If you're a therapist or an adjacent mental health professional, you may know that cognitive behavioral therapy (CBT) can be a bit intimidating. Although these are important, worksheets full of charts and trackers aren't always the most practical solutions for new clients taking such a program (or other therapies).
Fortunately, there are fun yet still effective activities you can use to enhance your healing practice beyond your roster of worksheets and trackers. Creative techniques are consistent with CBT (Kuehlwein, 2000), especially when you use them strategically to address the complex thoughts, feelings, and behaviors of your precious clients.
So, if you believe it's your time to spice things up or think outside the box, add these creative activities and exercises to your cognitive therapy practice toolbox, and combine them with evidence-based treatment! They're great for individual, group, and family therapy sessions, and they are great for dealing with many mental health conditions, managing negative feelings, and working through emotional challenges. Not only that, but it also allows them to develop more helpful behavior patterns and healthier coping strategies.
## **Countering unhelpful thoughts vision board**
What if traditional CBT techniques could come to life? Turn the process of cognitive restructuring into a thoughtful memory, complete with a keepsake. Traditionally, vision boards are used to help with goal setting and manifestation. A restructuring vision board involves a similar method but focuses on reinforcing a new belief.
Here's an example. If Joey feels depressed because he believes he's not popular and no one likes him, his vision board can challenge that. Perhaps there's a picture of his best friend from camp, his loyal pup, and his family having fun together on vacation. When he starts to have negative thoughts about rejection, depression, anxiety, or loneliness, he can look at his vision board and reflect.
Your clients can assemble a vision board the old-fashioned way, with recycled magazines and a little creativity. Have them flip through pages and tear out anything that speaks to them, especially their preferred belief. Once ready, they can choose specific images that bring positive reactions. Use a piece of poster board or a bulletin board as the base.
For those who aren't into the paper method, many digital options could help with creating vision boards. Your clients can use Canva, PowerPoint, or various smartphone apps. Once the vision board is complete, it can be printed or picked up at a local printing service. With screen-sharing tools, you can work on one together in a virtual session!
## **Self-esteem playlists**
Music itself is healing. Making and listening to it is an expressive act that allows the mind to process thoughts and emotions. Many of us have had moments where we found just the right song to match our mood. The opposite works as well.
Here are some moments or specific challenges in life when listening to a self-esteem playlist is a good immediate strategy for your clients to manage their emotional health:
- Feeling down or dealing with social anxiety right before they're about to go on a first date or simply meet a friend group
- Being completely overwhelmed and unsure if they can handle another day at work
- Being angry because a medical condition has set them back a bit (or a lot)
- Feeling insecure and lacking confidence when they're about to do something that could change the course of their life
Many clients have ways to create a playlist through Spotify or Apple Music. For this activity, ask them to consider how they want to feel on a given day. They can also think about the mindset they want for a specific situation. You can even help clients create a playlist to reinforce how they want to feel.
Many people create a series of playlists. They might prepare one for anxiety, low energy, and motivation. When the time comes, they have easy access to the right song.
For example, maybe Maria has a big match coming up and feels nervous, afraid, or self-conscious. She can pull up her confidence-boosting playlist for support. It's harder to feel discouraged when your favorite artist belts out a ballad on self-love!
The music doesn't have to be positive. Heavy metal and its subgenres can be therapeutic, despite the subject matter. Angry music can help purge negative emotions, especially rage, even if just for a short while. A professor named Tasha Howe conducted studies on people who listen to heavy metal and concluded that many adults who've been listening to metal music since childhood have become well-adjusted and happier (Rnz, 2019), so have some clients give this kind of music a shot.
If you can't access a music streaming app, pull up YouTube during your therapy sessions and sample songs together. Musical activities are a great tool for healing in both individual and virtual sessions.
## **CBT board games**
When you hear board games, you might think about a feisty evening of Monopoly or funny drawings in Pictionary. These common games can be turned into CBT techniques! All you have to do is add discussion prompts, and games become therapeutic strategies. This is way better and safer than subjecting your clients to exposure therapy.
For example, create your own CBT prompt cards for Candyland or Taboo. Each time a client has a turn, they must also answer a prompt to move forward or gain points. You might be amazed at how intimidating topics become more client-friendly when gamified.
There are also therapy and CBT-based board games you can purchase, including many printable games, that have prompts built in. Examples include Feelopoly, Feel, Act, & Draw, or the card game Humans Against Stress. Look for activities that focus on CBT-related topics, such as negative thoughts or identifying emotions.
## **Mental health journal prompts**
Journaling is another healing practice that's great for personal growth. Your clients can increase their understanding of thoughts and emotions while responding to thoughtful questions. There's no such thing as a negative emotion since each has a purpose.
However, they can process difficult or uncomfortable feelings through writing. The steps are similar to using an anxiety workbook. If you're unsure how journaling can incorporate CBT techniques, here are some prompts to get your clients started.
### **CBT and mental health journal prompts**
- Think about the stress signals your body sends when you're feeling anxious or angry. What do you usually notice? Are there any other physical sensations you experience with a strong emotion?
- What are some common unhelpful thoughts you tend to have repeatedly? Do you notice any triggers that relate to these, or do they seem to come out of nowhere?
- During times of stress, some people experience spiraling thoughts, when they think about the same thing repeatedly but don't come to any new conclusions. Have you experienced this before? What was going on?
- Identify one potentially unhelpful thought you have, perhaps about yourself or a difficult situation. Once you have identified the thought, examine it. What evidence do you have for or against the thought being true?
- Identify a belief you'd like to have. Perhaps it's a positive thought about others or an encouraging thought about yourself. Look for evidence that the belief is true. Write down at least 10 pieces of evidence to back it up. (For example, if you want to explore the belief "I am a good friend," create a list of positive experiences you've had with others. Could these support your new belief?)
## **Therapeutic quiz shows**
Would your clients be more inclined to fill in a CBT worksheet or participate in a quiz show? Written activities have their place in therapy. However, you can make therapy sessions more engaging while still addressing depression and negative thought patterns with therapeutic quiz shows! Activities like Jeopardy or Family Feud are user-friendly and add great value to your CBT toolbox.
Creating your Jeopardy-style game on a whiteboard or poster board is easy. Choose categories related to CBT, such as thoughts (including cognitive distortions), behaviors, and emotions. Under each category, create 3 to 5 discussion prompts relating to areas you're working on with your client or group.
Rather than recalling facts, your clients get points for responding to discussion questions about coping, stress, and mental health. You can also play just for fun if you would rather not have to focus on a competitive game.
If you don't have time to create your own game from scratch, you can find online ones created by other therapists. There are complete Jeopardy-style games based on CBT, DBT, emotions, and more!
## **Key takeaways**
CBT is a somewhat technical process that involves breaking down thoughts and emotions. Clients often track their thoughts and challenge them during talk therapy sessions. Incorporating creative CBT techniques builds upon and enhances such traditional strategies. It's a practical solution for clients who might struggle with more technical aspects of cognitive techniques. And for some individuals, it may just be the breakthrough they've been needing to interrupt old patterns.
As a CBT therapist, psychiatric nurse, family therapist, or a similar mental health professional, you can increase client engagement while encouraging behavioral activation. All the while, you'll be adding new strategies to your CBT toolbox. The only limit is your imagination!
Think of our suggestions as practical tips! Add the activities we discussed to your cognitive behavioural therapy practice, implement them into your CBT strategy, use them for mental health training, and find ways to have them help clients work through the likes of generalized anxiety disorder, substance use disorder, post-traumatic stress disorder, panic disorder, eating disorders, obsessive-compulsive disorder, and other mental health problems!
Not only will they develop new skills, but they might just have an overall better mental fortitude to get them through daily life.
What are you waiting for? Access a collection of these therapy worksheets, games, and activities today: click here for an exclusive discount!
## **References**
Kuehlwein, K. T. (2000). Enhancing creativity in cognitive therapy. Journal of Cognitive Psychotherapy, 14(2), 175–187. https://doi.org/10.1891/0889-8391.14.2.175
RNZ. (2019, June 15). Professor Tasha Howe: Heavy metal fans are happier, more well-adjusted adults than others. RNZ. https://www.rnz.co.nz/national/programmes/sunday/audio/2018699841/professor-tasha-howe-heavy-metal-fans-are-happier-more-well-adjusted-adults-than-others
