Extended Case Formulation CBT Worksheet

Use the Extended Case Formulation CBT Worksheet to learn about your patient’s problems, what caused them, and how they cope with and/or react to said problems.

By Matt Olivares on Apr 08, 2024.

Fact Checked by Ericka Pingol.

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What is the Extended Case Formulation CBT Worksheet?

The Extended Case Formulation CBT Worksheet is created by Positive Psychology. It’s a worksheet used in Cognitive Behavioral Therapy as a way for CBT therapists to get to know their patient, specifically the problems that their patient is dealing with.

Essentially, the Extended Case Formulation CBT Worksheet is a comprehensive record that identifies and analyzes a problem and the various factors contributing to its existence in a patient's life. These factors encompass past experiences or situations that shed light on the problem's origins and the patient's core beliefs. Additionally, it includes the attitudes and behaviors the patient adopts when confronted with the problem, even if these responses aren't necessarily helpful, as well as their coping mechanisms.

Moreover, the worksheet aims to uncover the automatic thoughts that arise within the patient when they encounter their problems. These thoughts represent the patient's interpretation of the problem and often trigger emotional and physical sensations, which should also be identified. Furthermore, the worksheet delves into the patient's behavioral responses to their automatic thoughts, emotions, and physical sensations.

By assimilating all this information, the professional can formulate a plan that guides the patient in reshaping their thought processes when confronted with the identified problems.

Printable Extended Case Formulation CBT Worksheet

Download this Extended Case Formulation CBT Worksheet to help clients work toward their goals.

How to use the Extended Case Formulation CBT Worksheet:

Using the Extended Case Formulation CBT Worksheet is quite easy because you will be logging information on it. The worksheet is divided into two parts: Part A and Part B.

To start, ensure you make three duplicates of the worksheet. Three copies are advised as it allows you to identify three distinct issues. This quantity is sufficient to help you recognize recurring patterns, both positive and negative, in their thinking and behavior when faced with specific problems.

For Part A, you just need to do the following:

  • First, you must identify a problem that your patient is dealing with or deals with every now and then.
  • Next, you must identify the automatic thoughts that pop up in their mind. These thoughts are how they interpret the problem they’re dealing with or the situation they find themselves in, not the problem or situation itself.
  • After that, you must identify what these automatic thoughts mean and the emotions and physical sensations the patient feels in relation to these thoughts.
  • Last, you must indicate what behavior(s) the patient exhibited as a response to their emotions and physical sensations.

For Part B:

  • Like with Part A, you must indicate the problem or situation that your patient is dealing with.
  • Next, you must list down the past experiences that contributed to the rise of the problem being discussed, plus the factors that perpetuate the problem.
  • After that, you must identify the patient’s core beliefs. In the context of this worksheet, these beliefs are what they believe about themselves in relation to the problem being discussed.
  • Then, you must specify the assumptions that they have, rules (e.g., If I don’t do this right, then I’m a failure; if I can’t accomplish this, I’m weak), and attitudes that help them cope with their core beliefs and the problem being discussed. List all of them, whether they are positive or negative.
  • After identifying those, you must specify your patient's maladaptive coping strategies.

These are all the things that you need to note down for this worksheet.

Extended Case Formulation CBT Worksheet Example:

Now that you know what the Extended Case Formulation CBT Worksheet is and what it asks from therapists, it’s time for you to see what it looks like. As we mentioned earlier, the Extended Case Formulation CBT Worksheet was created by Positive Psychology. We simply adapted their worksheet and added an additional comments box after Part B for therapists to write down their notes, descriptions of factors that were identified that they couldn’t fit in Part A or B, and whatever plans they have for the patient (e.g., teaching them techniques like decatastrophization, cognitive restructuring, etc.) moving forward.

If you like what you see and believe this is a good fit for your Cognitive Behavioral Therapy program, feel free to download our free Extended Case Formualtion CBT Worksheet!

Download this Extended Case Formulation CBT Worksheet Example:

Extended Case Formulation CBT Worksheet Example:

When is it best to use the Extended Case Formulation CBT Worksheet?

The optimal time to utilize the Extended Case Formulation CBT Worksheet is during the initial phase of building a patient relationship. By establishing a safe and non-judgmental space, along with nurturing trust and rapport, patients will feel comfortable discussing their problems. It is crucial to introduce and explain the purpose of this worksheet as an information log, ensuring that patients understand why notes are being taken. Obtaining their consent beforehand is essential, as it is their right.

Once the patient has agreed to use the worksheet during discussions, it is recommended to have multiple copies available, ideally three, to address various problems. This approach allows for identifying recurring maladaptive patterns, automatic thoughts, and other factors that contribute to a comprehensive case formulation. By gathering sufficient information about their challenges and the impact on their mental well-being, healthcare professionals can determine the most appropriate course of action to support their patients.

What are the benefits of using the Extended Case Formulation CBT Worksheet?

It serves as an information log about patients and their problems.

During therapy sessions, it’s best that you have a documentation system. If you don’t have the necessary tools for this, or you’re relying on just writing things down on some notebook or blank paper, consider using the Extended Case Formulation CBT Worksheet. The formats for Part A and B can give you structure in organizing your notes and even help you shape discussions.

It can help you formulate a plan for your patient.

The main purpose of the Extended Case Formulation CBT Worksheet is to serve as a comprehensive log of information regarding the patient's challenges and their responses to these challenges. By creating three copies to address three specific problems, therapists can gather valuable insights into the recurring automatic thoughts and maladaptive patterns that patients commonly experience when faced with these problems or similar ones. This in-depth understanding allows therapists to tailor the rest of the CBT program to effectively address these challenges and help patients develop healthier coping mechanisms.

It can be used to track any changes over time in the patient.

Let’s stipulate that you identified three problems and all the related emotions, physical sensations, thoughts, behaviors, etc., that your patient goes through. Let’s also stipulate that you formulated a plan for your patient and have taught them certain techniques and skills to help them cope healthily. You can use the Extended Case Formulation CBT Worksheet again to see how they have adjusted when dealing with the same problems. Suppose the information you logged before is different from the new information you’ve logged, and the new information reflects healthier coping mechanisms, adaptive behavior, and thinking, etc.. In that case, it’s safe to say they are getting better and your plan is working.

Is the Extended Case Formulation CBT Worksheet hard to use?
Is the Extended Case Formulation CBT Worksheet hard to use?

Commonly asked questions

Is the Extended Case Formulation CBT Worksheet hard to use?

No. It’s easy to use because you’ll just note things down. What will make it difficult is if your patient doesn’t want to speak or share about their problems, so it’s best to break the ice until they trust you enough to share.

Is the Extended Case Formulation CBT Worksheet free?

Yes! You can download our template for free. Same with the original by Positive Psychology!

What if I’m not a mental health therapist? Can I use this for myself?

Ideally, no. The worksheet is meant to be used by a professional. If you want to contemplate and organize your thoughts about certain problems you’re dealing with, by all means, download it. But please don’t diagnose yourself with anything or make rash decisions based on what you’ve noted. We recommend that you see a professional for this.

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