Thought Record – Universal

A versatile, general-purpose CBT worksheet that helps clients identify and re-evaluate negative automatic thoughts (NATs) from multiple perspectives. 

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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

Helping clients evaluate their negative automatic thoughts (NATs) is a key component of effective cognitive therapy. This Thought Record – Universal helps clients in identify, explore, and re-evaluate NATs from various perspectives. This includes examining whether these thoughts are accurate, useful, or biased in any way. This worksheet is suitable for a wide range of presentations and helps clients develop a practical, transferable skill that reduces distress and promotes self-reflection.

Why Use This Resource?

Understanding and re-evaluating automatic thoughts is central to cognitive therapy. This worksheet guides clients through the process of identifying and questioning their thoughts, helping address biased thinking and reduce distress.

  • Highlights the links between thoughts, emotions, and behavior.  
  • Helps clients evaluate the accuracy and helpfulness of distressing thoughts.
  • Supports the development of more realistic appraisals. 
  • Consolidates cognitive restructuring skills.

Key Benefits

Versatile

Useful for multiple difficulties and presentations.

Structured

Provides a step-by-step process for re-evaluating automatic thoughts.

Engaging

Involves clients in the process of change.

Practical

Helps clients develop and strengthen an important therapeutic skill.

Who is this for?

Depression

Clients struggling with excessive self-blame and feelings of hopelessness.

Generalized Anxiety Disorder (GAD)

Clients experiencing worry and catastrophic thoughts.

Social Anxiety Disorder

Addressing concerns regarding negative evaluations or social rejection.

Low Self-Esteem

Helps client re-evaluate negative self-perceptions and self-criticism.

Other Difficulties

Also suitable for clients experiencing PTSD, OCD, perfectionism, and many other difficulties.

Integrating it into your practice

01

Identify

Instruct clients to record specific situations that trigger negative automatic thoughts.

02

Record

Document negative automatic thoughts (NATs) related to the identified situation.

03

Evaluate

Help clients analyze distressing thoughts by considering how accurate, helpful, and opinionated the thought is.

04

Respond

Develop a new thought that accounts for all the recorded information.

05

Generalize

Encourage clients to practice using the record outside of their therapy sessions.

Theoretical Background & Therapist Guidance

Beck’s cognitive model (Beck, 1963; Beck & Haigh, 2014) suggests that events do not directly determine our feelings. Instead, it is our interpretation of those events – our appraisals, thoughts, and cognitions – that influences our emotional responses. Cognitive therapy proposes that we can change how we feel by changing what we think.

Cognitive reappraisal is a strategy where individuals reinterpret the meaning of a stimulus to change their emotional responses (Gross, 1998). A key approach to cognitive reappraisal in CBT is cognitive restructuring, which involves systematically identifying, re-evaluating, and, when necessary, modifying maladaptive thinking associated with distress (Wenzel, 2018), often using a 'thought record'.

This Thought Record – Universal is a cognitive restructuring worksheet that encourages clients to question and analyze their NATs from various perspectives. This includes examining the accuracy of their thoughts (e.g., examining the evidence for and against a NAT) and assessing their utility (e.g., determining whether the NAT is helpful). The central principle of this worksheet can be summarized as: “What do you believe, why do you believe it, and how else can you think about this?”

What's inside

  • An introduction to the cognitive model.
  • A comprehensive review of how thought records are used in therapy.   
  • Therapist prompts and guidance for using the thought record with clients.
  • Key references and recommended reading. 
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FAQs

It is best introduced when clients are somewhat familiar with the cognitive model. Use examples to illustrate how thoughts influence feelings and how examining them can lead to reduced distress.
Encourage them to focus on one thought at a time — typically the one rated most distressing or emotionally charged.
Emotion ratings before and after using the record help gauge the impact of cognitive restructuring. Shifts of 10–50% are typical when thought records are used effectively.

How This Resource Improves Clinical Outcomes

  • Highlights the link between thoughts and emotions.  
  • Helps clients identify and re-evaluate distressing thoughts. 
  • Reinforces the cognitive model and cognitive restructuring skills across sessions.  
  • Provides clients with a practical tool for change.  

References And Further Reading

  • Bagby, R. M., Quilty, L. C., Segal, Z. V., McBride, C. C., Kennedy, S. H., & Costa Jr, P. T. (2008). Personality and differential treatment response in major depression: a randomized controlled trial comparing cognitive-behavioural therapy and pharmacotherapy. The Canadian Journal of Psychiatry, 53, 361-370.  
  • Beck, A. T. (1963). Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry, 9, 324-333.  
  • Beck, A. T. (1976). Cognitive therapy and the emotional disorders. Penguin.  
  • Beck, A. T., Emery, G., & Greenberg, R. (1985). Anxiety disorders and phobias: A cognitive perspective. Basic Books.  
  • Beck, A. T., & Freeman, A. (1990). Cognitive therapy of personality disorders. Guilford Press.
  • Beck, A. T., & Haigh, E. A. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual Review of Clinical Psychology, 10, 1-24.  
  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. Guilford Press.  
  • Beck, A. T., Shaw, B. F., Emery, G., DeRubeis, R. J., & Hollon, S. D. (2024). Cognitive therapy of depression (2nd ed.). Guilford Press.  
  • Beck, J. S. (1995). Cognitive therapy: Basics and beyond. Guilford Press.  
  • Burns, D. D. (1980). Feeling good: The new mood therapy. Penguin.  
  • De Oliveira, I. R. (2008). Trial-Based Thought Record (TBTR): preliminary data on a strategy to deal with core beliefs. Brazilian Journal of Psychiatry, 30, 12-18.  
  • Dowd, E. T. (2002). History and recent developments in cognitive psychotherapy. In: R. L. Leahy & E. T. Dowd (Eds.), Clinical advances in cognitive psychotherapy (pp.15-28). Springer.  
  • Ellis, A. (1962). Reason and emotion in psychotherapy. Institute for Rational Living, Inc.
  • Ellis, A. (1971). Growth through reason: Verbatim cases in rational-emotive therapy. Science and Behavior Books.  
  • Fennell, M. J. V. (1998). Cognitive therapy in the treatment of low self-esteem. Advances in Psychiatric Treatment, 4, 296-304.  
  • Gilbert, P. (2009). Overcoming depression: A self-help guide using cognitive behavioral techniques. Robinson.  
  • Goldfried, M. R., & Davison, G. C. (1976). Clinical behavior therapy. Holt, Rinehart, and Winston.  
  • Greenberger, D., & Padesky, C. A. (1995). Mind over mood. Guilford Press.  
  • Greenberger, D., & Padesky, C. A. (2016). Mind over mood (2nd ed.). Guilford Press.  
  • Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2, 271-299.  
  • Hawley, L. L., et al. (2017). Cognitive-behavioral therapy for depression using Mind Over Mood. Behavior Therapy, 48, 29-44.  
  • Hollon, S. D., & Beck, A. T. (1979). Cognitive therapy of depression. In: P. C. Kendall & S. D. Barlow (Eds.), Cognitive behavioral intervention (pp. 153-203). Academic Press.  
  • Josefowitz, N. (2017). Incorporating imagery into thought records. Cognitive and Behavioral Practice, 24, 90-100.  
  • Kuehlwein, K. T. (2002). The cognitive treatment of depression. In G. Simos (Ed.), Cognitive behaviour therapy (pp. 3-48). Routledge.  
  • Kuyken, W., Padesky, C. A., & Dudley, R. (2009). Collaborative case conceptualization. Guilford Press.  
  • Leahy, R. L. (2017). Cognitive therapy techniques (2nd ed.). Guilford Press.  
  • McKay, M., Davis, M., & Fanning, P. (1981). Thoughts and feelings. New Harbinger Publications.  
  • McManus, F., Van Doorn, K., & Yiend, J. (2012). Examining the effects of thought records. Journal of Behavior Therapy and Experimental Psychiatry, 43, 540-547.  
  • Padesky, C. A. (1983). 7-Column Thought Record. Center for Cognitive Therapy.  
  • Padesky, C. A. (1993). Socratic questioning: Changing minds or guiding discovery. Paper presented at the European Congress of Behavioural and Cognitive Therapies.  
  • Padesky, C. A., & Greenberger, D. (2020). The clinician’s guide to CBT using Mind Over Mood (2nd ed.). Guilford Press.  
  • Persons, J. B., Davidson, J., Tompkins, M. A., & Dowd, E. T. (2001). Essential components of cognitive-behavior therapy for depression. APA.  
  • Sichel, J., & Ellis, A. (1984). RET self-help form. Cited in Ellis (1996), Better, deeper, and more enduring brief therapy.  
  • Stott, R., et al. (2010). Oxford guide to metaphors in CBT. Oxford University Press.  
  • Tallon, D., et al. (2019). Materials used to support CBT for depression: A survey. Cognitive Behaviour Therapy, 48, 463-481.  
  • Waltman, S. H., et al. (2019). Review and analysis of thought records. Current Psychiatry Research and Reviews, 15, 11-19.  
  • Waltman, S. H., et al. (2021). Socratic questioning for therapists and counsellors. Routledge.  
  • Wenzel, A. (2018). Cognitive reappraisal. In: S. C. Hayes & S. G. Hofmann (Eds.), Process-based CBT (pp. 325-337). Context Press.

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