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Cognitive Behavioural Therapy Worksheets and Exercises
The following Cognitive Behavioural Therapy – CBT worksheets and exercises can be downloaded free of charge for use by individuals undertaking NHS therapy or by NHS practitioners providing CBT in primary or secondary care settings. These worksheets form part of the Think CBT Workbook, which can also be downloaded as a static PDF at the bottom of this page. Please share or link back to our page to help promote access to our free CBT resources.
The Think CBT workbook and worksheets are also available as an interactive/dynamic document that can be completed using mobile devices, tablets and computers. The interactive version of the workbook can be purchased for single use only for £25. All Think CBT clients receive a free interactive/dynamic copy of the workbook and worksheets free of charge.
Whilst these worksheets can be used to support self-help or work with other therapists, Cognitive Behavioural Therapy is best delivered with the support of a BABCP accredited CBT specialist. If you want to book an appointment with a professionally accredited CBT expert, call (01732) 808626, complete the simple contact form on the right side of this page or email [email protected]
Please note: if you are a private business or practitioner and wish to use our resources, please email [email protected] to purchase a registered copy. This material is protected by UK copyright law. Please respect copyright ownership.
Exercise 1 - Problem Statements
Exercise 2 - Goals for Therapy
Exercise 3 - personal strengths / resources, exercise 4 - costs / benefits of change, exercise 5 - personal values, exercise 6 - the cbt junction model, exercise 7 - the cross-sectional cbt model, exercise 8 - the longitudinal assessment, exercise 9 - layers of cognition, exercise 10 - cognitive distortions, exercise 11 - theory a-b exercise, exercise 12 - the cbt thought record, exercise 13 - cognitive disputation "putting your thoughts on trial", exercise 14 - the cbt continuum, exercise 15 - the self-perception continuum, exercise 16 - the cbt responsibility pie chart, exercise 17 - noticing the thought, exercise 18 - four layers of abstraction, exercise 19 - semantic satiation, exercise 20 - the characterisation game, exercise 21 - speed up / slow down, exercise 22 - word translation, exercise 23 - the time-traveller's log, exercise 23a -the time-traveller's log continued, exercise 24 - leaves on a stream, exercise 25 - the traffic, exercise 26 - clouds in the sky, exercise 27 - taming the ape - an anchoring exercise, exercise 28 - the abc form in functional analysis, exercise 29 - pace activity exercise, exercise 30 - graded hierachy of anxiety provoking situations, exercise 31 - the behavioural experiment, exercise 32 - act exposures exercise, exercise 33 - worry - thinking time, exercise 34 - submissive, assertive & aggressive communication, exercise 35 - sleep hygiene factors, exercises 36 - 38.
(Abdominal Breathing, Aware Breathing & The Five-Minute Daily Recharge Practice)
Exercise 39 - Wheel of Emotions
Exercise 40 - linking feelings and appraisals, exercise 41 - personal resilience plan, exercise 42 - cbt learning log, act with choice exercise, angels and devils worksheet, transdiagnostic model of ocd worksheet, tuning in exercise, penguin-based therapy (pbt), big picture exercise, post-therapy journal, catch it-check it-change it exercise.
A brief cognitive change exercise for identifying and altering negative thinking
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Handouts on CBT Skills and Strategies
Summarizing skills and techniques for applying CBT (Cognitive-Behavioral Therapy), one of the top methods for overcoming depression, anxiety, anger, relationship problem, and other issues.
1 - Handouts on: Overview of CBT Skills and Principles 2 - Handouts on: Replacing Negative Thoughts 3 - Handouts on: CBT Logs and Worksheets
1 - Handouts on: Overview of CBT Skills and Principles
1-1) 10 Forms of Twisted Thinking - And How to Replace Them (1 p. ) An overview of 10 thought patterns that create and maintain emotional distress; their negative impact; and substitutions for each negative thought pattern. (Identifying and replacing these is the basis of CBT.)
1-2) ABC's of RET (1 p.) Outlines how a cognitive model (replacing negative thoughts) compares with a stimulus-response model. (Note - RET was a predecessor of CBT, laying the foundation of understanding how thoughts affect feelings, and how thought replacement can improve mood.)
1-3) Cognitive Triad (1 p.) A chart summarizing 3 major areas of thinking affected negatively by depression and other emotional problems. (Replacing these 3 areas with more positive attitudes is a core task in CBT.)
2 - Handouts on: Replacing Negative Thoughts
2-1) Replacing "All or Nothing Thinking" and "Mental Filter" (1 p.) Summarizes replacement strategies for Thought Distortions #1 (All or Nothing Thinking" and #3 (Negative Mental Filter).
2-2) Gratitude Journal - Cultivating Positive Awareness (1 p.) A simple but effective strategy for replacing Thought Distortion #3, Negative Mental Filter. Helpful for adults, youth, and children.
2-3) Decatastrophizing - Stopping the Anxiety Cycle (2 p.) A replacement strategy for Thought Distortion #5, Jumping to Conclusions. Page one outlines the 4-stage process of how anxiety develops, and how to replace it; Page 2 provides a worksheet to guide the change process.
2-4) Replacing the "Should's" (1 p.) Identifies a protocol for replacing Thought Distortion #8, Should Statements.
2-5) "Blame Pie" - Replacing Blame or Self-Blame (1 p.) An effective replacement for Thought Distortion #10, Blame or Self-Blame. This thought pattern is a significant contributor to depression, anger, and other problems. Replacing it can give significant emotional relief.
2-6) Learned Optimism - Replacing the 3 P's of Pessimism (1 p.) A pessimistic attitude both precedes and follows depression. Learn to identify and replace the "interpretive style" or mindset of pessimism that can make you vulnerable to deeper emotional challenges.
3 - Handouts on: CBT Logs and Worksheets
3-1) Mood Log 1: Identifying (1 p. ) A form to help you log negative triggers, thoughts, and feelings. First step in CBT-based recovery.
3-2) Mood Log 2: Replacing (1 p.) A continuation of Mood Log 1, when you are ready to replaced identified negative thoughts.
3-3) Vertical Columned Timeline - The Mosaic (1 p.) A form for creating a vertical timeline or life overview, looking at major events, both positive and negative, to see life in perspective.
3-4) Weighing the Pro's and Con's (1 p.) A form to help you evaluate the costs and benefits of maintaining or changing a given thought, behavior, or habit.
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CBT Worksheets for Depression to Use in Your Private Practice
Cognitive Behavioral Therapy (CBT) is one of the most widely used forms of therapy, and for good reason. Many mental health professionals use this therapy technique for a wide range of conditions, including different forms of depression . Having the right tools is an important part of providing effective treatment. In this post, we will highlight 15 CBT worksheets for depression that can help you deliver cognitive behavioral therapy more effectively to your clients.
Why CBT for Depression
Depression is one of the most common psychiatric disorders that can occur in people of all ages around the world. According to the National Institute of Health ,
“Cognitive behavioral therapy (CBT) is one of the most evidence-based psychological interventions for the treatment of several psychiatric disorders such as depression, anxiety disorders, somatoform disorder, and substance use disorder. The uses are recently extended to psychotic disorders, behavioral medicine, marital discord, stressful life situations, and many other clinical conditions. A sufficient number of researches have been conducted and shown the efficacy of CBT in depressive disorders. A meta-analysis of 115 studies has shown that CBT is an effective treatment strategy for depression and combined treatment with pharmacotherapy is significantly more effective than pharmacotherapy alone. Evidence also suggests that relapse rate of patient treated with CBT is lower in comparison to the patients treated with pharmacotherapy alone.”
CBT is one of the most widely used types of therapy for depression with a goal of:
- Uncover unhealth thinking patterns
- Replacing negative thoughts with positive thoughts in real-time
- Reduce negative or unhelpful thoughts
- Experience a better quality of life
The next sections will outline 15 different CBT worksheets for depression that you can use with your clients:
1. ABC Model Worksheet
In cognitive behavioral therapy, the ABC model is a framework used to help change thoughts. The goal of this worksheet is to challenge negative beliefs and develop more practical, rational ways to deal with upsetting situations.
Our CBT ABC Model Worksheet is designed to help your clients change irrational thoughts.
2. Triangle Worksheet
Thinking negatively is a common human trait. We actively search for problems so that we can be prepared for them. However, This negative thinking typically does the opposite of helping us and can worsen a client’s depressive symptoms.
Our CBT Triangle Worksheet is designed to help your clients change negative patterns of thought and can help with depression.
3. Behavioral Experiment Worksheet
A behavioral experiment is a CBT technique that involves testing negative thoughts (automatic) and then by reassessing beliefs and assumptions.
Our Behavioral Experiment Worksheet is an effective tool to help your clients cope in challenging or stressful situations:
4. Continuum Worksheet
The Continuum Technique is a tool used in CBT to help people challenge irrational beliefs about themselves or the world around them. This simple worksheet will help your clients contrast potentially harmful beliefs that they may simply accept as truth or allow to remain unchallenged. These can worsen conditions like depression.
Our CBT Continuum Worksheet is an effective tool to challenge negative beliefs your clients have about themselves:
5. Belief Driven Formulation Worksheet
CBT teaches that our behaviors, feelings, and thoughts are determined by what we believe and assume at our core. This Belief Driven Formulation worksheet will help you to explore what influences your behaviors, feelings, and thoughts.
Our Belief Driven Formulation Worksheet will help your clients explore what influences their thoughts that may be contributing to their depressive state:
7. Cognitive Distortions Worksheet
People experiencing anxiety, depression, or other mental health conditions often have unhealthy thinking patterns. Everyone experiences negative thoughts, but when they become more frequent and stronger, they can create problems. According to VeryWellMind.com , “ Cognitive distortions are negative or irrational patterns of thinking. These negative thought patterns can play a role in diminishing your motivation, lowering your self-esteem , and contributing to problems like anxiety, depression, and substance use.”
Our Cognitive Distortions Worksheet can help your clients recognize irrational thought patterns that may be harming them:
7. Core Beliefs Worksheet
The core beliefs we hold have a big impact on our mental health and well-being. Core beliefs are our central ideas that we see about ourselves, others, and the world at large. Our core beliefs can negatively effect us and cause depression.
Our CBT Core Beliefs Worksheet is a helpful worksheet to help your clients write down how they think about themselves, others, the world, and the future:
8. Decatastrophizing Worksheet
When we are struggling with depression, it’s easy to think of the worst. Thinking the worst will happen is called catastrophizing. This behavior can cause us to act irrationally and make our situations worse than they are. This decatastrophizing worksheet will help your clients think differently about their situation.
Our Decatastrophizing Worksheet will help your clients think differently about the situation they’re in:
9. Problem Solving Worksheet
Problem solving is an important intervention whenever we are presented with difficulties problems, and repetitive thoughts or worry, which often influence depressive symptoms. Effective problem solving will help clients generate solutions when they are feeling “stuck.”
Our CBT Problem Solving Worksheet is a helpful tool to help your clients think through their problem and come up with effective solutions:
10. Socratic Questions Worksheet
Our thoughts come and go. Because our thoughts can control our emotions and the way we act, it’s important to challenge any thoughts that can cause us harm, such as those that increase depressive symptoms. Socratic questioning is a technique for exploring ideas, emotions, and thoughts.
Our Socratic Questions Worksheet will help your clients explore their thoughts to help them reduce thoughts that cause anxiety:
11. Thinking Errors Worksheet
How we think and what we believe plays a major role in affecting our thoughts, feelings, and behaviors. When a person has a pattern of negative thinking, it can skew how they see and understand a situation.
Our Thinking Errors Worksheet will help your clients practice balanced thoughts when presented with examples you create:
12. Thought Record Worksheet
The purpose of a thought record is to get you into the habit of paying attention to your thoughts and working to change them.
Our Thought Record worksheet can teach your clients pay attention to their thoughts and make efforts to change them for the better:
13. Challenging Beliefs Worksheet
Irrational thoughts or beliefs can pop into our head at any time. They can take hold and cause us long-term pain and depression.
Our Challenging Beliefs worksheet can teach your clients examine their thoughts to consider if they are rational, factual, extreme, or not factual:
14. Cognitive Restructuring Worksheet
Also known as cognitive reframing, cognitive restructuring is a helpful process that allows your clients to identify and understand unhelpful thoughts they may be having and then challenge and replace their automatic thoughts (cognitive distortions).
Our Cognitive Restructuring Worksheet will help your clients challenge their irrational thoughts and replace them with more helpful thoughts:
15. Mindfulness Worksheets Bundle
Mindfulness is a powerful technique that teaches people to consciously be present, focused, and relaxed in the current moment.
Our Mindfulness Worksheets Bundle will help your clients lessen negative thoughts that can cause anxiety and depression:
Conclusion on CBT Worksheets for Depression
Depression is a serious mental health condition that can affect anyone at anytime. When treating your patients with depression, having the right tools makes a big difference. Our CBT worksheets for depression can help you with some of the heavy lifting. Thanks for reading our post!
Want all the above CBT worksheets plus more? Download our CBT Worksheets bundle:
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9 CBT Worksheets and Tools for Anxiety and Depression
CBT is one of the most effective psychological treatments when it comes to managing anxiety and depression, and can be a highly useful approach to apply in online therapy.
If you help clients tackle cognitive distortions and unhelpful thinking styles, we’ve compiled a list of essential worksheets that should be part of your therapy toolbox.
How To Use CBT Worksheets in Therapy
Cognitive-behavioral therapy (CBT) is based on the idea that thoughts, feelings, physical sensations and behaviors are interlinked, and that changing negative thought patterns can enhance the way we act and feel.
It encompasses a variety of techniques and interventions that have been proven effective in the treatment of many mental disorders.
Besides anxiety and depression, a few examples include: 
- Panic disorder
- Bipolar disorder
- Borderline personality disorder, and
- Obsessive-compulsive disorder.
With the advent of online therapy, guided online CBT has become an increasingly popular way for mental health professionals to help clients manage behavioral health conditions without the need to meet in person as often.
CBT worksheets, exercises, and activities play a large role in these treatments to encourage further progress between sessions, in the same way that face-to-face CBT involves between-session practice. 
5 Example Tools For Treating Anxiety
So what types of online CBT worksheets can be used to help clients cope better with symptoms of anxiety ?
There is a wide spectrum of therapeutic approaches that range from self-help activities to guided interventions, and all of them focus on identifying and changing unhelpful thoughts, feelings, and behaviors.
Here are a few of the best-known techniques that can be applied with the right tools.
Identifying cognitive distortions
Recognizing and identifying maladaptive automatic thoughts is a main goal of CBT.
Recognizing and identifying maladaptive automatic thoughts is a main goal of CBT. Cognitive distortions describe inaccurate or exaggerated perceptions, beliefs, and thoughts that can contribute to or increase anxiety, so increasing a client’s awareness of these is the first step to unraveling them and feeling better.
Quenza’s Unhelpful Thinking Styles – “Shoulding” and “Musting” worksheet, shown below, is an example exercise that can help clients recognize the damaging impacts of using “should” and “must” statements to place unreasonable demands or unnecessary pressure on themselves.
Cognitive restructuring involves disputing the distortions that underpin a client’s challenges. Various techniques that can be helpful here include Socratic questioning, decatastrophizing, and disputing troublesome thoughts with facts.
One example CBT exercise is the Cognitive Restructuring Expansion shown below, which can help clients identify automatic thoughts and substitute them with more fair, rational ways of thinking.
Journaling and thought records
Journaling is a form of self-monitoring that helps clients identify their thought patterns and emotional tendencies, as shown by the Stress Diary Expansion below.
Journals can involve logging negative thoughts or feelings as homework, with the aim of positioning clients to manage them successfully.
Stress Reduction Techniques
Stress reduction exercises such as deep breathing, meditation, and progressive muscle relaxation can all be effective CBT tools for managing anxiety.
The example below is Quenza’s Progressive Muscle Relaxation exercise, which clients can practice to increase their sense of control and calm when stressed or anxious.
Diaphragmatic breathing is another useful relaxation exercise often used in CBT for anxiety.
With this mindfulness practice, clients learn to regulate their breath and activate their body’s relaxation response, as shown in Quenza’s audio Diaphragmatic Breathing exercise below.
CBT Worksheets for Depression (PDF)
CBT worksheets are useful resources for therapists helping clients manage depression, because they can be used to encourage your clients’ progress between sessions.
If you are a mental health professional, the following worksheets can be shared as homework. Each is available as a customizable Quenza Expansion for easy sharing with clients with a $1, 30-day Quenza trial .
The ABC Model of Helpful Behavior
ABC is an acronym for Antecedents, Behavior, and Consequences, and the ABC model proposes that behavior can be learned and unlearned based on association, reward, and punishment.
This CBT worksheet allows clients to reflect on adaptive behavior, thus building their awareness of the triggers for and consequences of this behavior.
After introducing the ABC Model of Behavior and the ABC Model of Helpful Behavior, the exercise asks clients to try it out themselves by:
- Describing a recent personal problem
- Recalling a helpful behavior that they carried out that contributed to the problem in a positive way.
- Recalling the Antecedents of the helpful Behavior – where they were, who they were with, and what they were doing, thinking, and feeling
- Considering the short- and long-term Consequences of that behavior – how they felt, what happened, and what others said or did.
Unhelpful Thinking Styles – Emotional Reasoning
This worksheet invites clients to identify and decrease the negative impact of a specific cognitive bias known as “Emotional Reasoning,” which can be common in clients with depression.
As an introduction, clients learn about the negative impacts of regarding emotions as evidence of the truth, or basing one’s view of situations, yourself, or others on how they feel at a certain moment.
They are then invited to reflect on a time when they used emotional reasoning and describe the situation as well as their thoughts and emotions at the time.
Through self-reflection, this therapy exercise aims to help the user separate their feelings from their thoughts so that they can reduce the negative effect of emotional reasoning on their wellbeing.
As we’ve seen, patients with symptoms of depression often experience negative thoughts that result from faulty thinking rather than accurate experiences of reality.
Catastrophizing is amplifying the importance of adverse events and situations while minimizing their positive aspects or outcomes. The Decatastrophizing Expansion can be an impactful cognitive restructuring technique to help with this cognitive distortion when it is practiced over time.
Clients are asked to describe the situation that they are currently catastrophizing about before answering a series of questions to challenge their thinking:
- What is the worst that can happen?
- What three events would have to take place for the worst to happen?
- How likely is it that all three of these events will take place?
- What is a more likely outcome, given what you know about the situation?
Here’s an example of the PDF copy that you or your clients can download of these exercises: Decatastrophizing CBT worksheet
To customize these CBT worksheets for depression and browse more, take a look at the $1, 30-day Quenza trial .
Can CBT Help Build Self Esteem?
Studies have shown CBT to be useful in developing a client’s self-esteem so that they start to perceive themselves as more worthy and deserving. 
Cognitive restructuring is particularly can equip them with the skills to challenge or refute negative self-talk. This involves:
- Helping clients explore repetitive negative self-talk can be damaging to their sense of self-worth
- Challenging harmful cognitive distortions
- Supporting in the development of a more balanced, positive self-perspective.
Quenza’s Challenging Unhelpful Thoughts , pictured above, is an example CBT worksheet for self-esteem with the following prompts and questions:
- Describe a negative thought that keeps coming back.
- On a scale of 1 to 10, how strongly do you believe this thought to be true?
- What evidence supports this thought?
- What evidence do you have against the thought?
- What would you tell a friend (to help them) who would have the same thought?
CBT Toolbox for Online Therapists
Once you’ve found the most useful tools for your programs and are ready to start treating clients, it’s time to organize them for easy, convenient delivery.
Without a centralized library of digital materials – and the ability to quickly personalize and share them – it’s easy to spend more time than is necessary on the admin side of helping others.
With the right CBT app , you should have an entire toolbox of CBT worksheets plus the tools you need to deliver them:
- Activity design tools: for efficiently creating online CBT interventions
- Customizable templates: e.g., Quenza Expansions that include personalizable science-based exercises and activities
- Documentation tools: e.g., Quenza Notes – A secure, convenient way to create and store session notes and collaborate with clients
- Pathway builder tools: which help you assemble separate worksheets and tools into programs and mental health treatment plans
- Real-time results tracking: to securely collect and store client responses and results
- A free client app: so that clients can easily receive, complete, and return your CBT resources and assemble a library of their finished activities.
Whether you’re new to the world of online therapy or coaching or simply looking to increase your impact, our free 30-page guide is a great place to start.
This PDF will give you an easy-to-understand introduction to the essentials of digital practice: how to create and share your own CBT interventions, keep clients engaged in their treatment, and improve your clients’ results while growing and scaling your business.
Click here to download your copy of Coach, This Changes Everything .
Practicing CBT online for the first time may take some adapting, but the ability to help more clients with less work is always worth the payoff.
Hopefully, these worksheets and resources give you a solid starting point for building your CBT toolkit. Let your fellow practitioners know how you use them – leave a comment and join in the conversation below!
- ^ NHS. (2022). Overview - Cognitive behavioural therapy (CBT). Retrieved from https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/cognitive-behavioural-therapy-cbt/overview/
- ^ Harvard Health Publishing. (2015). Online cognitive-behavioral therapy: The latest trend in mental health care. Retrieved from https://www.health.harvard.edu/blog/online-cognitive-behavioral-therapy-the-latest-trend-in-mental-health-care-201511048551
- ^ McKay, M., & Fanning, P. (2016). Self-esteem. New Harbinger.
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Free Mental Health Workbooks
There are a lot of excellent mental health resources out there, and quite a few of them are actually free. Here are some of the good mental health workbooks and worksheets that I’ve come across, most of which are available as printable PDFs. They’re based on therapeutic approaches that have proven to be effective.
This page is updated regularly, but the availability of these resources is subject to change without notice.
Table of Contents
Acceptance and commitment therapy (act), cognitive behavioural therapy (cbt), dialectical behaviour therapy (dbt), other mental health workbooks and worksheets, large collections of worksheets, resources on mental health @ home.
Acceptance and commitment therapy identifies fusion with thoughts and resistance to uncomfortable inner experiences as key sources of distress. The therapy works on increasing psychological flexibility and choosing committed actions based on values.
- ACT for Anxiety Disorders worksheets : Dr. John Forsyth’s website has handout packs to accompany his books on ACT for anxiety
- ACT Mindfully : Russ Harris’s site has worksheets from all of his books on ACT, including The Happiness Trap
- ACT with Compassion: various handouts and worksheets
- ACTivate Your Life : worksheets to accompany the book by the same name
- Association for Contextual Behavioral Science : ACT videos and audio lessons
- How to Adapt and Thrive in the Age of Anxiety workbook
- Mindfulness and Acceptance-Based Group Therapy for Social Anxiety Disorder : a therapist manual and participant handouts
- Portland Psychotherapy Clinic : ACT exercises and audio files
- PositivePsychology.com : 21 ACT Worksheets and Ways to Apply Acceptance & Commitment Therapy
- When the Going Gets Tough, the Tough Get Mindful : A Toolkit Based on the Principles of Acceptance and Commitment Therapy – from Help With ACT
- 6 ACT Conversations : audio e-learning program and accompanying worksheets
CBT is an evidence-based treatment for a variety of different mental illnesses. A key element of CBT is identifying evidence to challenge cognitive distortions . This can sometimes be difficult to do without working with a therapist, but there are plenty of self-help resources to help you try on your own.
Here are links to some free CBT worksheets and workbooks:
- A Course in CBT Techniques: A Free Online CBT Workbook from Cognitive Behavioral Therapy Los Angeles
- Anger Management for Substance Use Disorder and Mental Health Clients: Participant Workbook from the Substance Abuse and Mental Health Services Administration (SAMHSA)
- Antidepressant Skills Workbook from CAMHA: a good intro for people who are new to CBT for depression, but might feel a little too basic if you are familiar with CBT
- Anxiety and Depression Student Workbook from the University of Arkansas
- Anxiety Toolbox Student Workbook from Liberty University: sections on anxiety 101, automatic thoughts, and alternative responses, grounding, and self-care
- Behavioural activation booklets from the NHS: this series of booklets focuses on the behavioural activation aspect of CBT for depression
- Behavioral Activation for Depression workbook from the University of Michigan
- CBT group program manuals for Depression and Anxiety from the University of Michigan: these manuals are meant to be used as part of a group program, but they’re clearly laid out and have exercises you can work on on your own
- CBT+ Notebook : CBT handouts and worksheets from the Harborview Abuse & Trauma Center
- CBT Skills Training Workbook : from the NHS, focused on low mood and anxiety
- Centre for Clinical Interventions : this Australian organization has workbooks/worksheets for a wide variety of mental health concerns
- Clinical Research Unit for Anxiety and Depression : workbooks for generalized anxiety disorder, PTSD, OCD, panic disorder, social phobia, and specific phobias
- Cognitive Processing Therapy Patient Workbook
- Anxiety-Busting: Challenging Your Thoughts
- Busting the Blues
- Managing Your Worries
- Behavioural activation for depression
- Graded exposure
- Managing your worries
- Overcoming perfectionism
- Integrated CBT patient workbook from Dartmouth University
- Living CBT self-help resources
- Managing Depression : A Self-Help Skills Resource for Women Living with Depression During Pregnancy, After Delivery, and Beyond
- Mind Over Mood – worksheets to accompany the book
- NHS inform : self-help guides for anxiety, depression, trauma-informed CBT, and other topics
- Self-Help Manual for Bulimia Nervosa from The Cullen Centre
- Social Anxiety Group Participation Workbook from Hamilton Family Health Team: a patient manual for group therapy that’s laid out in a way that makes it pretty easy to use on your own
- Stress management workbooks from SafeSpot
- TF-CBT Workbook : trauma-focused CBT for teens
- Think CBT Workbook : ThinkCBT also has other resources based on CBT, ACT, and compassion-focused therapy
- Your Best You: Managing Your Anxiety from Queen’s University
DBT is very skill-based, and while it’s used most often for borderline personality disorder, many of the skills can also be useful to people with other mental health issues.
Here are links to some free DBT worksheets and workbooks:
- DBT handouts from psychologist Dr. Linda Olson
- DBT Fosters Recovery and Resiliency Handouts
- DBT Peer Connections : DBT skills in a massively open online course format
- DBT Skills Application : a DBT self-help site with links to skills worksheets
- DBT Skills Handbook from Fulton State Hospital: available from a number of sources, including My Journey Through Madness
- DBT Skills Workbook for Rec Therapy Sessions from RecTherapyToday
- Dealing with Distress : distress tolerance workbook
- Dialecticalbehaviortherapy.com : videos, written info, and worksheets
- Diary card from University of Washington
- Dr. Mark Purcell : DBT youth group manual (link goes straight to a .docx download)
- ilovedbt.wordpress.com : DBT skills micro-lessons, handouts, and worksheets
- Mind Body Soul Therapy : free online mini DBT intro course
- Now Matters Now: diary card | skills practice worksheet
- Open-Minded Thinking DBT workbook
- Regulator Workbook : DBT skills manual from Mission Australia
- The DBT Homework Assignment Workbook : from Between Sessions Resources
- Breaking Free of Addiction
- Don’t Let Your Worries Run Your Life : Therapeutic Assignments to Help You Overcome Your Generalized Anxiety Disorder
- Overcoming Depression : 44 Therapeutic Activities to Bring Happiness and Fulfillment Back into Your Life
- Overcoming Your Binge Eating Disorder
- Overcoming Your Dental Anxiety
- Overcoming Your OCD : A Therapy Assignment Workbook
- Panic Attack Workbook : focus is on practicing skills
- The PTSD Workbook
- Tools for Helping Anxious Teens Workbook
- Your Most Important Assignment Is You : A Workbook of Mental Health Activities for Teens
- Coping skills handouts & worksheets from Harborview Center for Sexual Assault & Traumatic Stress
- Dealing with Psychosis Toolkit : this toolkit from Fraser Health Authority provides information about psychosis and skills that can help to manage it
- Living Successfully With a Mood Disorder Plan workbook from the Depression and Bipolar Support Alliance (DBSA)
- Mindfulness-Based Stress Reduction (MBSR) Workbook by Ken Lunn
- My Group Guide : many worksheets are for members only, but there are also quite a few free resources
- Queens University self-help workbooks on improving mood , managing anxiety , and self-care
- Seasons Therapy Anger Management Workbook
- STAIR for trauma web group handouts & worksheets from Kaiser Permanente
- The Self-Help Alliance: Building Better Boundaries
- The Wellness Society has a guide on How to Beat the Winter Blues, a Coronavirus Anxiety Workbook, and lots of other free resources
- Therapy worksheets from social worker Brian Konik
- Wellness worksheets (e.g. positive self-talk, resilience, self-love) from Western Washington University Counseling Center
- Your Recovery Journey workbook from the Schizophrenia Society of Canada
- GetSelfHelp : worksheets galore on a variety of topics
- PositivePsychology.com : info and worksheets based on a number of different therapy models, including CBT, DBT, and positive psychotherapy
- Psychology Tools : has a wide variety of worksheets, including CBT and DBT-based
- Therapist Aid : worksheets that are geared for therapists to use with their clients.
- Mental Health Coping Toolkit : has a broad collection of resources to support mental health and well-being
- Mental Health Resource Directory : has a collection of useful mental health websites and apps
- So You’ve Just Been Diagnosed With… [a Mental Disorder] : brings together info, advice, and resources from people who’ve been there
- Therapy Tools for Mental Health : a collection of tools from ACT, CBT, DBT, and more
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15 Behavioral Activation Worksheets for Depression & Anxiety
At its core, BA aims to enable individuals to reengage with their lives through specific activation techniques (Westbrook, Kennerley, & Kirk, 2011).
Activation techniques help combat behavioral patterns of withdrawal, avoidance, and inactivity, which may perpetuate depressive symptoms by causing additional, secondary problems.
For example, a common clinical symptom of depression is lethargy, where an individual battles to get out of bed. This may lead to skipping work or avoiding seeing friends, resulting in job loss or impaired social relationships.
BA also encourages positive reinforcement in an individual’s environment in order to help increase positive behaviors and reduce those that maintain the depressive cycle.
In this article, we’ve collated some key worksheets and resources to help your clients engage in healthy behaviors on a regular basis.
Before you continue, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free . These science-based exercises will equip you and those you work with, with tools to manage stress better and find a healthier balance in your life.
This Article Contains:
4 best behavioral activation worksheets, cbt worksheets for depression and anxiety, positivepsychology.com’s cbt resources, a take-home message.
When in the depths of depression, becoming behaviorally active may feel overwhelming. Breaking tasks and activities down into manageable chunks is an important step in helping clients overcome this.
One practical approach to address this is through the use of worksheets that encourage the application of activation techniques to everyday life. Worksheets can further help to track a client’s progress and can facilitate the use of positive reinforcement, which can motivate them to implement positive behaviors.
To help your clients get going, we’ve assembled some of the best behavioral activation worksheets to promote getting active in a healthy way.
Put simply, an Activity Schedule is a diary sheet for each day of the week, with each day divided into one-hour blocks. Because depression is likely to affect a person’s motivation levels, even scheduling basic daily tasks can help them get going.
Creating structure in the daily routine can help regulate sleeping and eating patterns, which are often disrupted when feeling low. It can also help clients gradually face up to activities they’ve been avoiding, such as hobbies and social engagements.
For depressed individuals, it can sometimes be hard to visualize activities that they may find enjoyable, let alone actually do them. This Activity Menu can help identify tasks that a person can engage with as they start to get more active.
It targets some key life areas that can help people feel better:
- Connecting with others
- Expanding the mind
- Caring for others
- Planning and goal setting
The activity menu is a useful tool for gradually building a client’s favorite activities into their daily schedule.
As part of promoting healthy behaviors and minimizing negative ones, it is important to surround yourself with people and environments in which this is encouraged. While self-motivation is the key to success, support from others who care about you can certainly aid in your progress.
Lejuez, Hopko, LePage, Hopko, and McNeil (2001) suggest talking to someone trustworthy, such as friends and family, about the need to increase healthy behaviors and avoid those that are detrimental to wellbeing. Clients may wish to ask their loved ones to help them pay attention to positive, rather than negative, experiences.
For instance, they may ask friends to only let them spend 25% of their time together talking about their problems and what’s bothering them, leaving the rest of the time to speak about positive experiences or a fun activity that they can do.
This Behavior Contract is a useful way for clients to create a concrete agreement with their friends and family, identifying how they can help the client build better wellbeing.
Pleasurable Activity Journal
When a person is clinically depressed, they can experience anhedonia, which is a lack of pleasure in activities that they used to find enjoyable (Treadway & Zald, 2011).
It can be useful for clients to outline which activities they typically enjoy and gradually build them into their recovery plan. It is further useful to track how pleasurable the client finds such activities over time, to monitor progress. The Pleasurable Activity Journal is a useful tool to help with this.
It examines the relationship between a person’s thoughts, feelings, and behaviors and helps individuals to understand and alter negative patterns.
One of the core concepts of CBT is that you ‘feel the way you think.’ CBT works on the idea that if you can think in more helpful ways, you can live a more fulfilling, productive, and happy life.
When faced with emotional difficulties, it’s easy to think that stressful life situations are the direct cause. However, in reality, how you feel and behave are often influenced by your perceptions, thoughts, and beliefs about the events.
With this in mind, we’ve put together key worksheets to help your clients challenge unhelpful thinking.
Increasing awareness of cognitive distortions
Cognitive distortions, or ‘thinking errors,’ are habitual ways of thinking that are often inaccurate and negatively biased. Most of us will experience some form of skewed thinking at least once in our lives, so it’s important to learn how to recognize and tackle these distortions when they arise.
Some of the most common cognitive distortions include:
- Catastrophizing When we jump to the worst possible conclusion, often using very little information to reach our decision.
- All-or-nothing thinking When we think of situations, people, and events in extremes.
- Overgeneralizing When we draw very broad conclusions based on limited experience or information.
- Mind reading When we think that we know what another person is thinking or feeling, without them actually saying so.
- Fortune telling When we predict negative events in the future, without realistically considering the chances of that outcome.
- Labeling When we attach a single negative descriptor to events and people (including ourselves).
- Emotional reasoning When we believe something to be true because it feels true.
- Personalizing When we think everything people say or do is directly related to us in some way.
The Unhelpful Thinking Styles worksheet will help clients become more aware of any distorted thinking so that its influence on their feelings and behaviors is reduced. This resource is particularly relevant when working with clients for whom maladaptive thinking styles are linked to symptoms of depression.
Thought Record (Cognitive Restructuring) Worksheet
As part of assessing thinking and identifying cognitive distortions, it’s useful to keep a thought record and consider ways to restructure unhelpful thoughts and perceptions.
The Thought Record worksheet will help clients to:
- Pause and reflect on their thoughts
- Identify and understand potential triggering events
- Recognize negative automatic thoughts
- Assess their emotional reaction
- Create alternative thoughts through reinterpretation (restructuring)
- Reassess their emotional response
The term ‘ catastrophizing ’ originated from the work of Albert Ellis (1962) and was later extended upon by Beck, Rush, Shaw, and Emery (1979) to describe a maladaptive thinking style employed by individuals with anxiety or depression.
Essentially, catastrophic thinking is when we jump to the worst possible conclusions, with very little hard evidence (Quartana, Campbell, & Edwards, 2009). For example, a student who catastrophizes may think they will be kicked out of a program after failing one test. They may drop out, concluding that they will be a ‘failure’ for life.
In reality, failing to pass one test is unlikely to result in such a catastrophe as being removed from a program, and this thinking style is unhelpful to the individual trying to reach their goals.
Use this Decatastrophizing Worksheet to help clients restructure their thoughts when they feel overwhelmed by catastrophic thinking.
Rumination, which is characterized by persistent negative thinking, has been identified as a key risk factor for depression (Joormann, Yoon, & Zetsche, 2007; Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008).
Ruminating on negative thoughts means there is less space in our working memory to focus on other information, which may be more positive.
Indeed, rumination has been associated with deficits in cognitive control, meaning it’s harder to direct our attention toward goal-directed tasks and away from distracting irrelevant information (Beckwé, Deroost, Koster, De Lissnyder, & De Raedt, 2014; Hallion, Ruscio, & Jha, 2014).
Commonly, ruminative thinking may involve persistently thinking about events that have already happened or questions that cannot be answered, such as:
“Why do I always feel this way?” “If only I hadn’t said that to him.” “If only I’d done X, Y, or Z differently.”
The Recognizing Rumination worksheet can help clients identify persistent thoughts that are interfering with their day-to-day lives.
Download 3 Free Stress & Burnout Prevention Exercises (PDF)
These detailed, science-based exercises will equip you or your clients with tools to manage stress better and find a healthier balance in their life.
Download 3 Stress & Burnout Prevention Exercises Pack (PDF)
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Table of Common Core Beliefs
‘Core beliefs’ refer to a person’s ‘bottom line’ (Fennell, 1997) – their enduring, fundamental beliefs about themselves, others, and the world around them. Core beliefs are not always negative; however, those that are can be problematic.
A number of factors characterize core beliefs:
- They are often developed early as a result of childhood experience. They can, however, change later in life (e.g., as a result of adult trauma ).
- They may exist out of conscious awareness.
- They can be exhibited through absolute statements and assumptions such as ‘the world is a terrible place.’
Because these beliefs are deeply held at our core, we may not be particularly aware of them. The Table of Common Core Beliefs can help your clients identify which negative core beliefs they are holding on to.
The Downward Arrow Core Belief Technique
The Downward Arrow Core Belief Technique is a method of Socratic questioning that can help identify problematic core beliefs. It involves identifying situations that bring about negative emotions such as depression, guilt, or shame.
Once a situation that brings up negative feelings has been identified, the client has to define what negative automatic thoughts arise in relation to the situation. The next step (narrowing down) encourages the client to keep asking themselves what the previous answer is likely to represent until they reach an absolute, global statement (reflecting their core belief).
SMART goal setting
One of the fundamental priorities of CBT is to help clients move away from their problems and toward their goals. For therapy to be most effective, it is typical to work toward mutually agreed upon, clearly defined milestones.
Goal setting indicates the possibility for change, which can give hope and reduce helplessness in the face of overwhelming emotions and difficult situations. Many individuals cannot overcome their problems because their goals are too vague. Detailing goals using the SMART technique can help with this.
Put simply, goals should be:
Specific Measurable Attainable Realistic Time-bound (allowing enough time for achievement)
Specifying goals with this level of detail can give clients a sense of autonomy and help break milestones down into manageable steps.
Our free Positive CBT Exercises Pack includes three resources that we believe to be most useful for helping clients to alter their negative patterns of thoughts, feelings, and behaviors, while promoting a positive view of the self.
This pack features three of our top tools from the Positive Psychology Toolkit© , all of which center on the theme of positive CBT:
- Solution-Focused Guided Imagery Exercise This visualization helps clients recognize how they can apply their strengths to overcome a problem or adversity. In this exercise, clients take forty minutes to picture a problem in detail, imagine a reality where it is resolved, and leverage their strengths to set goals that may help bring about this reality.
- Reframing Critical Self-Talk This exercise helps clients strengthen awareness of inner criticism and promote a more self-compassionate stance towards the self. To do this, clients will commit one week to noticing and pausing when critical self-talk arises and consciously rephrase this talk to be more in line with how they’d speak to a loved one.
- Strengths Spotting by Exception Finding This exercise helps you assess a client’s ability to deal with challenges while also increasing their confidence. In it, clients will reflect on past challenges and the strengths they used to overcome them to discover how they may apply these strengths to their present problems.
17 Positive CBT Exercises
If you’re looking for more science-based ways to help others through CBT, this collection contains 17 validated positive CBT tools for practitioners . Use them to help others overcome unhelpful thoughts and feelings and develop more positive behaviors.
It is natural that when we are feeling low, our motivation levels for common tasks and previously enjoyable activities can take a nosedive. This means there are fewer opportunities for positive and rewarding experiences. Often, the less we do, the worse we feel, leading to a perpetual cycle of inactivity and low mood.
Behavioral activation has proven to be an effective treatment for clinical depression (Jacobson et al., 1996). It helps clients to create structure with their day-to-day tasks while aiding in the rediscovery of recreational activities that they once found pleasurable. Reinforcing healthy, enjoyable activities can go a long way in helping a depressed individual feel better.
Sometimes getting going is the hardest part, but with some structure in place and a little nudge in the right direction, we can all move toward healthier, happier behaviors.
We hope you enjoyed reading this article. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free .
- Bannink, F. (2012). Practicing positive CBT: From reducing distress to building success . John Wiley & Sons.
- Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression . Guilford Press.
- Beckwé, M., Deroost, N., Koster, E. H. W., De Lissnyder, E., & De Raedt, R. (2014). Worrying and rumination are both associated with reduced cognitive control. Psychological Research , 78 (5), 651–660.
- Ellis, A. (1962). Reason and emotion in psychotherapy . Lyle Stuart.
- Fennell, M. J. (1997). Low self-esteem: A cognitive perspective. Behavioural and Cognitive Psychotherapy , 25 (1), 1–26.
- Hallion, L. S., Ruscio, A. M., & Jha, A. P. (2014). Fractionating the role of executive control in control over worry: A preliminary investigation. Behaviour Research and Therapy , 54 , 1–6.
- Jacobson, N. S., Dobson, K .S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., … Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology , 64 (2), 295–304.
- Joormann, J., Yoon, K. L., & Zetsche, U. (2007). Cognitive inhibition in depression. Applied and Preventive Psychology , 12 (3), 128–139.
- Lejuez, C. W., Hopko, D. R., LePage, J. P., Hopko, S. D., & McNeil, D. W. (2001). A brief behavioral activation treatment for depression. Cognitive and Behavioral Practice , 8 (1), 164–175.
- Mazar, A., & Wood, W. (2018). Defining habit in psychology. In B. Verplanken (Ed.). The psychology of habit: Theory, mechanisms, change, and contexts . Springer.
- Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science , 3 (5), 400–424.
- Quartana, P. J., Campbell, C. M., & Edwards, R. R. (2009). Pain catastrophizing: A critical review. Expert Review of Neurotherapeutics , 9 (5), 745–758.
- Treadway, M. T., & Zald, D. H. (2011). Reconsidering anhedonia in depression: Lessons from translational neuroscience. Neuroscience & Biobehavioral Reviews , 35 (3), 537–555.
- Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications . Sage.
- Wood, W., & Rünger, D. (2016). Psychology of habit. Annual Review of Psychology , 67 , 289–314.
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