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Cognitive Behaviour Therapy

Some of this information is taken form “Mind over Mood” by Greenberger and Padesky ISBN 0898621283

Cognitive means “Thought Processes” “Knowledge” and “Perception”
CBT believes in the link between your thoughts and beliefs and your mood and behaviour. The way you perceive an event will affect your emotional, behavioural and physiological responses to it.

CBT is proven to help people suffering from mood problems like depression, anxiety, anger, pain, jealousy, guilt and shame. CBT can also help with relationship problems, help you handle stressful situations, improve your self-esteem, become less fearful and more confident.

CBT uses a thought record sheet. The record sheet has 7 sections in which you work through your problem.

CBT tries to change the way one thinks from negative to positive. Words like MUST, SHOULD etc. are removed and replaced with “I would like to …………” This helps reduce the strength of the sentence.
E.g.
I must go and do some shopping.
I would like to go and do the shopping.

Imagine you are in a shopping queue, which thought is more helpful?

This will take a while; I might just as well relax.
This place is poorly managed. It’s not fair to have such a long queue.

With the second thought, you may well experience fidgeting, becoming tense, looking at your watch, grumbling to the assistant.

An example of a thought record would be:-

Situation	Mood	Automatic Thought	Evidence that supports the “Hot Thought”	Evidence that does not support the “Hot Thought”	Alternative / Balanced Thought	Rate your Moods Now
Sunday evening in the airplane on the runway waiting for the plane to take off	Fear 98%	I’m feeling sick My head is starting to beat harder and faster I’m starting to sweat I’m having a heart attack I’ll never be able to get off this plane and to a hospital in time I’m going to die	My head is racing I’m sweating These are two characteristics of a heart attack	A rapid heartbeat can be characteristic of anxiety My doctor told me the heart is a muscle, using a muscle is not dangerous and therefore a rapid heartbeat is not dangerous I have had this happen to me before in airports, on airplanes and when thinking about flying In the past my hear beat has returned to normal when I read a magazine, practiced deep breathing, did Thought Records or thought in non-catastrophic ways.	My heart is racing and I’m sweating because I’m anxious and nervous about being on an airplane 95% My doctors assured me that a rapid heartbeat is not necessarily dangerous and in all likelihood my hear will return to normal in just a few minutes 85%	Fear 25%

In order to use a Thought Record, it may help you if you answer as many of the questions below as you can using the thought record sheet.

Situation

Who were you with?
What were you doing?
When was it?
Where were you?

Mood

Describe each mood in one word
Rate each mood on a scale of 0 to 100% where 100% is highest

Automatic Thought

What was going through my mind just before I started to feel this way?
What does this say about me?
What does this mean about me? My life? My future?
What am I afraid might happen?
What is the worst thing that could happen if this is true?
What does this mean about how the other person(s) feel(s) think(s) about me?
What does this mean about the other person / people in general?
What images or memories do I have about this situation?

Think about each of the entries in automatic thought and circle the “Hot Thought” that’s the most powerful thought.

Evidence that supports the Hot Thought

What factual evidence is there to support this hot thought? (try not to mind read or interpret facts)

Evidence that does not support the Hot Thought

Have you and experiences that show that this thought is not completely true all the time?
If your best friend or someone you loved had this thought, what would you tell them?
If your best friend knew what you were thinking, what would their advice be? What evidence would they be able to prove this?
When you are not thinking this way do you think about this situation any differently? How?
When this thought(s) occurred in the past, what helped you to feel differently?
Have you been in this situation before? What happened? Is there anything different between how you felt then and how you feel today? What did you learn from the previous experience that might apply today?
Are there any small things that contradict your thoughts that you may be discounting as not important?
Five years from now, if you look back at this situation, will you look at it differently? Will you focus on any different part of your experience?
Are there any strengths or positives in you or the situation that you are ignoring?
Are you jumping to any conclusions in “Mood” and “Automatic Thought” columns that are not completely justified by the evidence?
Are you blaming yourself for something over which you do not have complete control?

Alternative / Balanced Thoughts

If someone you cared about was in this situation what would you say to them?
How would you suggest they understand the situation?
If the hot thought was true, what’s the worst that could happen? What is the best that could happen? What is the most realistic outcome?
Can someone you trust come up with another way of understanding the situation?
Write an alternative or balanced thought;
Rate how much you believe in each alternative or balanced thought on a scale of 0 to 100%

Rate your Mood Now

Copy the feelings you had in the Moods column and rate the intensity of each on a scale of 0 – 100%. Also note any new moods you are experiencing

LINK	Description
	Purchase the Mind over Mood Book ISBN: 0898621283 Published by: Guildford Press Author: Greenberger and Padesky

W H Smiths

www.rcpsych.ac.uk/mentalhealthinformation/therapies/cognitivebehaviouraltherapy.aspx will take you to the Royal College of Psychiatrists site where there is a section on CBT.

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