Thought records as a clinical tool in CBT

Thought records, also known as ‘examining the evidence’, is a way to tackle our negative thoughts. It is a very effective tool that is commonly used in cognitive behavioural therapy (CBT) and clinicians who practice CBT will often use thought records with their patients.

This post is specifically for people who are not clinicians or therapists who want to try thought records themselves to see if it’s beneficial and to start their journey to be their own therapist. The clinician guide can be found here.

Thinking errors are thoughts that that are negative and somewhat removed from reality. For example, somebody might react to a poor mark and say “I’m a failure and I won’t be able to get the job I want”. In this case, the thinking error is catastrophizing. Another example might be someone thinking that “if I don’t get 100%, then I am a failure”. In this case, we would call that thinking error, all-or-nothing or black and white thinking.

Thinking errors can be at the source of a lot of different psychological challenges, such as depression, anxiety, insomnia, post-traumatic stress, among many other problems.

Thought records are effective tool to tackle these thinking errors and really evaluate them to see if they are true. Below, I go about the steps for developing a thought record.

Clean thought record.
An example of a thought record

Steps to complete a thought record

1. Write down the situation. What was the event that led to you feeling bad and might have been associated with the negative thoughts? Examples could be “going to class”, “failing an exam”, “sitting at home alone”, among many other possibilities.

2. Jot down the negative thought. Think about what was going on in your mind at that time. Were there any negative thoughts you were thinking about yourself or other people? Perhaps you were putting yourself down or catastrophizing about something that could happen. Jot down those thoughts.

3. Write down your emotions and its intensity. What were the emotions going on at that time? Examples could be: guilt, sadness, shame, hopelessness, etc. You can also rate the intensity of each of the listed emotions from 0 (not at all) to 100 (extremely high).

4. Write down what you think the thinking errors were. Based on the thoughts, jot down possible thinking errors going on. Here’s a list of common thinking errors if you are not sure which ones apply. No need to be perfect here – just do your best!

5. Write evidence for the thought. I know, I know – it’s a shocker that we are even considering evidence for negative thoughts! However, in order to properly evaluate a thought, we need to accept the possible grains of truths inside our thoughts however small they may be. So jot down any evidence for the thought. For example, if you had a thought that “I am a bad mother” because the baby was crying, the evidence for the thought would be “that the baby was not in a happy mood and I wasn’t able to console her”.

6. Write evidence against the thought. Now, write down evidence against the thought. If we take the same example as #5, then perhaps evidence against the thought are times that the baby was happy with you and all the excellent love and care you give to your child. Give as many fact-based examples as you can!

7. Develop the balanced thought. Using both sides of the scale, create a balanced thought that honours both evidence for and against the negative thought. For example, “although my baby is crying and I can’t always make her happy, this does not mean I am a bad mother. I spend a lot of time caring for her (e.g., bathing her, coddling her in the dead of night, reading stories to her) and she is often happy to see me. Babies cry – that’s what they do, and it doesn’t not mean I am failing her”. Reread the thought several times!

8. Re-rate your emotions. At this time, reflect on your emotions to see if they have made any movements. Thought records take practice to perfect, so don’t feel like you need to see huge changes over night

Completed thought record
An example of a completed though record

Tips for success and consistency

– Find ways to integrate thought records in your life that works well for you! Some people enjoy the pen and paper approach, but if you don’t have time to write it all out, then over time you can start creating thought records in your mind. I’d still encourage you to write out the first few to practice, but I want this tool to be ultimately helpful to you.

– Stay grounded in the facts! Our brain loves examples, so the more examples you can use to support evidence against the negative thought, the better.

– Understanding it takes time. The more you practice, the better you will get with thought records (like anything else in life). Try to practice using thought records a couple times a week to get the hang of it!

I hope this post was helpful for learning how to use thought records.

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Best wishes,

P