4 Best Cognitive Therapy Techniques for Practitioners
CT is a short-term, solution-focused approach to changing maladaptive thoughts and behaviors. A variety of hands-on cognitive therapy techniques (some of which have already been discussed) are used depending on the client’s needs and therapy goals.
1. Exposure Therapy
Exposure therapy is an effective CT technique used for anxiety and phobias. It involves exposing the client to a person, place, situation, or object that creates the fear. The idea is to face fears in a safe environment and overcome negative emotions and reactions.
2. Thought recording
The creation of a thought journal is the cornerstone of CT. Clients capture, evaluate and restructure negative or anxious automatic thoughts. Our article What is a thought journal? provides more information and prompts to start a thought journal.
3. Role play
Roleplay is an effective CT technique. A therapist can help a client practice or experience a situation/event in a safe space by acting out the interaction.
For example, if a client is anxious about an upcoming interview, the therapist can act as a future employer and review questions and answers. With practice, experience, and reassuring feedback, client anxiety can lessen and confidence can increase.
4. Programming enjoyable activities
Activity planning And behavioral activation are methods of putting action before thoughts or motivation. Planning positive activities and doing them leads to more positive thoughts and feelings.
For example, scheduling a walk in the morning or a bath in the evening can provide energy in the morning and relaxation in the evening. Just as thoughts and emotions influence behavior, behavior can influence our thoughts and feelings.
4 exercises and games for your sessions
Using games and exercises in sessions allows for greater interaction during therapy and helps clients overcome their fears and challenge their own thoughts in a non-threatening way.
1. Thinking Games
As mentioned, challenging automatic thoughts is central to CT. It’s fun to make a game out of it to help individuals recognize and concretely challenge negative thoughts.
For example, use a small ball to play the game “Catch That Thought”. Toss the ball and ask the client to catch it, then identify and challenge a negative thought associated with a given situation. Once the thought has been identified, the client can offer a challenge to the thought and pass the buck.
2. Exhibition Games
Help clients deal with their fears and phobias in a safe and controlled environment.
For example, the game “Spider Phobia” consists of gradually exposing the individual to images of spiders either through a computer screen or with drawings. The images will become more realistic and the client will receive a prize or reward for being calm (low heartbeat, steady breathing) while viewing the images.
3. Three Cs Exercise: Catch, Check, Change
The Three Cs exercise asks the client to catch the thought, verify the thought, and then change the thought through verbal dialogue and writing the responses on paper.
4. Three columns exercise
The client will make three columns on a sheet of paper or spreadsheet. It is best to do this when the client feels the most anxious.
The first column is “automatic thinking” or negative self-talk (eg: I’m such a loser for ruining the presentation!).
Look for a cognitive distortion to label the thought in the second column (overgeneralizing, all-or-nothing thinking, making assumptions, catastrophic thinking, etc.).
In the third column, write a rational response or automatic thought replacement.
5 questions to ask your clients in therapy
Challenging faulty assumptions, cognitive distortions and automatic thoughts is a fundamental part of TC.
Here are some examples of these questioning methods:
- In order to refine your point of view to make it accurate, it is important to question it from time to time to determine if there are any reasons why it might not be true. What do you think is the strongest argument against this perspective?
- What would you need to learn or experience to change your mind about your current belief?
- What initially convinced you that your current thinking is correct?
- What three pieces of evidence contradict this thought or idea?
- Can you describe the specific benefits you receive from holding this belief or thinking this way?
Useful Worksheets and Assessment Methods
Worksheets and assessments can be very useful in cognitive therapy. They provide concrete guides to identify, understand and change thoughts, which is the premise of CT.
Ants are automatic negative thoughts. THE Identify ants The worksheet guides clients through identifying, writing, and challenging them. This exercise allows clients to do this daily, outside of sessions, to grasp the automatic thought and make changes before it leads to a negative emotional or behavioral response.
Having a repertoire of positive thoughts makes it easier to quickly replace negative thoughts. THE Alternative Positive Thoughts The worksheet guides clients to consider potential positives and have them handy when difficult situations or triggers arise in life.
Validated grading scale
THE Cognitive Therapy Rating Scale is a widely used and validated metric to assess the effectiveness of CT from the customer’s perspective. Clients and supervisors can use this scale to identify areas of weakness and potential growth areas and maximize every aspect of CT for optimal effectiveness.
Cognitive therapy books and apps for psychologists
The evidence-based nature and effectiveness of CT scanning has made it a popular subject for books and apps that can be helpful to both clinicians and their clients.
1. Feeling Good: The New Mood Therapy –David D. Burns
The book Feel good is based on the CBT principles created by Aaron Beck.
It provides practical guidelines for navigating difficult situations and reframing stressors by simply grasping and changing thoughts. It helps people with depression, anxiety, difficult relationships and low self-esteem to “feel good” every day.
Find the book at Amazon.
2. Cognitive therapy and emotional disorders – Aaron T. Beck
This book was created to help with a variety of emotional disorders.
It is based on the premise that mood disorders are caused by faulty assumptions about ourselves and the world. Recognizing this and changing thoughts and beliefs leads to better moods and more stable emotions.
Find the book at Amazon.
Recommended Apps
Clarity, a CBT Thought Diary App allows clients to track their moods, provides guided journals to reframe their thoughts, and offers quick assessments and videos related to CT concepts.
MoodKit is a mental health app in the iOS App Store that provides practical strategies for identifying and changing thoughts, moods, and behaviors. It highlights how changing thoughts and actions directly impact levels of anxiety and depression.
Resources from PositivePsychology.com
As mentioned earlier, exposure therapy is an excellent technique used in computed tomography. THE Imagery-Based Exposure The worksheet uses images to create a hierarchy of fear-based situations and helps clients imagine overcoming each stage. It can be an effective way to deal with fear and anxiety in a safe and secure setting.
Our automatic thoughts are usually false opinions rather than facts. THE Facts or opinions The worksheet provides examples of these automatic thoughts (or cognitive distortions) and asks the client to label each statement as true or false. It can provide a concrete look at how our thoughts are not reality.
The article CBT Techniques: 25 Cognitive Behavioral Therapy Worksheets provides more detailed and useful worksheets on CBT, which is a form of CT using the same principles and core beliefs.
If you’re looking for more scientific ways to help others through CBT, check out this collection of 17 Validated Positive CBT Tools for Practitioners. Use them to help others overcome unnecessary thoughts and feelings and develop more positive behaviors.
A take home message
Cognitive therapy is an evidence-based approach to treating a variety of mental health issues. It has been around for decades, and cognitive therapy techniques remain an effective way to improve mental, physical, and emotional well-being.
CT is based on the cognitive model, which connects our thoughts, behaviors, actions, and emotions. A fundamental principle behind CT is that a thought precedes a mood, and the two are interrelated with an individual’s environment, physical reaction, and subsequent behavior (Rupke et al., 2006).
Our minds are incredibly powerful and can determine the quality of our relationships, careers, health, and emotional state. Learning to use the mind in a positive way can ultimately improve all aspects of life.
We hope you enjoyed reading this article. For more information, don’t forget to download our three positive CBT exercises for free.