Thought Record Sheet

Thought Record Sheet

Situation Trigger

What happened? Where? When? Who with? How?

0% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Relaxation to learn more about Relaxation and to get in touch with one of iTherapy's counselors.

Emotions / Moods
(rate 0 - 100%)

What emotion did I feel at that time? What else? How intense was it?

16% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Relaxation to learn more about Relaxation and to get in touch with one of iTherapy's counselors.

Physical Sensations

What did I notice in my body? Where did I feel it?

33% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Relaxation to learn more about Relaxation and to get in touch with one of iTherapy's counselors.

Unhelpful Thoughts and Images

What went through my mind? What disturbed me? What did those thoughts/images/memories mean to me, or say about me or the situation? What am I responding to?
What ‘button’ is this pressing for me? What would be the worst thing about that, or that could happen?

50% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Relaxation to learn more about Relaxation and to get in touch with one of iTherapy's counselors.

Alternative response / Healthier
more balanced perspective

STOPP! Take a breath…. Is this fact or opinion? What would someone else say about this situation? What’s the bigger picture? Is there another way of seeing it?
What advice would I give someone else? Is my reaction in proportion to the actual event? Is this really as important as it seems?

66% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Relaxation to learn more about Relaxation and to get in touch with one of iTherapy's counselors.

What I did / What I could do /
Defusion technique /
What’s the best response?
Re-rate Emotion 0-100%

What could I do differently? What would be more effective? Do what works! Act wisely. What will be most helpful for me or the situation? What will the consequences be?

84% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Relaxation to learn more about Relaxation and to get in touch with one of iTherapy's counselors.

To learn more about Relaxation and to get in touch with one of iTherapy's counselors visit our Education and Resources Page for Relaxation.

Situation Emotions /
Moods
Physical
Sensations
Unhelpful Thoughts and Images Alternative Response/ Healthier
More balanced perspective
What I did / What I could do /
Defusion technique /
What’s the best response?

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Situation

Answer Question to Complete Worksheet

Emotions /
Moods

Answer Question to Complete Worksheet

Physical
Sensations

Answer Question to Complete Worksheet

Unhelpful Thoughts and Images

Answer Question to Complete Worksheet

Alternative Response/ Healthier
More balanced perspective

Answer Question to Complete Worksheet

What I did / What I could do /
Defusion technique /
What’s the best response?

Answer Question to Complete Worksheet


© Carol Vivyan 2009, permission to use for therapy purposes.

100% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Relaxation to learn more about Relaxation and to get in touch with one of iTherapy's counselors.
Thanks to www.getselfhelp.co.uk for this template.