Hello, there! If you stumbled upon this guide, then you’re any one of the following:
- A therapist looking to expand their horizons by adding another form of therapy to their skill set,
- A therapist who has been practicing Cognitive Behavioral Therapy for a while and is looking for more techniques and exercises to improve their work,
- Or, you’re a non-therapist interested in learning what Cognitive Behavioral Therapy is.
Whichever you are, welcome!
In this mini-guide, you will get a general overview of what Cognitive Behavioral Therapy is (for the benefit of those who don’t know), what it aims to do, how it can benefit clients, several techniques often used by therapists, and exercises for clients as they undergo a CBT program.
If you do therapeutic work, we hope that CBT is a topic that you find interesting enough to add to your repertoire. If you’re not a therapist and you happen to be looking for options on what therapy to take, we hope this guide gives you the information you need to help decide if CBT is the right therapy for you.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy, or CBT for short, is a talking therapy, meaning much of the work will be done through conversation. This therapy aims to positively change how clients respond to certain scenarios based on their behavior and emotions.
This therapy operates on the belief that a person’s feelings (emotions and physical sensations), thoughts, behaviors, and actions are all connected. Given this, it focuses on a person’s negative thoughts and patterns, breaking them down one by one and replacing them with positive, realistic, and rational thoughts. This process helps clients work through current problems that are causing psychological distress.
CBT is a highly collaborative form of therapy. Therapists practicing this will first establish rapport and trust with their clients by making them comfortable and safe through conversation. Once trust and a safe environment have been established, they will work together to identify all the negative thoughts and patterns that the client has based on the current set of problems plaguing their mind.
One important objective of the therapist is to help their client find the emotional distance they need to look at their problems in a detached and rational way. Once the client can find the emotional distance needed, they can properly examine their problems, identify how these problems affect mental well-being, and how they respond based on the negative thought patterns and feelings that were brought out by said problems. By identifying all of these, they can begin to challenge their thoughts and identify how they could have approached these problems more rationally. The therapist will be with them as they determine positive and rational thoughts and actions to consider to help them cope in healthier ways and work past these problems without engaging in problematic behaviors.
The therapist will do all these using Cognitive Behavioral Therapy Techniques.
Why are Cognitive Behavioral Therapy Techniques helpful?
Cognitive Behavioral Therapy Techniques are the methods that therapists rely on to get their therapy program rolling. Some of these techniques are for breaking down the walls of the client so they can find it in them to trust the therapist.
Some techniques are for teaching clients certain skills on how to keep themselves mentally composed when under psychological distress so they will be less susceptible to thinking negative and irrational thoughts. Instead, they can think of more positive or realistic ways of looking at things to help them ward off and work through their distress and its root causes.
The majority of Cognitive Behavioral Therapy Techniques are helpful in the sense that they can teach clients the necessary skills to combat problems affecting their cognition and mental well-being, such as:
- Self-monitoring to keep themselves from lapsing into states of negativity.
- Relaxation so they know how to compose themselves in stressful situations.
- Effective communication so they can learn how to assert themselves and resolve conflicts, especially if their current relationships are the ones causing them distress.
- Even problem-solving so they can break down their problems into smaller bits that are more manageable and develop ways to solve them individually.
8 Cognitive Behavioral Therapy Techniques and Exercises
Now that you know what Cognitive Behavioral Therapy is all about, here are some techniques and exercises that you should consider adding to your CBT program:
- Journaling - Most CBT therapists include this as part of their exercise roster for their clients. By having their clients jot down their problems and how they respond to said problems in a journal for a set amount of time before each session, the therapist can take a look at what they’ve written and identify any patterns worth noting, especially negative ones. That way, they can point them out to their clients and work together to determine how to counter these patterns.
- Decatastrophizing - Clients who deal with anxiety may expect unfavorable outcomes from certain situations. Sometimes, these are unfounded, but sometimes, there might be enough evidence for them to believe that a worst-case scenario is inevitable. Decatastrophizing is a technique that will help them sit down, relax, and think about their exaggerated thoughts and any negative outcomes they’re expecting, and then reconfigure how they think. Then, they can determine actionable steps to reach those positive outcomes instead of the worst-case scenario.
- Progressive Muscle Relaxation - If a person is distressed, it’s safe to say they are not calm or relaxed. If a person is not calm or relaxed, they become more susceptible to negative and exaggerated thoughts. One way to help keep the client composed is to teach them Progressive Muscle Relaxation. For this exercise, the client will tense and relax their muscles so that they can physically and mentally relax. Being calm and relaxed is necessary if they’re going to try to take a more rational look at their problems.
- Deep Breathing - This can be paired with Progressive Muscle Relaxation. This is another way to help the client relax. By taking slow and deep breaths, the client can enter a relaxed state and help reduce the effects of anxiety and distress, even just a little bit.
- Cognitive Restructuring - This can be done in or outside the therapy setting. Before this technique can be accomplished, the client needs to be able to identify the sources of their cognitive distortions and negative thinking and behavioral patterns. This can be done by being relaxed, calm, and detached from their negative thoughts and feelings. Once they identify these distortions and negative patterns, the therapist and the client can work together to reframe or replace these negatives with more rational, positive, and realistic ways of thinking to have something good and productive to work towards.
- Guided Discovery - The therapist will listen to their client’s problems and viewpoints. After listening to their client, they will formulate questions that should (constructively) challenge their viewpoints and beliefs. This involves asking the client to back their viewpoints regarding their problems with as much evidence as they can, as well as identifying evidence that runs counter to their views. This teaches them critical thinking, which is necessary for techniques and exercises like Decatastrophizing and Cognitive Restructuring.
- Exposure Therapy - The therapist will expose the client to things that can trigger their fears, anxieties, and even things that make them feel down. These may not necessarily be the specific things that trigger the patient. The therapist can settle for similar things instead. By exposing the client to these, they can make them desensitized when it comes to their triggers. However, the therapist must handle this technique with utmost care because they are exposing their client to triggers, after all. They should know how to moderate the number of triggers they will expose their clients to, and while doing so, they have to guide them so they learn how to cope and respond healthily. One risk of desensitization is that they become desensitized to the point that they no longer care enough to do anything about these triggers.
- Communication Training via Roleplaying - The therapist and client will determine what situations trigger the client’s distress and cognitive distortions. Then, they will act out a scenario to help the client face these triggering situations. It is similar to Exposure Therapy but involves acting out certain roles to teach the client important skills like being assertive, building confidence, learning how to become more sociable, practicing active listening, and conflict resolution. These skills won’t just help them with their current set of problems. These will be beneficial to them later on once the therapy program is over.
5 Cognitive Behavioral Therapy Worksheets:
Cognitive Behavioral Therapy also relies on worksheets. This is so they can practice the skills they have learned and even apply them to their actual problems later on. Here are five examples of Cognitive Behavioral Therapy Worksheets that you can issue to your clients:
- Decatastrophizing Worksheet - The name says it all. If you discussed what decatastrophizing is with your clients, this is a good way for them to apply what they’ve learned. This type of worksheet normally asks the client about what their biggest worry is at the moment. This worry needs to be causing them distress. Once they have identified that worry, the client will do the following:
- Identify how likely this worry will come true
- Specify all the evidence that points towards this worry coming true
- What would most likely happen if their worry comes true
- What would be the worst thing to happen if their worry comes true
- How would they feel if their worry comes true
- Specify favorable outcomes and what can be done to get to those outcomes instead
- What can put their mind at ease in the meantime
- Self-Compassion Worksheet - This may take different forms depending on the source, but they all work towards the same goal, which is to instill self-compassion and self-gratitude in a client. There’s a good chance that a client you’re handling doesn’t have a good view of themself, so this worksheet is one way to boost their self-esteem and help them find or rediscover a sense of self-worth. Clients who engage with this type of worksheet will specify what they love about themselves, their support systems (if any), and their goals. By identifying these, they can remind themselves that they are not alone or that there are great things to look forward to and work for. If they gain a sense of positivity, that should help combat their negative thoughts and patterns, even just a little. Baby steps are important.
- Thoughts and Behaviors Journal - This worksheet will be filled between CBT sessions. The client will write about whatever caused them distress, depression, or anxiety each day. They will identify the specific cause, what they thought about and felt while triggered, and how they responded (whether positively or negatively). This is a good opportunity for the client to become aware of their thought and behavioral patterns when it comes to their triggers. If they cannot become aware of these things while writing, the therapist can point these out during the next session. The client should write as descriptively as they can.
- Automatic Thoughts - This is similar to the Journal Worksheet, but instead of writing about their days and problems in-depth and as descriptively as they can, they will jot down all the causes of their negative thoughts and patterns, then identify what they automatically think about whenever they are exposed to their triggers. Then, right next to their automatic negative thought, they will write down a more realistic or positive way of looking at things. This will teach them to consider other perspectives and learn how to think more positively about things.
- Personal Values - Depending on the source, this worksheet may have a preset list of values, or it can be free-form. If it’s free-form, the client will have to list down all their values and indicate how important these values are to them. If there is a preset list, the client will simply indicate how important each value is for them. Once the therapist sees their answers, they can discuss their negative thoughts and behavioral patterns and see if these run counter to their values, especially ones that they consider to be important. Then, they can help nudge the client to counter these negatives with more realistic or positive thoughts and behaviors that align with their values. This will teach them how to cope and react healthily to their triggers.
When is it best to use Cognitive Behavioral Therapy Techniques and Exercises?
The best time to use Cognitive Behavioral Therapy Techniques will depend on the specific technique you plan on using.
For example, let’s stipulate that you just started your Cognitive Behavioral Therapy program for a certain client. This means you’re still in the stage where you must get to know your client first. There’s a high chance they have trouble talking to you, not because they don’t want to, but because they struggle to articulate themselves through conversation.
To help them express themselves and better explain what they are dealing with, you can encourage them to write in a journal before the next session. When they attend the session, you can use what they wrote as discussion prompts. This is the best time to point out certain patterns you might have noticed, then have the client expound on what they wrote.
Once you have identified all the problems they are dealing with and what their negative thought and behavioral patterns are, that’s when you can start using Guided Discovery to challenge their negative thoughts and beliefs while showing empathy. After challenging thoughts and identifying other ways of thinking about their problems and beliefs, you can start teaching them something like Decatastrophization and do Cognitive Restructuring to teach them critical thinking and problem-solving.
Again, there’s a time and place for everything, and that statement applies to CBT techniques.
Why use Carepatron for Cognitive Behavioral Therapy work?
If you are a therapist, especially a CBT therapist, we’d like to ask you for your time to explore the Carepatron platform. We’re sure you will find something that will benefit your therapeutic work, whether it’s Cognitive Behavioral Therapy, Interpersonal Therapy, or another!
One of the features we’re most proud of is our resource library. We have a collection that’s filled to the brim with worksheets, assessments, survey templates, general treatment plans, progress note templates, form templates, and much more that we’re sure will help you streamline your work and cover more ground when assessing and treating patients.
Earlier in this guide, we discussed worksheets that can be used during your Cognitive Behavioral Therapy program. We’d like you to know that we have an abundance of therapy worksheets that you can use to help your patient understand themselves better in terms of how they view themselves, how they cope when under distress, how they respond to triggers, and how they think and behave in light of those triggers. We have a Decatastrophizing Worksheet, Core Beliefs Worksheet, and even a CBT worksheet for anxiety! Feel free to download as much as you want and need!
Besides having clinical resources to download, Carepatron also has a storage system that you can access. You can store all your clinical documents with us in a HIPAA-compliant manner, especially the filled-out Cognitive Behavioral Therapy worksheets you issued to your clients! If you want to create backups of any therapy-related worksheet, store them with us! Storing them with us is the same as creating backups of your files, so just in case you lose your physical copies, you can download the files and print them again. Even if you’re storing them with us, we can’t access them! Only you can provide the access permissions.
Not only will Carepatron help you streamline your workflow, but we can also help preserve your work by securing them!