CBT For Me – Part 1: Starting with Thinking
VIDEO INTRO: https://youtu.be/HLBOpgHBqoc
Introduction: One thing that
everyone should get out of a substance use or mental health program is a basic
understanding of Cognitive-Behavioral Therapy (CBT). CBT is one of the easiest
to understand ways to change behaviors, for anyone who is motivated to make
those changes. This worksheet focuses on starting a discussion on Thinking,
Feelings and Behaviors, the core elements of CBT with emphasis on Thinking
first
As
an icebreaker, try the following exercise as a group. On the next page are some
common thoughts, feelings and behaviors that may be associated with substance
use and mental health. Of course, there are many more than this, but this list
is enough to start a discussion and to start the group talking about thoughts,
feelings and behaviors. Notice that some of the thoughts, feelings and
behaviors are more positive and others not so positive.
Directions: Everyone in the group should get a copy of the list. Take turns and when it’s your turn simply pick a Thought, Feeling, or Behavior on the list that stands out to you and tell a brief story related to it. If you are up to the challenge, you can pick two items from the list: a thought and a feeling or try to use all three: a thought, a feeling and a behavior for your story. It’s up to you
Examples
Group
member 1
picks the Thought: “It could be worse” and tells a story: “When I
was in detox for heroin last month I honestly felt like I was going to die
because I was so sick, but I kept remembering that I was telling myself at the
time: “It could be worse – I could be in jail or dead right
now”
Group
member 2
feels up to the challenge and picks two items: a Thought – “I’ve got
skills and talents” and a Feeling “Blessed” and tells the
story: “I nearly lost everything because of my substance use and mental health
issues until I got help. Now I am feeling so blessed because I’ve
got skills and talents doing carpentry and I have been able to get a
business started up again since I have been in recovery.
Group
member 3
goes for a combination of all three: Thoughts, Feelings and Behaviors from the
list and tells the story: “I used to struggle for years with negative thoughts
like I’m not good enough which left me feeling discouraged,
however now that I am working on things, I have learned to choose the behavior
of using my support system to help me work through these negative
feelings when they come up.
|
Thoughts |
Feelings |
Behaviors |
|
I quit I’m the greatest I’m not good enough I’ve got this No one cares I deserve better I’ll figure it out He/She/They are out to get
me I’m not going to quit I can’t do it Everyone else has it better Things are getting better I’ll never get there I have a good shot at this I have no idea It’s starting to work I am a fake and a phony I’m steadily improving This just isn’t fair I’m making the best of it I’m fooling everyone I’ll survive I’m not strong enough I’ll get through this I don’t measure up I have a lot to offer The deck is stacked against
me I’ve got skills and talents I can’t adapt to this I’m flexible and clever I’m not smart enough I can master this with time I’m going to fail I’ll win if I stay in the
game It’s never going to happen I can see it in my future I’m about to break down I’m resilient and will
endure I can’t do this honestly I can face the truth today This is too much for me I have what it takes I can’t handle any more It could be worse |
Angry Happy Sad Excited Disappointed Grateful Calm Anxious Bored Amused Distracted Focused Disgusted Relieved Afraid Courageous Bitter Satisfied Resentful Appreciative Horrified Proud Stuck Motivated Apathetic Enthusiastic Driven Burned Out Blessed Stressed Content Aggravated Hopeful Desperate Confident Discouraged Beautiful Ugly Joyful Troubled Comfortable Upset Pessimistic Optimistic
|
Aggression (Verbal) Reach out for help Run away Use support system Pretend everything is fine Practice and learn to
improve Aggression (Physical- Fight) Compromise to find peace Stay stuck in situation Explore new options Repeat the cycle Keep on trying Isolate Seek professional help Find a way out Return to bad situation Recover Relapse Use coping skills Sulk and complain Handle my business Sit back and wait Take accountability Blame others Accept and move forward Neglect responsibility Try something new Avoid change Stand up for self Come up with excuses Set new goals Give up Adjust priorities Stay lost Remain grounded Strategize new plans Scheme, cheat or lie Do some self-searching Shut down Find a way to make peace Take it out on someone else Patiently endure Suffer in silence Rise to the occasion |
Change your thinking, change your life
There are several factors that need to be in place in order to change our thinking in a positive way. Discuss each one below and answer the questions:
Self-Awareness – Learning to look
inward into our own mind to examine and openly define our own thoughts is a
skill that can be learned but takes practice. This comes easier to some people
than to others, but anyone can develop this skill. How about you, do you
feel ready to look deeper into your own thinking?
Self-Honesty – It can be a challenge
to admit to ourselves that we are having negative thoughts, especially fearful
or embarrassing thoughts. For example, it can be difficult for some people to
openly admit things out loud that may make them seem vulnerable. Are you
able to get honest about your own thoughts even the difficult to admit or
accept ones?
Courage – Sometimes we may be
afraid to face our thoughts. Facing thoughts can mean facing reality and
accepting the need to change. Are you prepared to face and admit some of
your fears and insecurities?
Break
the Habit
– Negative
thinking can become habitual. Complaining about life, looking at the dark side
of things, being pessimistic or self-defeating can all become “comfortable” when
it becomes a regular habit. If you have the habit of looking at things in
a negative way, are you prepared to change?
Open
Mindedness-
We
have all met someone who ignores facts and experiences in favor of stubbornly
holding on to a certain way of thinking. Instead, life is about learning and
growing which requires looking at different perspectives and adapting our
thinking with new information and experiences. Are you working on being
open minded about new information instead of stubbornly holding on to old opinions?
Ability
to “Reframe”
– When
we identify a negative or harmful thought, it is essential to be able to
reframe those negative thoughts in a more positive and realistic way. An
example would be reframing the negative thought ‘I’m not good enough” to
something like “I am still a work in progress, but I am getting better with
time” Do I need to learn more about or practice using cognitive
reframing?
Help
for More Serious Mental Health Issue – Professional help may be needed when
disorders like Major Depressive Disorder or Obsessive Compulsive Disorder are
present because negative thinking can be symptomatic of these and other mental
health disorders. This does not mean that you cannot work on changing thinking
but sometimes some more outside help is needed in therapy or with a
psychiatrist/APN. Talk to your counselor more about this if you feel that
you need more help with negative thinking
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