Cognitive Behavioral Therapy, or CBT, is one of the most prevalent and promising treatments for anxiety, stress, depression and other mental health issues. It is very helpful in changing negative self-talk and improving confidence. It is the gold-standard of treatment for changing negative thinking patterns that fuel “issues” such as anxiety, stress, and depression. We offer CBT therapy in Kelowna, BC and online therapy throughout British Columbia.

The premise of CBT is that our thoughts (cognitive) influence how we feel, which influence what we do, or do not do (behaviour).

Our thoughts influence how we feel, which influence how we act.

It’s not necessarily the situation, it’s our perspective on the situation.

When we work together, we go through a personalized example of your Situation, Thoughts, Feelings, and Behaviours.

Examples of How CBT and Counselling Can Help

I love to use personalized resources, worksheets, practical exercises, and books, podcasts, websites, and apps for clients to own & hone their skill in this.

One of the most popular CBT resources and exercises is called a CBT Thought Record. We do this together, and you have a tangible takeaway to do outside of session (where you live the majority of your life!), to be educated, equipped, and empowered. Take a look below to see what a CBT Thought Record is and how it can help you!

A CBT Thought Record is an effective exercise to help clients identify, challenge, and reframe unhelpful or distorted thoughts. This tool is particularly useful for clients dealing with anxiety, depression, or self-criticism, as it promotes self-awareness and empowers them to respond more constructively to their thoughts.

CBT Thought Record Exercise

Purpose

This exercise helps clients examine the relationship between their thoughts, emotions, and behaviors. By analyzing automatic thoughts, clients can identify patterns, challenge distortions, and develop balanced perspectives.

CBT Thought Record

1. Identify the Situation

• Ask the client to think of a recent situation where they experienced a strong emotional response. This could be a moment that led to anxiety, sadness, frustration, or self-criticism.
• Prompt: “Think of a recent time when you felt overwhelmed, anxious, or upset. What was happening at the time?”

2. Describe Emotions

• Have the client identify and rate their emotions on a scale of 0–10 in terms of intensity.
• Questions:
  • “What specific emotions did you feel in that moment?”
  • “On a scale of 0–10, how intense was each emotion?”
• Example: “I felt anxious (8/10), sad (6/10), and frustrated (7/10).”

3. Identify Automatic Thoughts

• Encourage the client to reflect on the automatic thoughts that arose in response to the situation.
• Questions:
  • “What was going through your mind at the time?”
  • “Were there any specific phrases or images that stood out?”
• Remind them that these thoughts might be self-critical, worry-based, or negative in nature.
• Example: “I thought, ‘I’m going to fail,’ ‘I can’t handle this,’ or ‘I’m not good enough.’”

4. Identify Thinking Patterns or Cognitive Distortions

• Explain cognitive distortions (such as catastrophizing, black-and-white thinking, or mind-reading) and ask the client to identify any distortions in their thoughts.
• Common Cognitive Distortions:
  • Catastrophizing: Assuming the worst possible outcome.
  • All-or-Nothing Thinking: Seeing things in black-and-white terms, with no middle ground.
  • Mind Reading: Assuming you know what others are thinking about you.
• Example: “I’m catastrophizing by assuming I’ll fail completely and that I can’t handle this.”

5. Challenge the Thoughts

• Guide the client in examining the evidence for and against their automatic thoughts.
• Questions:
  • “What evidence supports this thought?”
  • “What evidence contradicts this thought?”
  • “If a friend had this thought, what would you tell them?”
• Encourage the client to consider more balanced, realistic alternatives.
• Example: Evidence against “I’m going to fail” could include “I’ve succeeded in similar situations before” or “I’ve prepared for this and have resources for support.”

6. Reframe with a Balanced Thought

• Help the client reframe their initial thought into a more balanced, compassionate perspective.
• Prompt: “What’s a more realistic or constructive way to look at this situation?”
• Example: Instead of “I’m going to fail,” they might reframe to “This is challenging, but I’ve handled similar things before and can take it one step at a time.”

7. Re-rate Emotions

• After reframing their thoughts, ask the client to re-rate their initial emotions to see if the intensity has changed.
• Prompt: “Now that you’ve considered a more balanced perspective, how intense do those emotions feel now?”
• Example: The client may find their anxiety has reduced from an 8/10 to a 4/10.

Example CBT Thought Record Template

Example Summary for Client

“This thought record exercise can help you gain a more balanced perspective when you feel overwhelmed by automatic negative thoughts. By recognizing and challenging these thoughts, you can reduce the intensity of your emotions and approach situations with greater clarity and self-compassion. Remember, it’s okay to revisit this process whenever you notice patterns of unhelpful thinking.”

Encourage clients to practice this exercise whenever they feel emotionally overwhelmed or stuck in negative thought patterns. Regular use of a CBT Thought Record can increase resilience and create healthier thought habits over time.

CBT is helpful in shifting irrational, negative self-talk to more realistic thinking.

Changing our Negative Self-Talk to more Realistic Thinking

Our thoughts really can impact the way we feel. If you are telling yourself:

“YOU ARE NOT GOOD ENOUGH, OR NOT AS ‘SMART/PRETTY/INTERESTING’ AS ‘SO-AND-SO’ OR ‘YOU SHOULD BE DOING MORE’

You probably are not going to feel your best, or perform your best in your sport, work, relationships, or overall life.

“Changing our unhelpful thoughts to realistic or helpful ones is a key to feeling better. “Realistic thinking” means looking at yourself, others, and the world in a balanced and fair way, without being overly negative or positive. For example:”

One of my favourite CBT resources for anxiety is the website Anxiety Canada and the free app Mindshift. Check out more about what exactly is cognitive behavioral therapy (CBT) and how it can help you and your anxiety ! I hope you find it helpful for you or someone you care about 🙂

What is Cognitive Behavioural Therapy (CBT)?

Why is Cognitive Behavioural Therapy considered the “gold standard” in anxiety treatment?

Cognitive Behavioural Therapy (CBT) is an evidence-based psychological treatment that was developed through decades of scientific research.

Research shows that CBT is the most effective psychological treatment for managing anxiety. It is also an effective treatment for depression, chronic pain, disordered eating, anger issues, addiction, and low self-esteem.

CBT Focuses on the Present

An important principle of CBT is that treatment involves dealing with the symptoms that you face in the present, rather than focusing on the cause of your problem. Although it can be interesting to understand how your anxiety developed, just knowing why you have anxiety is often not enough to help you manage it. CBT:

…gives you a new way of understanding and thinking about your problem.

…provides you with the skills to deal with the issues that you are struggling with right now.

… is often a short-term treatment option and is offered in both individual and group settings.

… can be done with a trained CBT therapist, in a group setting, or you can practice it on your own.

Read on to learn more.

#OurAnxietyStories – The Anxiety Canada Podcast features several anxiety stories involving CBT. In this episode of #OurAnxietyStories, CBC’s Tom Power shares his journey with anxiety—something he didn’t realize he struggled with until his adult years.

Tom recalls being in his mid-twenties at a social gathering and thinking he was having a heart attack, only to learn it was a panic attack when he sought medical attention.

In this episode, Tom reflects on several instances of anxiety in his life, including at the dentist and the grocery store, and while interviewing Academy Award-winning director Guillermo del Toro.

Through exposure therapy, Tom learned that panic attacks only last so long and he can get through them—an invaluable lesson that has helped him until this day.

Anxiety is still present in Tom’s life, but he shares that CBT and meditation have helped him manage it.

LISTEN NOW

Why is CBT effective?

CBT focuses on the way people think (“cognitive”) and act (“behavioural”). CBT suggests that our thoughts about a situation affect how we feel (emotionally and physically) and how we behave in that situation. By identifying these unhelpful thoughts initially through the principles of CBT, we are able to stop them in their tracks.

As human beings, we naturally give meaning to events that are happening around us. However, we often don’t realize that two people can give two very different meanings to the same event. The meanings we assign to the situation affect how we feel and act rather than the situation itself, and these meanings are not always accurate, realistic, or helpful.

Unhelpful thoughts lead to unpleasant emotions and unhelpful behaviours (e.g., avoidance) that reinforce our negative thoughts and maintain the problem. In other words, our thoughts, feelings and behaviours can interact and influence each other to create a vicious cycle.

We all have negative thoughts every now and then, but if we consistently apply negative meanings to events, then we are likely to experience problems with anxiety or depression. CBT can help us break out of the vicious cycle.

Exposure therapy (see Facing Your Fears – Exposure) and balanced thinking are vital tools in your CBT toolkit. Learning to take a closer look at your thoughts and coming up with more balanced and realistic thoughts is an important step in managing anxiety (see Helpful Thinking for more information).

Key Aspects of CBT:

Cognitive Behavioral Therapy (CBT) is a widely used therapeutic approach that focuses on the relationship between thoughts, feelings, and behaviors. It is based on the idea that our thoughts and beliefs influence our emotions and behaviors, and that changing maladaptive thought patterns can lead to changes in emotional well-being and behavior.

Key principles of CBT include:

1. Cognitive Restructuring: This involves identifying and challenging negative thought patterns or cognitive distortions. Clients learn to recognize and reframe irrational or negative thoughts, replacing them with more realistic and positive ones.
2. Behavioral Techniques: CBT also emphasizes the role of behavior in influencing emotions. Clients work on changing specific behaviors that may be contributing to their difficulties. This involves setting goals, developing coping strategies, and gradually exposing oneself to feared or avoided situations.
3. Homework and Skill Building: Clients often engage in homework assignments between therapy sessions to practice and reinforce the skills learned in therapy. This helps to generalize the skills to real-life situations.
4. Goal-Oriented and Time-Limited: CBT is typically a short-term, goal-oriented therapy. Clients and therapists collaborate to identify specific, measurable goals and work towards achieving them within a defined timeframe.
5. Collaborative Relationship: The therapist and client work together as a team, with the therapist providing support, guidance, and teaching practical skills. The client is an active participant in the therapeutic process.

CBT has been shown to be effective for a variety of mental health conditions, including anxiety disorders, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and many others. It is a structured and practical approach that is often used in individual or group therapy settings.