The Prompts for Challenging Negative Thinking guides clients through a series of helpful questions aimed at re-evaluating negative thoughts.
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.
An editable Microsoft PowerPoint version of the resource.
NOTE: An improved version of this resource is available here: Prompts For Challenging Negative Thinking. Older versions of a resource may be archived in the event that they are available in multiple languages, or where data indicates that the resource continues to be frequently used by clinicians.
The cognitive behavioral therapy (CBT) model proposes that how we think affects the way we feel. Challenging our unhelpful thoughts (cognitive restructuring) is an essential skill which takes practice. The Prompts For Challenging Negative Thinking (Archived) information handout guides individuals through a series of helpful questions.
This resource provides a structured approach to evaluating thoughts using targeted questions.
Addressing self-critical and self-blaming thoughts that contribute to low mood.
Questioning catastrophic, anxiety-provoking automatic thoughts.
Challenging extreme all-or-nothing thoughts related to performance.
Suitable for other difficulties where cognitive restructuring might be helpful, such as low self-esteem and social anxiety.
Help the client identify a negative automatic thought.
Use the prompts to re-evaluate the thought from multiple angles.
Help the client develop a more balanced, alternative thought.
Encourage the client to continue challenging their negative thoughts for homework.
Beck’s cognitive model (Beck et al., 1979) proposes that events are not directly responsible for the way we feel. Rather, it is the interpretation of those events - our appraisals, thoughts, or cognitions - that generates emotional responses. The model implies that we can change how we feel by changing how we think.
Automatic thoughts that generate negative emotions (e.g., sadness, anxiety, or anger) are commonly referred to as negative automatic thoughts (NATs). Some negative thoughts are accurate representations of the world. For example, thinking, “That person could hurt me too”, after witnessing an assault would be both negative and accurate. However, automatic thoughts are often inaccurate or biased in characteristic ways, and there is considerable evidence that different mental health problems are associated with specific biases in thinking. For example, people with obsessive compulsive disorder often believe that unpleasant or unacceptable thoughts can influence events in the world (Shafran & Rachman, 2004), while those with social anxiety tend to discount positive social interactions (Vassilopoulos & Banerjee, 2010).
Cognitive restructuring is a key therapeutic strategy in CBT involving the identification, evaluation, and modification of cognitions that are distressing or associated with problematic behaviors (Beck et al., 1979; Wenzel, 2018). For instance, an individual with low self-esteem might notice the thought, “People don’t like spending time with me” and respond to this with the self-directed question, “How do I know that is true and does anything suggest it isn’t?” (i.e., evaluating the evidence supporting an automatic thought). Other restructuring techniques include distancing oneself from maladaptive cognitions, searching for alternative explanations, and exploring the impact of distressing thoughts and beliefs (e.g., Leahy, 2017; Waltman et al., 2021). Research suggests that cognitive restructuring is effective across a range of disorders (e.g., Ezawa & Hollon, 2023) and is associated with symptomatic improvement (e.g., Lorenzo-Luaces et al., 2015).
This Prompts For Challenging Your Negative Thinking (Archived) information handout is designed to help clients evaluate negative automatic thoughts, generate balanced responses, and develop insight into problematic patterns of thinking.
