ABCDE CBT Worksheets

Target your client’s negative thought processes and help them find alternative and more effective thoughts with our ABCDE Worksheet based on the principles of Cognitive Behavioral Therapy.

By Emma Hainsworth on Jun 20, 2024.

Fact Checked by Ericka Pingol.

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What Is An ABCDE CBT Worksheet?

ABCDE is an approach developed by Dr. Albert Ellis, founder of Rational Emotive Behavioral Therapy (REBT), however, this approach can also be applied to Cognitive Behavioral Therapy (CBT) as a technique for targeting and overcoming maladaptive thought patterns, or cognitive distortions.

While the commonly used ABC model includes Activating Events, Beliefs, and Consequences (including physical and emotional consequences), the ABCDE model extends to include a Disputation, or challenging one’s irrational thoughts or beliefs, and creating an Effective new response, also called an Exchange of the old thoughts to more effective, new ones.

CBT is based upon the principle that each of the three aspects of thinking, feeling, and behaving are interwoven, and solving a client’s cognitive distortions will in turn help them achieve their behavioral or emotional goals1. Targeting cognitive distortions through CBT has been proven to be effective in the treatment of anxiety disorders2, depression3, and a range of other mental health conditions. This means that targeting irrational thoughts will have many flow-on benefits for a client’s well-being, and that’s why we created this ; to make it easy for you to help your clients achieve their treatment goals by targeting their own distorted cognitions.

Printable ABCDE Worksheet

Download these ABCDE Worksheets and help your clients overcome negative thought patterns and strive towards positive clinical outcomes.

How To Use This ABCDE CBT Worksheet 

If you are already familiar with the ABCDE CBT model, feel free to jump ahead and take a look at our ABCDE CBT Worksheet example in the next section. But if you’d like to ensure you fully understand each step of the ABCDE worksheet, just follow this simple step-by-step guide. 

Step One. Download the ABCDE CBT Worksheet 

The first step is to grab a copy of our ABCDE CBT Worksheet, which you can do using the link on this page. This link will provide you with a PDF copy of the worksheet, which you can send to your client in a digital version or print out for them to fill out by hand if they prefer.

Step Two. Ensure your client understands what each section entails 

Before your client begins to tackle their negative thinking patterns, they need to understand what the worksheet is asking of them in each section. We have included some helpful tips in each section to enable your client to complete this worksheet independently, but they will need to be familiar with different types of unhelpful thinking styles, and be able to describe their physical and emotional responses in order to get the most out of this worksheet. 

Step Three. Have your client complete the worksheet fully 

Once you have armed your client with any extra information they need to confidently complete the worksheet, it’s time for them to go into battle with their negative thoughts. They will do this following the ABCDE model as laid out in this worksheet, and briefly described here:

  • Activating Event: Describe the event that triggered their negative thoughts or emotions
  • Beliefs: Recall the thoughts they had at the time
  • Consequences: Describe the physical and emotional response they had as a result of these thoughts and beliefs
  • Disputation: Challenge the most distressing of the thoughts recalled in the Beliefs section
  • Exchange: Exchange the old, maladaptive thoughts for new, effective thoughts. 

Step Four. Discuss your client’s answers 

Depending on your client’s needs, you may wish to use their responses to this worksheet as a discussion point in their future sessions. Additionally, your client may wish to share some of the results of completing this worksheet with you. 

Step Five. Store securely 

Finally, if your client chooses to return this worksheet to you - ensure you store it securely in their clinical record as it contains sensitive and confidential health information.

ABCDE CBT Worksheet Example (Sample)

To see this worksheet in action, just take a look at our example ABCDE CBT Worksheet. Although the responses are based on a fictional client, it can still be useful to see how your client’s answers to the previous sections in the ABCDE model will inform the later steps in the worksheet. Feel free to read this example here, or download it as a PDF if you prefer.

Download this ABCDE Worksheet Example (Sample) here: 

ABCDE CBT Worksheet Example (Sample)

Who Can Use these Printable ABCDE CBT Worksheets (PDF)?

CBT is a widely effective technique used for the treatment of anxiety, depression, ADHD, PTSD, and a range of other mental health conditions. As such, any mental health professional who practices CBT in their work with clients can benefit from incorporating this ABCDE CBT Worksheet into their practice.

There is a range of professionals who can practice CBT or use CBT techniques in their treatment of clients. These include:

  • Therapists and Psychotherapists
  • Counselors
  • Coaches
  • Clinical Psychologists
  • Psychiatrists
  • Psychiatric Nurses

Why Is This Form Useful For Therapists?

Includes Prompts and Explanations

To help your client get the most out of this worksheet, we have included some helpful prompts and explanations at certain parts of this worksheet. You may wish to provide them with further explanation of some aspects of the ABCDE model, however, we have tried to ensure that the worksheet can be completed independently by your client without too much external help.

Target your client’s Hot Thought

We have incorporated a “Hot Thought” section into this worksheet to help your client focus their efforts on the area of their cognition that most needs it. By prioritizing their efforts in this way, your client will be able to get the most out of this worksheet rather than working with multiple, less distressing thoughts they may have had at the time. 

Help your client build good habits

The ABCDE model is something your client can take into many aspects of their life, and this worksheet is designed to help them understand the process from start to finish and immediately start reaping the benefits.

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Benefits of ABCDE CBT Worksheet Template

Digital Format

A major benefit of this ABCDE CBT Worksheet is the ability for it to be completed entirely digitally using interactive text boxes. This means your client can access the worksheet from their device of choice, and complete it without needing access to a printer. 

Repeatable Exercise

Learning to identify, dispute, and replace one’s negative cognitions is not something that will happen overnight, and this worksheet can be completed multiple times in order to build up your client’s ability to resolve their cognitive distortions and strengthen resilience to their negative thoughts. 

Maintain progress between sessions

By offering our ABCDE Worksheet, you can ensure your client’s progress doesn’t plateau in between sessions with you. While different practitioners will have different preferences on offering “homework”, it can be hugely beneficial to provide your clients with a tangible resource to refer to between appointments with you.

Widely applicable

The ABCDE CBT model is not limited to one mental health condition or disorder, and can even be used in life coaching, professional coaching, or mindfulness practices. As such, this worksheet is a very handy resource to have in your toolkit.

Gain insight into your client’s thought processes

Finally, one of the greatest benefits of this ABCDE CBT Worksheet is how it gives you insight into your client’s cognition, which in turn can inform any treatment decisions or the focus of their sessions with you.

Why Use Carepatron For ABCDE CBT Worksheet Software?

Clinical documentation, such as worksheets, progress notes, and treatment plans, comes with a responsibility for the practitioner to store, share, and access this documentation in a secure way to protect the confidential patient health information they contain. As well as meeting HIPAA obligations for information security and confidentiality, the practitioner must also navigate the maze of medical codes, superbill creation, and clinical audits to contend with. But luckily, Carepatron has invested time in smart and intuitive solutions to all of these problems, meaning you can save time on your administrative workload and get back to treating your patients.

Carepatron is state-of-the-art software for practice management that is guaranteed to save you time and streamline your practice’s administration. We do this by offering a huge range of features including:

  • Smart team calendar management
  • Medical coding, billing, and payment integration
  • Client portal for your clients to book appointments with you and access their medical records
  • AI-powered smart dictation software
  • Mobile and Desktop platforms to support flexible working
  • Telehealth appointment capability
  • Automated SMS and email appointment reminders
  • Automated Superbill creation
  • A vast library of templates and resources to standardize and organize your practice

And much more! Try out Carepatron for free today and see why over 10,000 health practitioners have entrusted us to take their practice to the next level. 

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  1. Beck AT, Rush AJ, Shaw BF, et al. Cognitive therapy of depression. New York: Guilford Press; 1979
  2. Kodal A, et al. (2018). Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. DOI: 10.1016/j.janxdis.2017.11.003 
  3. Driessen E, Hollon SD. Cognitive behavioral therapy for mood disorders: efficacy, moderators and mediators. Psychiatr Clin North Am. 2010 Sep;33(3):537-55
What is the difference between the ABC and the ABCDE model?
What is the difference between the ABC and the ABCDE model?

Commonly asked questions

What is the difference between the ABC and the ABCDE model?

ABC is a commonly used model and is simply a shortened form of the ABCDE model. Before your client starts disputing and exchanging their cognitive distortions, they need to be able to identify their emotional and physical responses, as well as recall their thoughts and beliefs at the time their negative thoughts occurred. As such, the ABC model can be useful for introducing your clients to the principles of CBT before they move on to the full ABCDE model.

Who should complete this ABCDE CBT worksheet?

This worksheet can be completed by any clients struggling with negative thoughts, behaviors, or emotions that they wish to engage with and reduce. This could be negative thoughts about themselves, poor self-image, or feelings of sadness, anxiety, or guilt.

When should my clients complete this ABCDE CBT worksheet?

While your client may need an explanation of unhelpful thinking styles (e.g. all-or-nothing thinking, fortune-telling, personalizing, etc.), in order to complete the Disputation section of this worksheet, they should be able to complete the majority of this worksheet independently. As such, it can be a good idea to provide this worksheet to your client to take home and complete between sessions. This will ensure they have enough time to think about their answers and in turn, give you the best insights into their thought processes. 

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