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 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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

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

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.

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

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

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.

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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.

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

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

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

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

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

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.

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

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

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

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).

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

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.

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

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

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.

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

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

Assess current sleep hygiene practices and identify areas for improvement.

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

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

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.

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

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

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.

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.