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CBT Questions

Cognitive-Behavioral Therapy (CBT) targets distressing emotions by intervening in unhelpful thoughts and behaviors. CBT assesses cognition by examining how clients perceive themselves, others, and the future. It assesses behaviors by examining events, thoughts, or emotions that trigger difficulties. The ABC model in CBT postulates that behaviors are determined by antecedents preceding them and consequences following them. Examining antecedents, behaviors, and consequences can provide insight into problematic patterns to help develop more balanced thinking and combat automatic thoughts.

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751 views3 pages

CBT Questions

Cognitive-Behavioral Therapy (CBT) targets distressing emotions by intervening in unhelpful thoughts and behaviors. CBT assesses cognition by examining how clients perceive themselves, others, and the future. It assesses behaviors by examining events, thoughts, or emotions that trigger difficulties. The ABC model in CBT postulates that behaviors are determined by antecedents preceding them and consequences following them. Examining antecedents, behaviors, and consequences can provide insight into problematic patterns to help develop more balanced thinking and combat automatic thoughts.

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denfan
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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The basic premise of 

Cognitive-Behavioral Therapy (CBT) is that because emotions


are difficult to change directly, CBT targets emotions by intervening in thoughts and
behaviors that are contributing to the distressing emotions (Chambless & Ollendick,
2001; DeRubeis & Crits-Christoph, 1998).

Assessing cognition within the CBT model comes down to helping the client examine
their thoughts by asking questions related to how the client perceives themself,
others, and the future.

For example, when a client describes themself as incapable or a burden and


generally perceive others to be critical or hard to please, their view of the future
might be mostly pessimistic and contain beliefs that the future will only hold more
losses and disappointments.

Assessing behaviors and precipitating situations within the CBT model is about
examining the events, behaviors, thoughts, or emotions that activate, trigger, or
compound patient difficulties (Chambless & Ollendick, 2001; DeRubeis & Crits-
Christoph, 1998).

At the end of the day, the questions we ask of ourselves determine the type of people
that we will become.

Leo Babauta

One helpful approach to examining behavior and symptoms is to address them in a


broader context. The antecedents, behavior, consequences (ABC) model postulates
that behaviors are primarily determined by antecedents or events that precede
behavior, thoughts, or mood, and consequences or events that follow them.

The ABC model can be used as a functional assessment where behavior is shaped by
antecedents and followed by consequences (Ellis & MacLaren, 1998).

The antecedent occurs before a behavior and may be a trigger for a particular
reaction in the patient and can both increase and decrease a particular behavior.
Antecedents, or events that occur before a behavior, typically elicit emotional and
physiological responses.

Antecedents may be affective (an emotion), somatic (a physiological response),


behavioral (an act), or cognitive (a thought). They are also subject to contextual
factors (situational) and relational (interpersonal) factors.
For example, a patient who reports being depressed (behavior) may feel bad when
they are alone at home late at night (contextual antecedent) or better when they are
around family (relational antecedent). Consequently, they may feel even more
dejected by thinking that they will always be alone (cognitive antecedent) (Ellis, &
MacLaren, 1998).

Below are some questions to help examine antecedents to a particular behavior:

 What were you feeling right before you did that? (Affective)
 What happens to you physically before this happens? Do you feel sick?
(Somatic)
 How do you normally act right before this happens? (Behavioral)
 What thoughts go through your mind before this happens? (Cognitive)
 Where and when does this usually happen? (Contextual)
 Do you do this with everyone, or just when you are around certain people?
(Relational)

Behavior is any activity, including thoughts or feelings, that the patient exhibits in
response to an antecedent. The questions below help examine a particular behavior:

 How do you feel immediately after this occurs? (Affective)


 Do you have any bodily sensations after this happens, like trembling?
(Somatic)
 How do you react after this behavior occurs? (Behavioral)
 What do you think about after this happens? (Cognitive)
 Are you in a different place when this behavior ends? (Contextual)
 Are there any people who make this behavior worse? Make it better?
(Relational)

Consequences are events that occur after the behavior and direct the patient to
either continue or discontinue the behavior. Two kinds of consequences are
examined in a functional assessment: short-term and long-term consequences. The
questions below help explore the consequences of a particular behavior:

 Does this behavior get your attention in some way?


 What good things happen as a result of this behavior?
 Does this help you in some way?
 Do you feel a certain rush from doing this?
 Does this behavior help you avoid something you don’t want to do?
The goal of Cognitive-Behavioral Therapy is to help the client develop more balanced
thinking about the situation and combat their automatic thoughts and reactions. The
questions below can help the client challenge automatic thoughts:

 What evidence is there that this thought is true?


 What evidence is there that this thought is not true?
 What would I tell someone I loved if they were in this situation and had these
thoughts?
 If my automatic thought is true, what is the worst that could happen?
 If my automatic thought is true, what is the best thing that could happen?

Once the evidence has been generated, we want to combine it to form a more
balanced thought. This thought will likely be much longer and more nuanced than
the original emotionally charged thought. The questions below can help the client
create a more balanced thought:

 What is a more balanced view that more accurately reflects the facts?
 Is there an alternative way of thinking about the situation?
 Can someone I trust understand this situation in a different way?

In the final step, ask the client to rate the believability of the alternative thought on a
scale of 0–100. If the thought is not more than 50 believable, more work is needed to
identify an alternative view. Go back to the evidence and keep working.

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