10.1016/j.jbtep.2004.04.002.
  • Vassilopoulos, S. P., & Banerjee, R. (2010). Social interaction anxiety and the discounting of positive interpersonal events. Behavioural and Cognitive Psychotherapy, 38, 597-609. DOI: 10.1017/S1352465810000433.
  • Leahy, R. L. (2017). Cognitive therapy techniques: A practitioner’s guide (2nd ed.). Guilford Press.
  • Waltman, S. H., Codd III, R. T., McFarr, L. M., & Moore, B. A. (2021). Socratic questioning for therapists and counselors: Learn how to think and intervene like a cognitive behavior therapist. Routledge.
  • Wenzel, A. (2018). Cognitive reappraisal. In S. C. Hayes & S. G. Hofmann (Eds.), Process-based CBT: The science and core clinical competencies of cognitive behavioral therapy (pp.325-337). Context Press.
  • Ezawa, I. D., & Hollon, S. D. (2023). Cognitive restructuring and psychotherapy outcome: A meta-analytic review. Psychotherapy, 60, 396–406. DOI: 10.1037/pst0000474.
  • Lorenzo-Luaces, L., German, R. E., & DeRubeis, R. J. (2015). It’s complicated: The relation between cognitive change procedures, cognitive change, and symptom change in cognitive therapy for depression. Clinical Psychology Review, 41, 3-15. DOI: 10.1016/j.cpr.2014.12.003.