CBT Worksheet Library

Map how thoughts, emotions, physical sensations, and behaviour interact around a triggering situation using the CBT 5-area model.

Map the developmental pathway from early experiences through core beliefs and rules to the current maintenance cycle.

A structured 6-step safety plan for crisis intervention and suicide prevention.

A maintenance-focused formulation for psychosis — mapping triggers, experiences, appraisals, emotions, and coping responses.

A longitudinal formulation based on Fennell's cognitive model of low self-esteem — mapping how early experiences created a negative bottom line that is maintained by biased processing and unhelpful rules.

Explore how the traumatic event has affected your beliefs about yourself, others, and the world.

A formulation based on Fairburn's enhanced cognitive-behavioural model — mapping over-evaluation of eating, shape, and weight alongside maintaining mechanisms.

Identify personal early warning signs for both depression and mania/hypomania, and create a stepped action plan for each mood polarity.

The classic cognitive restructuring tool. Identify automatic thoughts, evaluate the evidence, and develop more balanced alternatives.

A formulation based on the cognitive-behavioural model of health anxiety — mapping the vicious cycle of misinterpretation, anxiety, checking, and temporary reassurance.

Explore the triggers, thoughts, feelings, and consequences associated with substance use to understand its function in your life.

A formulation based on Clark and Wells' cognitive model of social anxiety — mapping self-focused attention, the observer-perspective self-image, and safety behaviours.

Record and reflect on social situations to identify the role of self-focused attention, safety behaviours, and predictions.

A formulation based on Salkovskis' cognitive model of OCD — mapping intrusions, responsibility appraisals, distress, and neutralising behaviours.

A formulation based on Spielman's 3P model — mapping predisposing, precipitating, and perpetuating factors that maintain insomnia.

A formulation based on the cognitive-behavioural model of BDD — mapping self-focused processing, distorted self-image, rumination, and safety behaviours.

A biopsychosocial formulation for chronic pain — mapping biological, psychological, and social maintaining factors.

A formulation based on Wells' metacognitive model of GAD — mapping the role of positive and negative beliefs about worry in maintaining the worry cycle.

Build a graded exposure hierarchy for Exposure and Response Prevention therapy. List anxiety-provoking situations, rate them, and plan structured exposures.

A structured preparation worksheet based on the Padesky supervision model. Helps supervisees organise their agenda, case discussions, and learning goals before each supervision session.

A longitudinal formulation mapping early experiences, core beliefs (schemas), coping strategies, and current patterns — the foundation for schema-focused work.

A formulation based on Ehlers and Clark's cognitive model of PTSD — mapping the nature of the trauma memory, negative appraisals, sense of current threat, and the maintaining strategies.

A formulation based on Clark's cognitive model of panic — mapping the vicious cycle of catastrophic misinterpretation of body sensations.

A longitudinal CBT formulation based on Beck's cognitive model of depression — mapping early experiences through core beliefs to current maintenance cycles.

Learn to distinguish between practical worries (that you can act on) and hypothetical worries (that are about "what if") to respond differently to each.

Self-rate your CBT competencies using the Cognitive Therapy Scale — Revised (CTS-R) framework. Designed for supervisees to reflect on their own session performance before supervision.

Track activities hour by hour alongside mood to identify patterns linking what you do to how you feel.

The full extended thought record with evidence for and against, balanced thought, and re-rating of emotion.

Compare your internal self-image with how you actually appear on video to challenge distorted self-perception in social anxiety.

Track OCD episodes — intrusions, appraisals, rituals, distress, and duration — to identify patterns and measure progress.

Map out how early experiences led to negative core beliefs and the rules, triggers, and maintenance cycles that keep low self-esteem going.

Practise and record the use of grounding techniques when experiencing flashbacks, dissociation, or overwhelming emotions.

Practise responding to yourself with the same kindness you would offer a friend — challenging the self-critical voice with compassion.

Work through a structured process to decide whether a worry is practical (take action) or hypothetical (practise letting go).

Track health anxiety episodes — the trigger, misinterpretation, anxiety level, safety behaviour used, and the actual outcome.

A longitudinal formulation for bipolar disorder — mapping life events, episode patterns, and maintaining factors across time.

Record panic episodes with triggers, sensations, catastrophic thoughts, safety behaviours, and actual outcomes to identify patterns and build evidence against catastrophic predictions.

The standard CBT-I sleep diary — record bed times, sleep times, wake times, and daytime functioning to track patterns and calculate sleep efficiency.

Track pain levels alongside activity, mood, and coping strategies to identify patterns.

Track BDD episodes — triggers, preoccupation with the perceived flaw, rituals, and mood impact.

Move from all-or-nothing core belief thinking to a continuum — placing yourself and evidence along a 0–100 scale.

Identify triggers that activate trauma memories and systematically compare the original trauma context with the present reality to reduce flashback intensity.

Examine beliefs about the power of voices — challenging omniscience, omnipotence, and the need to comply.

Weigh up the pros and cons of continuing to use substances versus making a change. A core motivational interviewing technique.

The core CBT-E self-monitoring tool — record what you eat, when, where, and how you felt, including any binge/purge episodes and triggers.

Practise noticing and tolerating everyday uncertainty to build your tolerance muscle.

Plan and track a pattern of regular eating — three meals and two to three snacks — to establish a predictable structure that reduces binge urges.

Practise using mirrors differently — shifting from selective, critical zooming to a full, descriptive, non-judgemental observation of your whole body.

Track urges to seek reassurance, whether you resisted, and what happened — building evidence that you can tolerate uncertainty without reassurance.

Explore how common unusual experiences are in the general population — and how context, stress, and sleep deprivation can produce them in anyone.

Identify the distorted observer-perspective self-image that drives social anxiety — the "felt sense" of how you appear to others.

Track daily mood on a depression-euthymia-hypomania/mania scale alongside sleep, medication, and key events.

Prepare for trauma reliving sessions and process the experience afterwards — tracking hotspots, emotions, and updated meanings.

Identify common thinking errors (cognitive distortions) present in your automatic thoughts.

Calculate and track sleep efficiency (time asleep ÷ time in bed × 100) — the key metric for CBT-I sleep restriction therapy.

Create coping flashcards that capture a triggering situation, the old unhelpful response, and a new, more adaptive response — for quick reference in difficult moments.

Track urges to use substances without acting on them. Practice the skill of riding the wave of craving until it passes.

Log exposure and response prevention practice sessions with SUDS ratings, urge strength, and whether you resisted the compulsion.

Build a catalogue of your strengths, qualities, and achievements — evidence that doesn't fit the negative bottom line.

Plan and rate activities with mastery and pleasure scores to gradually rebuild a rewarding routine.

A structured log for recording supervision sessions. Tracks topics covered, competencies discussed, key learning points, and agreed actions. Builds an ongoing record of professional development.

Log interoceptive exposure exercises that deliberately produce feared body sensations to break the link between sensations and catastrophic interpretations.

Identify and break the boom-bust pattern — doing too much on good days and crashing on bad days.

Track worries as they occur, classify them, practise postponing hypothetical worries to a designated worry period, and record outcomes.

Track daily routine stability — wake time, meals, activity, social contact, and bedtime — as routine disruption is a key trigger for mood episodes.

Challenge inflated responsibility beliefs that drive OCD by examining the appraisal and generating realistic alternatives.

Monitor and challenge the post-mortem rumination that follows social situations — a key maintenance factor in social anxiety.

Identify and challenge positive beliefs about worrying — the beliefs that keep you worrying because you think it helps.

Test how attention to the body creates and amplifies sensations — demonstrating that body scanning is part of the problem, not the solution.

Challenge catastrophic misinterpretations of body sensations by examining evidence and generating realistic alternatives.

Systematically evaluate and build on existing coping strategies for managing distressing psychotic experiences.

Plan a gradual, time-based increase in activity from a sustainable baseline — not guided by pain, but by a pre-set schedule.

Design, carry out, and reflect on behavioural experiments to test anxious predictions and unhelpful beliefs.

Track schema activations — when old patterns get triggered, what mode you went into, and what you could do differently.

A structured template for presenting a case formulation in supervision. Covers case overview, presenting problems, provisional formulation (4 Ps), treatment plan, and specific supervision questions.

Examine what determines your self-worth — and how much is dominated by eating, shape, and weight compared to other life domains.

Set and track your prescribed sleep window as part of sleep restriction therapy — with weekly adjustments based on sleep efficiency.

Trace a negative automatic thought down through underlying assumptions to the core belief using the "what would that mean?" technique.

Compare your mental image of yourself with photographic evidence to test whether the perceived flaw is as visible as you believe.

Identify the "hotspot" moments in a trauma memory — the moments of peak emotion — and work on updating their personal meaning.

Gather normalising evidence by surveying others about whether they experience the same body sensations and fears — challenging the belief that your experience is abnormal.

Compare the effects of self-focused attention vs external focus during social situations to test whether self-focus makes anxiety worse.

Identify and challenge negative beliefs about worry — the beliefs that worry is uncontrollable or dangerous.

Build a hierarchy of appearance-related situations you avoid, ranked by distress, to guide graded exposure.

Track body checking and body avoidance behaviours, their triggers, and function.

The core stimulus control rules for CBT-I — rebuilding the association between bed and sleep.

Review evidence for and against a core belief across different life periods — childhood, adolescence, and adulthood.

Weigh up the costs and benefits of specific health anxiety behaviours — checking, Googling, reassurance-seeking — to build motivation for change.

Identify and challenge stuck points — the unhelpful beliefs about the trauma and its aftermath that maintain PTSD symptoms.

Track your substance use day by day to identify patterns, triggers, and the relationship between mood and use.

Identify a core belief, rate its conviction, gather evidence for and against, and develop a more balanced alternative.

Identify and challenge positive beliefs about mania/hypomania that reduce motivation for relapse prevention — e.g. "I'm more creative when high."

Test the belief that thinking something makes it more likely to happen (likelihood TAF) or that thinking something is morally equivalent to doing it (moral TAF).

A structured reflective practice log based on the Gibbs Reflective Cycle. Guides supervisees through systematic reflection on a clinical experience — description, feelings, evaluation, analysis, conclusion, and action plan.

Explore what matters most to you across key life domains to guide goal-setting and behavioural activation.

A formulation based on Dugas' intolerance of uncertainty model — mapping IU, positive beliefs about worry, negative problem orientation, and cognitive avoidance.

Create a personalised plan for protecting sleep — the single most important modifiable risk factor for mood episodes in bipolar disorder.

Assess current sleep hygiene practices and identify areas for improvement.

Challenge contamination-specific appraisals by examining the realistic probability of harm, the role of disgust vs danger, and what "clean enough" means.

Identify rigid dietary rules and design experiments to test what happens when you break them.

Trace a problem behaviour back through the chain of vulnerability factors, events, thoughts, emotions, and actions that led to it — then identify intervention points.

Track changes in a specific social belief across multiple experiments — building cumulative evidence for an updated view of yourself in social situations.

Track gradual reduction in body checking behaviours — setting targets, monitoring frequency, and recording what happens when you check less.

A comprehensive plan for maintaining progress after therapy — covering warning signs, coping strategies, and an action plan for setbacks.

Track rumination episodes and analyse their triggers, content, function, and consequences — to understand why you ruminate and what alternatives might work.

A simplified motivational tool to explore your reasons for and against changing your substance use.

Create a plan for managing pain flare-ups — covering prevention, early action, and what to do at each level of severity.

Track PTSD symptoms across the four DSM-5 clusters — intrusion, avoidance, negative cognitions and mood, and arousal and reactivity — to monitor progress through treatment.

Track covert / mental compulsions — mental reviewing, counting, praying, reassuring self — which are often missed because they're invisible.

Track key belief conviction ratings before and after each therapy session to measure progress across treatment.

Identify and challenge dysfunctional beliefs about sleep that fuel insomnia-related anxiety and arousal.

Identify and challenge catastrophic thoughts about pain — helplessness, magnification, and rumination.

Track weekly weight to observe natural fluctuation and reduce the power of daily weighing.

Test the depressive prediction that "nothing will be enjoyable" by predicting pleasure before activities and comparing with actual experience.

Prepare for a visit to the trauma site, record predictions, and process the experience afterwards to update the trauma memory.

A cognitive formulation of substance misuse based on Beck et al.'s (1993) model. Maps the pathway from early experiences through beliefs and automatic thoughts to substance use and its maintaining cycle.

Weigh up the costs and benefits of maintaining a schema-driven coping pattern vs changing it.

Track Attention Training Technique (ATT) practice sessions with focus ratings and observations.

Track detached mindfulness practice — learning to observe thoughts and worries without engaging with or trying to control them.

Identify recurring patterns across relationships — mapping what triggers the pattern, what you expect, what you do, and the outcome.

Test specific predictions about the consequences of changes in shape, weight, or eating.

Write a letter to yourself from the perspective of a compassionate, wise observer — addressing your struggles with understanding rather than criticism.

Explore the difference between struggling against pain and accepting its presence while engaging in valued activities — a key shift in chronic pain management.

Identify valued activities lost to PTSD and plan a graded return to engagement with life.

Write a structured impact statement exploring how the trauma has affected your beliefs about safety, trust, power, esteem, and intimacy.

Explore clinical perfectionism as a maintaining mechanism — mapping the cycle and testing perfectionist rules.

Build a hierarchy of situations involving uncertainty, ranked by distress, to guide graded exposure to tolerating not knowing.

Explore how difficulty tolerating emotions drives eating disorder behaviours — and develop alternative ways to manage intense feelings.

Track applied relaxation practice through the stages: progressive muscle relaxation, release-only, cue-controlled, differential, and rapid relaxation.

Identify safety behaviours that maintain anxiety, understand their costs, and plan experiments to gradually drop them.

Track daily body image fluctuations alongside mood, context, and eating — to show that body image feelings change and are influenced by mood, not just body size.

Compare two explanations for your difficulties — the threat-based explanation (Theory A) and the anxiety-based explanation (Theory B) — to guide treatment focus.

Challenge inflated responsibility by listing all contributing factors to a negative event and assigning realistic percentages.

Weigh up the short-term and long-term advantages and disadvantages of a behaviour, belief, or decision.

Log exposure exercises with SUDS ratings, safety behaviours dropped, and key learning points.

Build a hierarchy of feared situations ranked by anxiety level, from least to most challenging, to guide graded exposure work.

Work through a structured problem-solving process: define the problem, brainstorm solutions, evaluate options, and create an action plan.

Collect evidence that contradicts a negative core belief and supports a more balanced alternative — building a new perspective over time.

Identify your personal early warning signs across thinking, mood, behaviour, and physical health, and create a stepped action plan for responding.

Identify your core values and assess how well your current activities align with them — then plan changes to close the gap.

Challenge all-or-nothing thinking by placing beliefs, qualities, or experiences on a continuum rather than in black-and-white categories.

Plan a paced approach to activity — balancing rest and engagement to avoid boom-bust cycles in chronic pain, CFS, or depression.

Prepare for and process an imagery rescripting session — recording the original image, its meaning, and the rescripted version.