Guide
CBT (cognitive behavioural therapy) starts from a simple idea: our thoughts, emotions and behaviours influence one another. By changing one link, the others can shift.
CBT starts from a simple idea: it isn’t only what happens to us that makes us suffer, but also how we interpret it and what we do next. Thoughts, emotions and behaviours influence each other in a loop.
Automatic thoughts
In a situation, thoughts appear on their own (“I’m going to fail”, “he’s angry with me”). They are quick, we tend to believe them without checking and they colour what we feel. CBT helps you spot them, examine them against the facts and find ways of seeing things that are more accurate, not necessarily more positive.
Behaviours
What we do counts as much as what we think. Avoiding, checking or isolating yourself brings relief in the moment, but often keeps the problem going. CBT suggests trying other ways of doing things, in small steps, and observing what happens.
A little theory · CBT is the most studied psychotherapy in the world. Reviews of meta-analyses show its effectiveness for anxiety, depression, insomnia and many other difficulties (Hofmann et al., 2012). For depression, a meta-analysis of 409 trials found it as effective as antidepressants, and the combination of both works better than either alone (Cuijpers et al., 2023).
How it works
- Concrete work, focused on today’s difficulties.
- Goals defined together and exercises between sessions (like these worksheets).
- A scientifically evaluated method for anxiety, depression and many other difficulties.
The most common thinking traps
- Catastrophising: jumping straight to the worst.
- Mind reading: believing you know what others are thinking.
- All or nothing: if it isn’t perfect, it’s a failure.
- Overgeneralising: “always”, “never”, based on a single event.
- “Musts”: rigid rules for yourself.
Worksheet 11 helps you recognise them. It isn’t about “thinking positive”, but about thinking more accurately.
A little theory · In the 1960s, Aaron Beck described how depressed people interpret situations in a systematically negative way, about themselves, the world and the future. CBT suggests treating these thoughts as hypotheses to be tested, not as facts (Beck, 2020).
And third-wave CBT?
It adds acceptance, mindfulness and values (ACT, DBT). Instead of only changing thoughts, it also helps change your relationship with them.
Worksheets to practise
- 61 · The thought record · Examining an automatic thought and finding a more balanced one
- 62 · The downward arrow · Going down from a thought to the belief underneath it
- 63 · Questions that help you think · Questioning a thought without fighting it
- 06 · Understanding my anxiety · The cycle of trigger, thoughts, body, behaviours (psychoeducation)
- 11 · The traps of anxious thinking · Spotting the most common thinking errors
- 71 · My activity and mood log · Seeing the link between what I do and how I feel
Sources
Beck, J. S. (2020). Cognitive Behavior Therapy: Basics and Beyond (3rd ed.). Guilford.
Clark, D. A. & Beck, A. T. (2010). Cognitive Therapy of Anxiety Disorders: Science and Practice. Guilford.
Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T. & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440.
Cuijpers, P., Miguel, C., Harrer, M., Plessen, C. Y., Ciharova, M., Ebert, D. & Karyotaki, E. (2023). Cognitive behavior therapy vs. control conditions, other psychotherapies, pharmacotherapies and combined treatment for depression: A comprehensive meta-analysis including 409 trials with 52,702 patients. World Psychiatry, 22(1), 105-115.
These worksheets do not replace therapy. If you are in distress or having suicidal thoughts, call your local emergency number (112 in Europe; 3114 in France, free, 24/7).
