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Cognitive Behavioural Therapy Worksheets and Exercises

The following Cognitive Behavioural Therapy – CBT worksheets and exercises can be downloaded free of charge for use by individuals undertaking NHS therapy or by NHS practitioners providing CBT in primary or secondary care settings. These worksheets form part of the Think CBT Workbook, which can also be downloaded as a static PDF at the bottom of this page. Please share or link back to our page to help promote access to our free CBT resources. 

The Think CBT workbook and worksheets are also available as an interactive/dynamic document that can be completed using mobile devices, tablets and computers. The interactive version of the workbook can be purchased for single use only for £25. All Think CBT clients receive a free interactive/dynamic copy of the workbook and worksheets free of charge.

Whilst these worksheets can be used to support self-help or work with other therapists, Cognitive Behavioural Therapy is best delivered with the support of a BABCP accredited CBT specialist. If you want to book an appointment with a professionally accredited CBT expert, call (01732) 808626, complete the simple contact form on the right side of this page or email [email protected]  

Please note: if you are a private business or practitioner and wish to use our resources, please email [email protected]  to purchase a registered copy. This material is protected by UK copyright law. Please respect copyright ownership.

Exercise 1 - Problem Statements

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Exercise 2 - Goals for Therapy

Exercise 3 - personal strengths / resources, exercise 4 - costs / benefits of change, exercise 5 - personal values, exercise 6 - the cbt junction model, exercise 7 - the cross-sectional cbt model, exercise 8 - the longitudinal assessment, exercise 9 - layers of cognition, exercise 10 - cognitive distortions, exercise 11 - theory a-b exercise, exercise 12 - the cbt thought record, exercise 13 - cognitive disputation "putting your thoughts on trial", exercise 14 - the cbt continuum, exercise 15 - the self-perception continuum, exercise 16 - the cbt responsibility pie chart, exercise 17 - noticing the thought, exercise 18 - four layers of abstraction, exercise 19 - semantic satiation, exercise 20 - the characterisation game, exercise 21 - speed up / slow down, exercise 22 - word translation, exercise 23 - the time-traveller's log, exercise 23a -the time-traveller's log continued, exercise 24 - leaves on a stream, exercise 25 - the traffic, exercise 26 - clouds in the sky, exercise 27 - taming the ape - an anchoring exercise, exercise 28 - the abc form in functional analysis, exercise 29 - pace activity exercise, exercise 30 - graded hierachy of anxiety provoking situations, exercise 31 - the behavioural experiment, exercise 32 - act exposures exercise, exercise 33 - worry - thinking time, exercise 34 - submissive, assertive & aggressive communication, exercise 35 - sleep hygiene factors, exercises 36 - 38.

(Abdominal Breathing, Aware Breathing & The Five-Minute Daily Recharge Practice)

Exercise 39 - Wheel of Emotions

Exercise 40 - linking feelings and appraisals, exercise 41 - personal resilience plan, exercise 42 - cbt learning log, act with choice exercise, angels and devils worksheet, transdiagnostic model of ocd worksheet, tuning in exercise, penguin-based therapy (pbt), big picture exercise, post-therapy journal, catch it-check it-change it exercise.

A brief cognitive change exercise for identifying and altering negative thinking

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Download The Think CBT Workbook Here

To get a free copy of the 90 page Think CBT Workbook and Skills Primer, click on the download button and save the PDF document to your personal drive or device. The free version of the Think CBT Workbook is presented as a static PDF, so that you can read the document on your device and print worksheets to complete by hand.

In return for a free copy of the workbook, please help us to promote best practice in CBT by sharing this page or linking back to your website or social media profile.

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CBT Worksheets, Handouts, And Skills-Development Audio: Therapy Resources for Mental Health Professionals

Resource type

Therapy tool.

"Should" Statements

Information handouts.

A Guide To Emotions (Psychology Tools For Living Well)

Books & Chapters

A Memory Of Caring For Others

A Memory Of Feeling Cared For

Abandonment

Activity Diary (Hourly Time Intervals)

Activity Diary (No Time Intervals)

Activity Menu

Activity Planning

Activity Selection

All-Or-Nothing Thinking

Alternative Action Formulation

Am I Experiencing Anorexia?

Am I Experiencing Body Dysmorphic Disorder (BDD)?

Am I Experiencing Bulimia?

Am I Experiencing Burnout?

Am I Experiencing Death Anxiety?

Am I Experiencing Depersonalization And Derealization?

Am I Experiencing Depression?

Am I Experiencing Generalized Anxiety Disorder (GAD)?

Am I Experiencing Health Anxiety?

Am I Experiencing Low Self-Esteem?

Am I Experiencing Obsessive Compulsive Disorder (OCD)?

Am I Experiencing Panic Attacks?

Am I Experiencing Panic Disorder?

Am I Experiencing Perfectionism?

Am I Experiencing Post-Traumatic Stress Disorder (PTSD)?

Am I Experiencing Psychosis?

Am I Experiencing Social Anxiety?

An Introduction To CBT (Psychology Tools For Living Well)

Anger - Self-Monitoring Record

Anger Decision Sheet

Anger Diary (Archived)

Anger Self-Monitoring Record (Archived)

Anger Thought Challenging Record

Anxiety - Self-Monitoring Record

Anxiety Self-Monitoring Record (Archived)

Approach Instead Of Avoiding (Psychology Tools For Overcoming Panic)

Approval-/Admiration-Seeking

Arbitrary Inference

Assertive Communication

Assertive Responses

Attention - Self-Monitoring Record

Attention Training Experiment

Attention Training Practice Record

Audio Collection: Psychology Tools For Developing Self-Compassion

Audio Collection: Psychology Tools For Mindfulness

Audio Collection: Psychology Tools For Overcoming PTSD

Audio Collection: Psychology Tools For Relaxation

Autonomic Nervous System

Avoidance Hierarchy (Archived)

Barriers Abusers Overcome In Order To Abuse

Before I Blame Myself And Feel Guilty

Behavioral Activation Activity Diary

Behavioral Activation Activity Planning Diary

Behavioral Experiment

Behavioral Experiment (Portrait Format)

Behaviors In Panic (Psychology Tools For Overcoming Panic)

Being A Compassionate Person

Being With Difficulty (Audio)

Belief Driven Formulation

Belief-O-Meter (CYP)

Body Posture

Body Scan (Audio)

Body Sensations In Panic (Psychology Tools For Overcoming Panic)

Boundaries - Self-Monitoring Record

Breathing To Activate Your Soothing System

Breathing To Calm The Body Sensations Of Panic (Psychology Tools For Overcoming Panic)

Broadening Your Perspective

Catastrophizing

Catching Your Thoughts (CYP)

CBT Appraisal Model

CBT Daily Activity Diary With Enjoyment And Mastery Ratings

CBT Thought Record Portrait

CFT Calm Place

Challenging Your Negative Thinking (Archived)

Changing Avoidance (Behavioral Activation)

Checking Certainty And Doubt

Checklist For Better Sleep

Classical Conditioning

Coercive Methods For Enforcing Compliance

Cognitive Behavioral Model Of Anorexia Nervosa (Fairburn, Cooper, Shafran, 2003)

Cognitive Behavioral Model Of Body Dysmorphic Disorder (BDD: Veale, 2004)

Cognitive Behavioral Model Of Bulimia Nervosa (Fairburn, Cooper, Shafran, 2003)

Cognitive Behavioral Model Of Clinical Perfectionism (Shafran, Cooper, Fairburn, 2002)

Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)

Cognitive Behavioral Model Of Fear Of Body Sensations

Cognitive Behavioral Model Of Generalized Anxiety Disorder (GAD: Dugas, Gagnon, Ladouceur, Freeston, 1998)

Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Cognitive Behavioral Model Of Insomnia (Harvey, 2002)

Cognitive Behavioral Model Of Intolerance Of Uncertainty And Generalized Anxiety Disorder Symptoms (Hebert, Dugas, 2019)

Cognitive Behavioral Model Of Panic (Clark, 1986)

Cognitive Behavioral Model Of Persistent Postural-Perceptual Dizziness (PPPD: Whalley, Cane, 2017)

Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)

Cognitive Behavioral Model Of Social Phobia (Clark, Wells, 1995)

Cognitive Behavioral Model Of The Relapse Process (Marlatt & Gordon, 1985)

Cognitive Behavioral Model Of Tinnitus (McKenna, Handscombe, Hoare, Hall, 2014)

Cognitive Behavioral Treatment Of Childhood OCD: It's Only A False Alarm: Therapist Guide

Treatments That Work™

What is Psychology Tools?

Psychology Tools develops and publishes evidence-based psychotherapy resources and tools for mental health professionals. Our online library gives you access to everything you need to deliver more effective therapy and support your practice. With a wide range of topics and resource types covered, you can feel confident knowing you’ll always have a range of accessible and effective materials to support your clients, whatever challenges they are facing, whatever stage you are at, and however you work.

Choose from assessment and case formulations to psychoeducation, interventions and skills development, CBT worksheets, exercises, and much more. Our resources include detailed therapist guidance, references and instructions, so they are equally suitable for those with less experience but who want to expand their practice. Each resource explains how to work with the material most effectively, and how to use it with clients.

Are these resources suitable for you?

Psychology Tools is used by thousands of professionals all over the world as a key part of their practice and preparation, and our resources are designed to be used with clients who experience psychological difficulties or distress. Professionals who use our resources include:

• Clinical, Counseling, and Practitioner Psychologists
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Psychology Tools resources are perfect for individuals, teams and students, whatever their preferred modality, or career stage.

What kinds of resources are available at Psychology Tools?

Psychology Tools offers a range of relatable, engaging, and evidence-based resources to ensure that your clients get the most out of therapy or counseling. Each resource has been carefully designed with accessibility in mind and is informed by best practice guidelines and the latest scientific research.

Therapeutic exercises are used in many evidence-based psychotherapies including cognitive behavioral therapy, rational emotive behavior therapy, compassion-focused therapy, schema therapy, emotion-focused therapy, systemic family-based therapies, and several others.

Therapists and counselors benefit from incorporating exercises into their work. They can be used to:

• Introduce and explain key concepts.
• Collect information about clients’ difficulties.
• Bring therapeutic ideas to life.
• Keep therapy active and engaging.
• Alleviate distress and/or reduce problematic symptoms.
• Practice new skills and coping strategies.
• Develop new insights and self-awareness.
• Give clients a sense of accomplishment and progress.

Psychology Tools offers a variety of exercises that you can use with your clients as a part of therapy or counseling. These interventions can be incorporated into your sessions, assigned as homework tasks, or used stand-alone interventions. Many of our exercises are either evidence-based (meaning they have been shown to effectively treat certain difficulties) or evidence-derived (meaning they form part of a treatment program that has been shown to effectively treat certain difficulties).

The exercises available at Psychology Tools have a variety of applications. You can use them to:

• Develop case conceptualizations , formulations, and treatment plans.
• Address specific difficulties, such as worry, insomnia, and self-focused attention.
• Introduce clients to new skills, such as grounding , problem-solving, relaxation, and assertiveness .
• Support key interventions, such as exposure and response prevention, safety planning with high-risk clients, and perspective-taking.
• Plan treatments and prepare for supervision.

Psychology Tools exercises have been developed with practicality and convenience in mind. Most exercises include simple step-by-step instructions so that clients can use them independently or with the support of their therapist or counselor. In addition, therapist guidance is available for each exercise, which includes a detailed description of the task, relevant background information, an overview of its aims and potential uses in therapy, and simple instructions for its delivery. A comprehensive list of references is also provided so that you can access key studies and further your understanding of each exercise’s applications in psychotherapy.

Did you know that 40 – 80% of medical information is immediately forgotten by patients (Kessels, 2003)? The same is probably true of therapy and counseling, so clients will almost always benefit from having access to additional written information.

Psychology Tools information handouts provide clear, concise, and reliable information, which will empower your clients to take an active role in their treatment. Learning about their mental health, helpful strategies and techniques, and other psychoeducation topics helps clients better understand and overcome their difficulties. Moreover, clients who understand the process and content of therapy are more likely to invest in the process and commit to making positive changes.

Psychology Tools information handouts can help your clients:

• Understand their difficulties and what keeps them going.
• Learn what therapy is and how it works.
• Understand what they are doing in therapy and why.
• Remember and build upon what has been discussed during sessions.
• Create a personalized collection of resources that can used between appointments.

Our illustrated information handouts cover a wide variety topics. Each has been informed by scientific evidence, best practice guidelines, and expert opinion, ensuring they are both credible and consistent with evidence-based therapies. Topics featured among these resources include:

• ‘ What is… ’ handouts. These one-page resources provide a concise summary of common mental health problems (e.g., anxiety , depression , low self-esteem ), key therapeutic approaches (such as cognitive behavioral therapy, eye movement desensitisation and reprocessing , and compassion-focused therapy), and psychological mechanisms which maintain the problem (such as worry and rumination ).
• ‘ What keeps it going… ’ handouts. These handouts explain the key mechanisms that maintain difficulties such as burnout, panic disorder, PTSD, and perfectionism. You can use them to inform your case conceptualization or as a roadmap in therapy.
• ‘ Recognizing… ’ handouts. These guides can help you identify and assess specific disorders, comparing key diagnostic criteria taken from leading diagnostic manuals.
• Simple explanations of key psychological concepts, such as safety behaviors , psychological flexibility, thought suppression, and unhelpful thinking styles .
• Overviews of important psychological theories, such as operant conditioning and exposure.

Each information handout comes with guidance written specifically for therapists and counselors. It provides suggestions for introducing psychoeducation topics, facilitating helpful discussions related to the handout, and ensuring the content is relevant to your clients.

Worksheets are a core ingredient of many evidence-based therapies such as CBT. Our worksheets take many forms (e.g., diaries, diagrams, activity planners, records, and questionnaires) and can be used throughout the course of therapy.

How you incorporate worksheets into therapy or counselling depends on each client’s difficulties, goals, and stage of recovery. You can use them to:

• Assess and monitor clients’ difficulties.
• Inform treatment plans and guide decision-making.
• Teach clients new skills such as ‘self-monitoring’ or ‘thought challenging’.
• Ensure that clients apply their learning in the real world.
• Track their progress over time.
• Help clients to take an active role in their recovery.

Clients also benefit from using worksheets. These tools can help them:

• Become more aware of their difficulties.
• Identify when, how, and why these problems occur.
• Practice using new skills and techniques.
• Express and explore difficult feelings.
• Process difficult events.
• Consolidate and integrate insights from therapy.
• Support their self-reflection.
• Feel empowered and build self-efficacy.

Psychology Tools offers a wide variety of worksheets. They include general forms that are widely applicable, disorder-specific worksheets, and logs that are used in specific therapies such as CBT , schema therapy, and compassion-focused therapy . These resources are typically available in editable or fillable formats, so that they can be tailored to your client’s needs and used in a flexible manner.

Guides & self-help

People want clear guidance on mental health, whether for themselves or a loved one.

Our ‘ Understanding… ’ series is designed to introduce common mental health difficulties such as depression, PTSD, or social anxiety. Each of these guides uses a clear and accessible structure so that readers can understand them without any prior therapy knowledge. Topics addressed in each guide include:

• What the problem is.
• How it arises.
• Where it might come from.
• What keeps it going.
• How the problem can be treated.

Other guides address important topics such as trauma and dissociation, or the effects of perfectionism. They usually contain a mixture of psychoeducation, practical exercises and skills development. They promote knowledge, optimism, and positive action related to these difficulties, and have been informed by current research and evidence-based treatments, ensuring they are consistent with best practices.

Therapists can use Psychology Tools guides in several ways:

• As a screening tool. Clients can read the guide to see if the difficulty or topic is relevant to them.
• As psychoeducation. Each guide provides essential information related to the difficulty or topic so that client can develop a better understanding of it.
• As self-help. Each guide describes key skills and techniques that can be used to overcome the difficulty.

Each guide contains informative illustrations, practical examples, and simple instructions so that clients can easily relate to the content and apply it to their difficulties.

Therapy audio

Audio exercises are a particularly convenient and engaging way help your clients and can add variety to your therapeutic toolkit. Psychology Tools audio resources can help your clients:

• Augment and consolidate their learning in therapy.
• Practice new techniques.
• Integrate skills and practices into their daily lives.
• Access additional support when they need it.
• Create a sense a continuity between your meetings.

A variety of audio resources are available at Psychology Tools. Each one has been developed and recorded by highly experienced clinical psychologists and can be easily integrated into your therapeutic practice. Audio collections include:

• Psychology Tools for Developing Self-Compassion
• Psychology Tools for Relaxation
• Psychology Tools for Mindfulness
• Psychology Tools for Overcoming PTSD

Many of these audio resources are widely applicable (e.g., mindfulness-based tools), although problem-specific resources are also available (e.g., tools for overcoming PTSD). You can use these tools:

• During your therapy sessions.
• As a homework task for clients to complete.
• As a stand-alone intervention or ongoing part of therapy.

Treatments That Work®

Authored by leading psychologists including David Barlow, Michelle Craske, and Edna Foa,  Treatments That Work ® is a series of workbooks based on the principles of cognitive behavioral therapy (CBT). Each pair of books in the series – therapist guide and workbook – contains step by step procedures for delivering evidence-based psychological interventions. Clinical illustrations and worksheets are provided throughout.

You can use these workbooks:

• To plan treatment for a range of specific difficulties including depression, obsessive compulsive disorder (OCD), social anxiety, and substance use.
• As a self-help intervention that you guide the client through during sessions.
• As a supplement to therapy, which clients work through independently.
• To consolidate the content of your sessions.
• As an ongoing intervention at the end of treatment (e.g., for difficulties that haven’t been fully addressed).

Each book is available to download chapter-by-chapter, and Psychology Tools members with a currently active subscription to our ‘Complete’ plan are licensed to share copies with their clients.

Archived resources

We work hard to keep all resources up to date, so we regularly review and update our library. However, we understand that you might get used to a certain version of a resource as part of your workflow. Instead of removing older versions, we keep them in our archive so that you can still access them if you want to. We also clearly explain if an improved version is available, so you can choose which you prefer.

Series and ranges

As well as many topic-specific resources, we also publish a variety of ranges and series.    

• The ‘What is…’ series. These one-page resources cover a range of common mental health problems. In client friendly language they provide a concise summary of the problem, what it can feel like, what maintains it and an overview of key evidence-based therapeutic approaches (e.g., CBT, EMDR, and compassion-focused therapy) to treatment.
• The ‘What keeps it going…’ series . These are one-page diagrams that explain what tends to maintain common mental health conditions such as burnout, panic disorder, PTSD, and perfectionism. You can use them to inform your case conceptualization or as a roadmap in therapy. They provide a quick and easy way for clients to understand why their disorder persists and how it might be interrupted.
• The ‘Recognizing…’ series can help you identify and assess specific disorders, comparing key diagnostic criteria from leading diagnostic manuals.
• The ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are comprehensive sources of information for your clients. Concepts are explained in an easily digestible way with plenty of case examples and diagrams. Each guide covers symptoms, treatments and some key maintenance factors .
• The ‘Guide to…’ resources give clients a deep dive into a condition or treatment approach. They cover a mixture of information, psychoeducation, practical exercises and skills development to help clients learn to manage their condition. Each of these guides offers psychoeducation about the topic alongside a range of practical exercises with clear instructions to help clients identify, monitor, and address their symptoms.
• The ‘ Self-monitoring’ collection provides problem-specific records designed to help you and your clients get the most from this essential but often overlooked technique. Covering a broad range of conditions, these worksheets allow you to give clients a tool that is targeted to their experience, with relevant language and prompts.
• The ‘Formulation’ series provides a client-friendly adaptation of cognitive behavioral models for disorders including panic, PTSD, and social anxiety. These useful tools can help you and your clients come to a shared understanding of their difficulties, and can help you to develop a roadmap for therapy.  

Multilingual library of translations

Did you know that Psychology Tools has the largest online, searchable library of multilingual therapy resources? We aim to make our resources accessible to everyone. With over 3500 resources across 70 languages, you can give clients resources in their native language, enabling a deeper understanding and engagement with the treatment process. Translations are carried out by specially selected professional translators with experience of psychology, and our pool of volunteer mental health professionals. We also make sure that the resource design is the same for each translated resource so that you can be confident you know what section you are looking at, even if you don’t speak the language.

Simply find the resource you want to use, then explore which languages that resource is available in, or you can see all the resources available in a particular language by using our search filters.  

What formats are the resources available in, and how can I use them?

People work in different ways. Our formats are designed to reflect that, so you can choose the style that suits how you and your client want to work. Psychology Tools resources are perfectly formatted to work whether you practice face to face, remotely, or use a blended approach.

• Professional version. Designed for clinicians, this comprehensive option includes everything you need to use the resource confidently. As well as the resource, each PDF contains useful information, including therapist guidance explaining how to use the resource most effectively, descriptions that provide theoretical context, instructions, therapist prompts, and references. Some resources also include case examples and annotations where appropriate.
• Client version.  This is a blank PDF of the resource, with client-friendly instructions where appropriate, but without the theoretical description. These are ideal for printing and using in-session, or giving to a client.
• Fillable PDFs are great for clients who want to work with resources online instead of on paper. Your client can fill in and save the resource on a computer, before sending it back to you without the need for a printer. This format is also useful if you have remote sessions with clients and want to work through a resource on screen together.
• Editable PowerPoint documents are useful if you want to make any changes to the resource structure, or personalize it for your client.
• Editable Word documents are also useful if you want to make changes to the resource, and are more suited to printing.

How do we design our resources to support your practice?

Our resources are informed by evidence-based treatments, best practice guidelines, and the latest published research. They are written by highly experienced therapists and experts in mental health, ensuring they are effective and as up to date as possible. In addition, every resource goes through a rigorous peer review process to confirm they are accurate and easy to use.

Each resource is designed with both clients’ and therapists’ needs in mind. For clients, that means using clear, user-friendly language, as well as plenty of visual and case examples, illustrations, diagrams and vignettes that readers can relate to. They include information on how the resource can help them, how they should use it, and other useful tips.

We also include useful information and descriptions for clinicians to help them use the resource most effectively. The therapist versions of each resource contain therapist guidance, prompts, instructions, and full references. They outline how the resource can be used and what types of problems it could be helpful for.

• Designed to make strong theory-practice links . We pay close attention to the theory underpinning our resources, which provides therapists with useful context and helps them make theory-practice links. Having a greater understanding of each tool ensures best practice.
• One concept per page. Wherever possible, we create resources using the principle of one therapeutic concept per page, as this ensures that we have distilled the idea down to its essence. This makes each tool simple for therapists to communicate and easy for clients to grasp. We also pay close attention to visual layout and design, to make our resources as accessible as possible. Every resource aims to maximize clinical benefit and engagement, without overwhelming readers.
• Action focused. Resources are designed to be interactive, collaborative and goal-focused, with prompts to facilitate self-monitoring of progress and goals.

How can I use this page?

This page is where you can explore all the resources in the Psychology Tools library. The different search filters on the left-hand side enable you to customize your search, depending on what you need. Materials are organized by resource type, problem, and therapy tool, though you can also filter by language or use the search box. You can find more detailed instructions for how to find resources here .  

Can I share resources directly with my clients?

If you have a paid Psychology Tools membership, you are licensed to share resources with clients in the course of your professional work. You can even email resources (even large audio collections) directly to your clients from our website. All emails are secure and encrypted, so it is a quick and easy way to save you time and facilitate clients’ self-practice.

What if I need more help?

We have a wide range of ‘ How-to’ guides and an FAQ in our help centre , which answers questions on how to use the library and tools, such as ‘ How do I download resources? ’ or ‘ How do I email resources to my clients directly from the website? ’.

Kessels, R. P. C. (2003). Patients’ memory for medical information . Journal of the Royal Society of Medicine, 96 , 219-222.

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Mental Health Worksheets

Mental health worksheets & workbooks for adolescents, mental health worksheets & workbooks for adults, mental health worksheets & workbooks for couples, mental health worksheets & workbooks for families.

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Table of Contents

CBT Problem Solving Worksheet

The Happier Therapy editorial team is made up of Masters and PhD counselling psychologists. Each worksheet is created by a team member with exposure to and experience in the subject matter.  The worksheet then gets reviewed by a more senior editorial member. This is someone with extensive knowledge of the subject matter and highly cited published material.

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What is the theory behind this CBT Problem Solving Worksheet?

Problem Solving is a key skill that can help clients cope with difficult situations in their life. It can help them learn how to respond effectively to a problem rather than reacting to it without thinking about the consequences.  In CBT, the therapist can guide the client through the process, encouraging them to think of solutions rather than worrying about the problem itself. 

How will the worksheet help?

This worksheet will guide clients through the process of effective problem solving. It will help them identify the actual problem, then shortlist possible solutions by examining their costs and benefits. This will help them choose the best possible option with maximum benefits. 

How to use the worksheet?

Instruct the client to write down their problem as objectively as possible. Then list down possible solutions to the problem. Mention advantages and disadvantages of each solution so that they can shortlist the best option. Apply that solution and write down the outcome. If things don’t work out they should review the shortlisted options and try a new one. 

Was this helpful?

Nezu, A. M., Nezu, C. M., D’Zurilla, T. J. (2013). Problem-solving therapy: a treatment manual. New York: Springer.

Cognitive Behavioral Therapy

Solving problems the cognitive-behavioral way, problem solving is another part of behavioral therapy..

Posted February 2, 2022 | Reviewed by Ekua Hagan

• What Is Cognitive Behavioral Therapy?
• Find a therapist who practices CBT
• Problem-solving is one technique used on the behavioral side of cognitive-behavioral therapy.
• The problem-solving technique is an iterative, five-step process that requires one to identify the problem and test different solutions.
• The technique differs from ad-hoc problem-solving in its suspension of judgment and evaluation of each solution.

As I have mentioned in previous posts, cognitive behavioral therapy is more than challenging negative, automatic thoughts. There is a whole behavioral piece of this therapy that focuses on what people do and how to change their actions to support their mental health. In this post, I’ll talk about the problem-solving technique from cognitive behavioral therapy and what makes it unique.

The problem-solving technique

While there are many different variations of this technique, I am going to describe the version I typically use, and which includes the main components of the technique:

The first step is to clearly define the problem. Sometimes, this includes answering a series of questions to make sure the problem is described in detail. Sometimes, the client is able to define the problem pretty clearly on their own. Sometimes, a discussion is needed to clearly outline the problem.

The next step is generating solutions without judgment. The "without judgment" part is crucial: Often when people are solving problems on their own, they will reject each potential solution as soon as they or someone else suggests it. This can lead to feeling helpless and also discarding solutions that would work.

The third step is evaluating the advantages and disadvantages of each solution. This is the step where judgment comes back.

Fourth, the client picks the most feasible solution that is most likely to work and they try it out.

The fifth step is evaluating whether the chosen solution worked, and if not, going back to step two or three to find another option. For step five, enough time has to pass for the solution to have made a difference.

This process is iterative, meaning the client and therapist always go back to the beginning to make sure the problem is resolved and if not, identify what needs to change.

Advantages of the problem-solving technique

The problem-solving technique might differ from ad hoc problem-solving in several ways. The most obvious is the suspension of judgment when coming up with solutions. We sometimes need to withhold judgment and see the solution (or problem) from a different perspective. Deliberately deciding not to judge solutions until later can help trigger that mindset change.

Another difference is the explicit evaluation of whether the solution worked. When people usually try to solve problems, they don’t go back and check whether the solution worked. It’s only if something goes very wrong that they try again. The problem-solving technique specifically includes evaluating the solution.

Lastly, the problem-solving technique starts with a specific definition of the problem instead of just jumping to solutions. To figure out where you are going, you have to know where you are.

One benefit of the cognitive behavioral therapy approach is the behavioral side. The behavioral part of therapy is a wide umbrella that includes problem-solving techniques among other techniques. Accessing multiple techniques means one is more likely to address the client’s main concern.

Salene M. W. Jones, Ph.D., is a clinical psychologist in Washington State.

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Cognitive Remediation Therapy: 13 Exercises & Worksheets

This can result in concentration, organizational, and planning difficulties that impact their quality of life and independent living.

Cognitive Remediation Therapy (CRT) helps by increasing awareness of intellectual difficulties and improving thinking skills. While originally designed for people with thinking problems associated with schizophrenia, it has also proven successful for those with other diagnoses (Bristol Mental Health, n.d.).

CRT works by encouraging a range of exercises and activities that challenge memory, flexible thinking, planning, and concentration problems.

This article explores CRT and its potential to help clients and includes techniques, activities, and worksheets to build effective therapy sessions.

Before you continue, we thought you might like to download our three Positive CBT Exercises for free . These science-based exercises will provide you with detailed insight into Positive CBT and give you the tools to apply it in your therapy or coaching.

This Article Contains:

What is cognitive remediation therapy (crt), how does cognitive remediation work, 8 techniques for your sessions, 7 exercises, activities, & games, 6 helpful worksheets and manuals, implementing online crt programs, 3 best software programs for helping your clients, a take-home message.

“Cognitive remediation is a behavioral treatment for people who are experiencing cognitive impairments that interfere with daily functioning” (Medalia, Revheim, & Herlands, 2009, p. 1).

Successful cognitive functions, including memory, attention, visual-spatial analysis, and abstract reasoning, are vital for engaging with tasks, the environment, and healthy relationships.

CRT improves cognitive processing and psychosocial functioning through behavioral training and increasing individual confidence in people with mental health disorders (Corbo & Abreu, 2018). Training interventions focus on the skills and supports required to “improve the success and satisfaction people experience in their chosen living, learning, working, and social environments” (Medalia et al., 2009, p. 2).

Exercises typically focus on specific cognitive functions, where tasks are repeated (often on a computer) at increasing degrees of difficulty. For example:

• Paying attention
• Remembering
• Being organized
• Planning skills
• Problem-solving
• Processing information

Based on the principles of errorless learning and targeted reinforcement exercises , interventions involve memory, motor dexterity, and visual reading tasks. Along with improving confidence in personal abilities, repetition encourages thinking about solving tasks in multiple ways (Corbo & Abreu, 2018).

While initially targeted for patients with schizophrenia, CRT is an effective treatment for other mental health conditions , including mood and eating disorders (Corbo & Abreu, 2018).

CRT is particularly effective when the cognitive skills and support interventions reflect the individual’s self-selected rehabilitation goals. As a result, cognitive remediation relies on collaboration, assessing client needs, and identifying appropriate opportunities for intervention (Medalia et al., 2009).

Cognitive remediation vs cognitive rehabilitation

CRT is one of several skill-training psychiatric rehabilitation interventions. And yet, cognitive remediation is not the same as cognitive rehabilitation (Tchanturia, 2015).

Cognitive rehabilitation typically targets neurocognitive processes damaged because of injury or illness and involves a series of interventions designed to retrain previously learned cognitive skills along with compensatory strategies (Tsaousides & Gordon, 2009).

While initially done in person, they can subsequently be performed remotely as required (Corbo & Abreu, 2018; Bristol Mental Health, n.d.).

Well-thought-out educational software provides multisensory feedback and positive reinforcement while supporting success, choice, and control of the learning process. Its design can target either specific cognitive functions or non-specific learning skills and mechanisms (Medalia et al., 2009).

CRT successfully uses the brain’s neuroplasticity and is often more effective in younger age groups who haven’t experienced the effects of long-term psychosis. It works by increasing activation and connectivity patterns within and across several brain regions involved in working memory and high-order executive functioning (Corbo & Abreu, 2018).

The Neuropsychological Educational Approach to Cognitive Remediation (NEAR) is one of several approaches that provide highly individualized learning opportunities. It allows each client to proceed at their own pace on tasks selected and designed to engage them and address their cognitive needs (Medalia et al., 2009).

NEAR and other CRT techniques are influenced by learning theory and make use of the following (Medalia et al., 2009):

• Errorless learning Encouraging the client to learn progressively, creating a positive experience without relying on trial and error.
• Shaping and positive feedback Reinforcing behaviors that approximate target behaviors (such as good timekeeping) and offering rewards (for example, monthly certificates for attendance).
• Prompting Using open-ended questions that guide the client toward the correct response.
• Modeling Demonstrating how to solve a problem.
• Generalizing Learning how to generalize learned skills to other situations.
• Bridging Understanding how to apply skills learned inside a session outside  in everyday life.

Encouraging intrinsic motivation (doing the tasks for the satisfaction of doing them rather than for external rewards) and task engagement are also essential aspects of successful CRT programs (Medalia et al., 2009).

Therapy is most effective when it successfully supports clients as they transfer learning skills into the real world.

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Cognitive remediation techniques must be selected according to the skills and needs of the client and typically fall into one of three major intervention categories (Medalia et al., 2009):

• Planning exercises, such as planning a trip to the beach to practice cognitive strategies
• Cueing and sequencing , such as adding signs or placing reminder notes at home to encourage completing everyday tasks (for example, brushing teeth)

Such techniques rely on several key principles, including “(1) teaching new, efficient, information processing strategies; (2) aiding the transfer of cognitive gains to the real world; and (3) modifying the local environment” (Medalia et al., 2009, p. 5).

• Restorative approaches Directly target cognitive deficits by repeating task practices and gradually increasing difficulty and complexity; along with regular feedback, they encourage accurate and high levels of performance.

Practice is often organized hierarchically, as follows:

• Elementary aspects of sensory processing (for example, improving auditory processing speed and accuracy)
• High-order memory and problem-solving skills (including executive functioning and verbal skills)

This technique assumes a degree of neuroplasticity that, with training, results in a greater degree of accuracy in sensory representations, improved cognitive strategies for grouping stimuli into more meaningful groups, and better recall.

• Repetition and reaching for increasing levels of task difficulty
• Modeling other people’s positive behavior
• Role-play  to re-enact experienced or imagined behavior from different perspectives
• Corrective feedback to improve and correct unwanted or unhelpful behavior

Complex social cognitive processes are typically broken down into elemental skills for repetitive practice, role-play, and corrective feedback.

Professor Dame Til Wykes: cognitive remediation therapy

It is vital that activities within CRT are interesting and engaging for clients. They must foster the motivation required to persevere to the end of the task or game.

The following three games and puzzles are particularly valuable for children and adolescents (modified from Tchanturia, 2015):

SET is a widely available card game that practices matching based on color, shape, shading, etc.

Clients must shift their thinking to identify multiple ways of categorizing and grouping cards, then physically sort them based on their understanding.

It may be helpful to begin with a limited set of cards to reduce the likelihood of the clients becoming overwhelmed by the game or finding it less enjoyable.

2. Rush Hour

Rush Hour is another fun game that balances problem-solving skills with speed.

Puzzles start simple and increase in complexity, with additional elements involved. Skills developed include problem-solving and abstract thinking, and the game requires a degree of perseverance.

Other activities require no specialist equipment and yet can be highly engaging and support clients in learning transferable skills (modified from Tchanturia, 2015).

• Bigger picture thinking This involves the client picturing a shape in their minds or looking at one out of sight of the therapist. They then describe the shape (without naming it), while the therapist attempts to draw it according to the instructions. This practice is helpful with clients who get overwhelmed by detail and cannot see the bigger picture.
• Word searches Word searches encourage the client to focus on relevant information and ignore everything else – an essential factor in central coherence. Such puzzles also challenge memory, concentration, and attention.
• Last word response Last word response is a challenging verbal game promoting cognitive flexibility. The first player makes up and says a sentence out loud. Each subsequent player makes up a new sentence, starting with the last word of the previous player’s sentence. For example, ‘ I like cheese’ may be followed by the next player saying, ‘ Cheese is my favorite sandwich ingredient ,’ etc.
• Dexterity Using your non-dominant hand once a week (for example, combing your hair or brushing your teeth) stimulates different parts of your brain, creating alternative patterns of neuron firing and strengthening cognitive functions.

The following therapy worksheets help structure Cognitive Remediation Therapy sessions and ensure that the needs of clients are met using appropriately targeted CRT interventions (modified from Medalia et al., 2009; Medalia & Bowie, 2016):

Client referral to CRT

The Cognitive Remediation Therapy Referral Form captures valuable information when a client is referred from another agency or therapist so that the new therapist can identify and introduce the most appropriate CRT interventions. The form includes information such as:

Primary reasons

Secondary reasons

• Self-confidence
• Working with others
• Time management
• Goal-directed activities

Cognitive Appraisal for CRT

The Cognitive Appraisal for CRT form is helpful for identifying and recording areas of cognitive processing that cause difficulty for the client and require focus during Cognitive Remediation Therapy sessions.

Clients are scored on their degree of difficulty with the following:

• Paying attention during conversation
• Maintaining concentration in meetings
• Completing tasks once started
• Starting tasks
• Planning and organizing tasks and projects
• Reasoning and solving problems

Software Appraisal for CRT

The Software Appraisal for CRT form helps assess which software would be most helpful in a specific Cognitive Remediation Therapy session. It provides valuable input for tailoring treatment to the needs of the client.

For example:

• Level of reading ability required
• Cognitive deficits addressed by the software
• What is the multimedia experience like?
• How much input is required by the therapist?

Appraisal records become increasingly important as more software is acquired for clients with various cognitive deficits from multiple backgrounds.

Software Usage for CRT

The Software Usage for CRT form helps keep track of the software clients have tried and how effectively it supports them as they learn, develop, and overcome cognitive deficits.

The client considers the software they use and whether they practiced the following areas of cognition:

• Concentration
• Processing speed
• Multitasking
• Logic and reasoning
• Organization
• Fast responses
• Working memory

Thought Tracking During Cognitive Remediation Therapy

Thought Tracking During Cognitive Remediation Therapy is valuable for identifying and recording the client’s goals for that day’s Cognitive Remediation Therapy session and understanding how it relates to their overall treatment goals.

Planning to Meet Goals in CRT

The Planning to Meet Goals in CRT worksheet is for clients requiring support and practice in planning, goal-setting, and goal achievement.

Working with the client, answer the following prompts:

• What goal or project are you working toward?
• What date should it be completed by?
• Are there any obstacles to overcome to complete the goal?
• Are there any additional resources required?
• Then consider the steps needed to achieve the goal.

Other free resources

Happy Neuron provides several other free resources that are available for download .

Consider the five Cs when selecting online CRT programs (modified from Medalia et al., 2009):

• Cognitive – What target deficits are being addressed?
• Client – What interests and level of functioning does the client have?
• Computer – What computing requirements and compatibility factors need to be considered?
• Context – Does the software use real-world or fantasy activities and environments? Are they age and cognitive ability appropriate?
• Choice – Is the learner given choice and options to adapt the activity to their preferences?

Once you’ve ordered the software, give it a thorough review to understand when it is most appropriate to use and with whom.

For online CRT programs to be effective as teaching tools and activities, they should include the following features (modified from Medalia et al., 2009, p. 53):

• Intrinsically motivating
• Active use of information
• Multisensory strategies
• Frequent feedback
• Control over the learning process
• Positive reinforcement
• Application of newly acquired skills in appropriate contexts
• Errorless learning – challenging yet not frustrating

Therapists must become familiar with each program’s content and processes so that targeted deficits are fully understood and clients are engaged without confusion or risk of failure.

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These 17 Positive CBT & Cognitive Therapy Exercises [PDF] include our top-rated, ready-made templates for helping others develop more helpful thoughts and behaviors in response to challenges, while broadening the scope of traditional CBT.

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A great deal of software “targets different skills and offers a variety of opportunities for contextualization and personalization” (Medalia et al., 2009, p. 43).

We focus on three suppliers of extensive CRT software resources below (recommended by Medalia et al., 2009).

1. Happy Neuron

Happy Neuron provides a wide variety of online brain training exercises and activities to stimulate cognitive functioning in the following areas:

• Visual-spatial

When you’re performing well, the exercises become increasingly difficult.

The exercises are grouped into the following areas:

• Brain speed
• People skills
• Intelligence

3. Games for the Brain

Cognitive difficulties, such as challenges with paying attention, planning, remembering, and problem-solving, can further compound and exacerbate mental health issues

While initially created for schizophrenia, CRT is also valuable for other mental health problems, including eating and mood disorders. Treatments are effective in one-to-one and group sessions, and lessons can be transferred to the outside world, providing crucial gains for a client’s mental wellbeing and social interaction.

Through repeated and increasingly challenging skill-based interventions, CRT benefits cognitive functioning and provides confidence gains to its users. The treatment adheres to learning theory principles and targets specific brain processing areas such as motor dexterity, memory, and visual-spatial perception, along with higher-order functioning.

Involving clients in treatment choices increases the likelihood of ongoing perseverance, engagement, and motivation as activities repeat with increasing degrees of difficulty.

This article offers a valuable starting point for exploring CRT and its benefits, with several worksheets and forms to encourage effective treatment.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free .

• Bristol Mental Health. (n.d.). Cognitive remediation therapy: Improving thinking skills . Retrieved December 15, 2021, from http://www.awp.nhs.uk/media/424704/cognitive-remediation-therapy-022019.pdf
• Corbo, M., & Abreu, T. (2018). Cognitive remediation therapy: EFPT psychotherapy guidebook . Retrieved December 15, 2021, from https://epg.pubpub.org/pub/05-cognitive-remediation-therapy/release/3
• Medalia, A., & Bowie, C. R. (2016). Cognitive remediation to improve functional outcomes . Oxford University Press.
• Medalia, A., Revheim, N., & Herlands, T. (2009). Cognitive remediation for psychological disorders: Therapist guide . Oxford University Press.
• Tchanturia, K. (2015). Cognitive remediation therapy (CRT) for eating and weight disorders . Routledge.
• Tsaousides, T., & Gordon, W. A. (2009). Cognitive rehabilitation following traumatic brain injury: Assessment to treatment. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine , 76 (2), 173-181.

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What our readers think.

To my surprise this is a treatment that has not been discussed in the area I live and work. I just stumbled upon this when I was researching cognitive impairments with schizophrenia. I currently work on a team with multiple mental health professionals that go out into the community, to work with people diagnosed with Schizophrenia. It seems like most of what we do is manage and monitor symptoms. Are you aware of anyone or any agency in Buffalo, NY that uses this method of treatment? I am trying to figure out how to get trained and use it in practice, if that is possible. Any help will be greatly appreciated.

This looks like the treatment my daughter needs. She has struggled for years with the cognitive problems associated with depression. How do we find a therapist near us who can use these techniques?

I’m sorry to read that your daughter is struggling. You can find a directory of licensed therapists here (and note that you can change the country setting in the top-right corner). You’ll also find that there are a range of filters to help you drill down to the type of support you need: https://www.psychologytoday.com/us/therapists

I hope you find the help you need.

– Nicole | Community Manager

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10 Best Therapy Games for Kids

Growing up can put a lot of pressure on a child—pressure to fit in, succeed academically, and develop their skills. Occasionally, they may have trouble coping or interacting with others. Fortunately, play therapy allows children to overcome issues from earlier developmental stages and enjoy going to therapy. Explore the ten best therapy games for kids of all ages!

What are Therapy Games?

Therapy games aim to help children address emotional and social challenges in fun, engaging, and less intimidating ways. Some games are adapted from classics like Uno or Jenga or mimic popular board games. Others take the form of creative expression, such as painting and coloring, or are emotion-focused.

These games encourage discussions, hone communication techniques, help identify emotions, and find healthy ways for children to express themselves.

Benefits of Therapy Games for Kids

Besides making therapy a more approachable and less daunting activity for children, therapy games also provide the following benefits:

• Safer outlet for emotions. Play therapy provides a safer, more comfortable space for children to identify, express, and manage difficult emotions.
• Healthy coping mechanisms. Young children who struggle with stress, frustration, and negative emotions can benefit from emotional regulation through play therapy. In addition, play therapy can address symptoms during trauma-focused CBT settings [ * ].
• Higher self-esteem. As therapy games help children develop interpersonal skills over time, kids develop higher self-esteem, making decisions with greater confidence.
• Improved problem-solving skills. Some therapy games involve overcoming challenges or working toward a common goal, helping children hone their critical thinking skills.

If you’re looking for new and innovative ways to teach concepts or introduce your child to therapy, consider these therapy games for kids.

1. Feelings Jenga

Feelings Jenga is a twist on the classic game. Players answer prompts on the corresponding blocks by writing a prompt on each block, such as “Name something you were grateful for today” or “Tell us what you think anger looks like.”

2. Trust Fall

Building trust is vital for young children, as it improves communication and cooperative skills [ * ]. This activity involves having the child stand up straight, close their eyes, cross their arms across their body, and fall backward as someone catches them.

The classic trust fall aims to teach children that their partner will catch them safely, but that trust requires courage.

3. Icebreakers

Icebreaker questions aren’t just an excellent getting-to-know-you exercise—they break down barriers and open the floor for discussions about deeper topics.

Simple icebreaker questions might include:

• What is an embarrassing story you haven’t shared before?
• What did you want to grow up to be as a child?
• What is your favorite book and why?

The activity aims to make your child comfortable sharing personal anecdotes, thoughts, and opinions.

Uno is a simple card game that introduces the concept of crafting strategies, matching patterns, developing communication skills, and coping with losing.

Players take turns matching card numbers and colors. They add a card to their hand if they cannot match anything. The aim for each player is to eliminate all their cards.

Uno is available on Amazon for $10.99.

5. Emotion Charades

Young children may struggle to identify and manage intense emotions like fear, disappointment, and frustration. “Gamifying” these experiences through charades can make these emotions more approachable and easier to express.

The instructions are simple—act out an emotion and have your child guess what the emotion is. Then, ask them to act out their interpretation of the emotion.

Use our Exploring Emotions worksheet to debrief after the game and discuss how your child might experience their emotions.

6. Finish the Story

To play Finish the Story, each player takes a turn adding a sentence to the overall story, building on ideas together, and exploring their creative imagination.

Finish the Story is a fun way to improve a child’s language and communication skills, enhance sentence formation, and build vocabulary.

7. Obstacle Course

Obstacle courses are excellent for reinforcing communication and cooperation, as children must work together to overcome the challenges in front of them. Arrange obstacle courses according to age—use pillows and soft surfaces for younger children.

Older children may require more stimulation and challenging obstacle courses that you can set up outdoors.

8. Feelings Bingo

If your child struggles to express their emotions, try playing Feelings Bingo. Create boards using stickers or words to represent happiness, sadness, and anger. To play, call out an emotion and ask your child to mark it on their cards.

Feelings Bingo is excellent for vocabulary building, as you expose children to new feelings and discuss their meanings. You can also use Feelings Bingo to normalize tricky emotions like anger, reinforcing that these emotions are valid.

Our Feelings Wheel can help you put together your bingo board.

9. FEELOPOLY

As its title suggests, FEELOPOLY is a variation on the classic board game Monopoly. Instead of playing against one another, players work cooperatively to “validate” the feelings on the board through example prompts. Some of these prompts might include:

• What might help you feel better when you’re feeling sad?
• Explain how something can cause you to feel angry or frustrated.
• What are some healthy outlets for managing anxiety?

You can find a printable FEELOPOLY board on Etsy for $13.50.

10. DBT Board Game

Like FEELOPOLY, the DBT Board Game is customizable and printable, making reviewing DBT vocabulary and strategies more approachable for young children and teens. The game covers mindfulness, interpersonal skills, distress management, and emotional regulation.

Players must move across the board, answering prompts like:

• Think of a clever way to turn a negative thought into a positive one.
• Describe a rude way to ask for help and turn this into a more compassionate, effective way.

You can find a printable DBT Board Game board on The Counseling Palette for $9.99.

The Bottom Line

Needing therapy can be a challenging thought to accept, especially for a young child. Fortunately, therapeutic games can help your child’s therapy journey become less scary and more exciting!

Pair your play therapy with our Feelings worksheets to inspire your child to discover coping mechanisms that work for them.

• Allen B. “Structured Trauma-Focused CBT and Unstructured Play/Experiential Techniques in the Treatment of Sexually Abused Children.” A Field Study With Practicing Clinicians - Brian Allen, Natalie Armstrong Hoskowitz, 2017.
• Rotenberg KJ, Boulton M. “Interpersonal Trust Consistency and the Quality of Peer Relationships During Childhood.” Social development, 2012.

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