Cognitions (interpretations) regarding situations and events are a fundamental part of CBT and thought monitoring is an essential skill for clients to develop. Thought monitoring can be used to:
- Identify negative automatic thoughts (NATs), images, or memories
- Notice associations between events and cognitions
- Help clients understand the links between thoughts, emotions, and body sensations
- Begin to identify distortions / biases in their thinking
This Thought Distortion Monitoring Record is designed to help clients to better understand biases / distortions in their thinking which contributes to distress.
Clients should be instructed to record specific instances in which they noticed significant emotions, or significant changes in how they were feeling.
- In the first column (Situation) clients should be instructed to record what they were doing when they started to notice a significant change in how they were feeling. Training clients to record specific details (such as who they were with, where they were, and what had just happened) is often helpful when later elaborating a memory for an event, or simply in understanding the reasons for subsequent thoughts and responses
- In the second column (Automatic thoughts) clients should be directed to record any automatic cognitions. They should be reminded that cognitions can take the form of verbal thoughts, but can also take the form of images, or memories. If a recorded cognition is an image (e.g. “I had a picture in my mind of him smiling as he pushed in”) clients should be directed to question what that image means to them (e.g “It means he knows that he’s taking advantage, that he thinks I’m weak”) and to record that idiosyncratic meaning.
- In the third column (Emotions & body sensations) clients should be instructed to record their emotional and physiological reactions in that moment. Emotions can typically be described using single words (e.g. anxious, miserable, humiliated). Clients should be encouraged to rate the intensity of these sensations on 0–100% scale.
- In the fourth column (Unhelpful thinking styles) clients should be instructed to record whether their automatic thought could be categorised as belonging to any of the common cognitive biases including: all or nothing thinking, catastrophizing, over-generalizing, filtering, disqualifying the positive, jumping to conclusions, minimization, emotional reasoning, making demands, labelling, personalization, or low frustration tolerance.
- Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.
- Leahy, R. L. (1996). Cognitive therapy: Basic principles and applications. Jason Aronson, Incorporated.