Cognitive Behavioral Therapy: Thought Journaling

Cognitive Behavioral Therapy: Thought Journaling

Cognitive Behavioral Therapy or CBT is a widely used approach with many disorders including depression and anxiety. It is one of the most empirically validated depression treatments in existence currently. Many insurance companies and even clients seek out practitioners who offer Cognitive Behavioral Therapy and related interventions. Many continuing education courses offer Cognitive Behavioral training for clinicians.

There are many proven effective cognitive behavioral treatment strategies including thought journaling. This is a technique which allows the person to examine their distorted thoughts or cognitions with opposing facts and evidence. Once this is accomplished, the client may then replace their negative false automatic thought with a more realistic thought. This often results in an improved emotional state.

Before asking the client to complete a journal, it may be helpful to explain in a session the concepts and benefits of doing one. Then, assist the client in understanding the thought journaling process including step by step instructions. Ask the client for an example of a recent situation and resulting negative automatic thought they have experienced. Then discuss the emotion experienced as a result of the automatic thought. Assist the client with brainstorming about evidence contrary to their negative automatic thought. Guide the client in establishing a new, more realistic thought and discuss the new resulting emotion. The emotion itself may remain the same as earlier but with a decreased intensity.

Once you have successfully assisted the client in formulating an example, assign homework for the client to complete. For example, you may ask the client to purchase or locate a journal specifically designated for thought journaling and ask them to complete at least two thought journal entrees throughout the next week. The following includes an example of thought journal entry prompts:


Automatic Negative Thought:

Resulting Emotion:

Evidence Against Automatic Negative Thought:

Revised Thought:

New Emotion:

Provide the client with these prompts in order to assist and guide them through the homework assignment. Keep in mind that there are many versions of a thought journal and associated prompts. For example, some versions and prompts include that the client rate their emotional intensity on a 1-10 scale. These versions may be easily located in reference books or even via online continuing education for social workers and/or counselors.