The purpose of this record is to recognize automatic thoughts outside of therapy sessions, and to strive for a more balanced alternative view. This record helps people analyze negative-emotion-connected (such as too much anxiety, depression, too angry, etc.) thoughts, is brought by the client to therapy sessions, and becomes an integral part of therapy treatment.
You as the client should fill out this form as soon as possible after becoming aware of a strong negative emotion. Initially complete thefirst three columns of the record: (1) situation leading to the emotion; (2) emotion felt and degree of emotion; and (3) automatic thought and degree of belief in the thought. This process helps you learn how to monitor changes in the level of the emotion, to recognize automatic thoughts, and to understand their relationship to emotion. When you have mastered these skills, you are ready to begin providing the “rational response” and outcome ratings required by the remaining columns.
An alternative to the printed form is a notebook that you carry with you. Get a small notebook that is easy to carry anytime. Often people may try writing down their thinking and concentrate only on the threat side. It is important that this written homework be divided into at least two parts – strong negative emotion-producing thoughts and corrections of their exaggerations.
You may not want to write down your thoughts because of fearing that doing so will make you more anxious or because they will look “silly” or “childish.” The reasons you may have for avoiding your homework often are the same ones that maintain your negative emotion(s). When you fail to do and/or bring in your homework, you should probe the thoughts behind this avoidance. One client avoided doing his homework because he believed he “would screw it up!” Another believed that I, the therapist, was incompetent. Awareness of avoidance thinking helped to identify the underlying assumptions of the first client (“I have to show everyone a flawless image of myself”) and the second’s general distrust of others (“I can’t trust anyone”).
Clients with acute negative emotions may need to do written homework only while they are in therapy. Clients with chronic negative emotions often have to write up their thoughts systematically for at least a year and, afterward, when needed.
COGNITIVE THERAPY OUTLINE
1st step – recognize your automatic thoughts whenever you feel particularly problematic emotions, like depression, high anxiety, obsessions and/or compulsions, phobias, unreasonable fears, overly strong anger, persistent guilt or shame, etc.
2nd step – keep track of automatic thoughts in a notebook
3rd step – develop and carry out strategies for testing your thoughts and beliefs about what might happen
4th step – discuss the results of the test
5th step – role playing
Thinking Errors Connected to Automatic Thoughts –
1) Exaggerating 2) Catastrophizing 3) Overgeneralizing 4) Ignoring the positive
5) Personalizing
Homework –
1) Keep a daily record of dysfunctional thoughts.
2) Let go of your problematic emotions through:
A) Observing your emotion
B) Experiencing your emotion as a wave, coming and going
C) Remembering you are not your emotion
D) Practicing accepting, rather than judging, your emotion
3) Change your problematic emotions by acting opposite to the current emotion:
A) Approach anxiety-triggering situations gradually;
Do what you are afraid of doing
B) Repair what you feel guilty or shame about if this is justified;
If not justified do what makes you feel guilty or ashamed
C) For sadness or depression, get active and don’t avoid
D) For anger, take time-outs, gently avoid the anger stimulus when too angry, and focus on sympathy and empathy rather than blame
4) Practice the technique of attention shifting and diversion
5) Consider “rescue factors”
6) Think through situation to worst possible outcome
7) Make a list of images of disaster or pain or humiliation and consider each in light of logic and degree of probability
8) Get all the facts you can about specific fears
Remember! A-W-A-R-E
A – Accept your particularly problematic emotion(s)
W – Watch your particularly problematic emotion(s)
A – Act with your particularly problematic emotion(s)
R – Repeat the steps
E – Expect the best