The Theory A / Theory B worksheet guides therapists and clients in exploring alternative explanations for the client's problems, promoting behavioral change through the elaboration of new and less threatening perspectives.
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.
This resource aids therapists in fostering a collaborative understanding of a client's difficulties through the Theory A / Theory B technique. This approach encourages clients to explore different interpretations of their experiences, facilitating a non-confrontational way to gather evidence and test these perspectives. The worksheet emphasizes a structured approach, with case examples illustrating its application across various clinical contexts.
The Theory A / Theory B technique offers a robust and flexible framework for cognitive restructuring and behavioral change.
Supporting clients in exploring beliefs related to harm, responsibility, and intrusive thoughts.
Helping clients evaluate beliefs about illness and reduce reliance on safety behaviors.
Addressing rigid negative beliefs about the self, world, and future via exploration of alternative perspectives.
Reframing trauma-related interpretations and addressing the perceived ongoing threat.
Facilitating exploration of threat-focused explanations for symptoms and other experiences.
Frame client beliefs, based on their experiences, as a theory they use to explain the world around them.
Investigate how clients derived their beliefs, and the consequences of holding them.
Invite clients to entertain 'Theory B' as an alternative interpretation of events.
Guide clients in gathering evidence to support or undermine each theory.
Help clients reflect on long-term consequences of maintaining Theory A.
Encourage behavioral experiments to explore the evidence for each theory.
Build motivation by visualizing the implications of accepting Theory B.
A core principle of cognitive-behavioral therapy is that people make sense of their experiences by developing personal explanations — hypotheses or theories — about what is happening to them. These theories guide how they respond to difficulties. However, when beliefs are inaccurate or only partially correct, the resulting behaviors often inadvertently maintain the problem.
Paul Salkovskis (1989) first described a non-confrontational approach to working with clients holding firm beliefs about the primarily physical nature of their problem. Noting that directly challenging these beliefs risks disengagement he offered a collaborative alternative — a new way of understanding the problem, which could be tested over time.
This clinical observation evolved into the theory A / theory B technique (Salkovskis, 1996). It invites the client to place their current understanding (theory A) alongside an alternative explanation (theory B), treating them as competing hypotheses. Clients are encouraged to examine evidence for each theory and to test them through collaborative experiments — a process sometimes described as “don’t trust me, test it out for yourself” (Salkovskis, 1999, p. S36).
