6 Cognitive Restructuring Techniques
Although cognitive distortions are stubborn and surprisingly insidious thought patterns, there are ways to combat them. Cognitive restructuring techniques have had great success in identifying, challenging, and replacing faulty ways of thinking with more accurate, helpful, and positive ways of thinking.
Socratic questioning
Socratic questioning is a very effective cognitive restructuring technique that can help your clients challenge irrational, illogical, or harmful thinking errors.
This technique involves asking the following questions:
- Is this thought realistic?
- Am I basing my thoughts on facts or on feelings?
- What is the evidence for this thought?
- Could I be misinterpreting the evidence?
- Am I viewing the situation as black and white when it’s really more complicated?
- Am I having this thought out of habit, or do facts support it?
Answering and reflecting on these questions can help your clients challenge the beliefs that are causing them harm.
Thought records
Keeping thought records is an excellent way to help your clients become aware of any cognitive distortions that went previously unnoticed or unquestioned, which is the necessary first step to restructuring them (Myles & Shafran, 2015).
There are several different ways to structure a thought record, but the main idea is to note what recurrent thoughts are coming to mind and the situations in which they come up.
Decatastrophizing, or the “what if” technique
This technique is basically asking, “What’s the worst that can happen?” and following a scenario logically through to completion (Dattilio & Freeman, 1992).
Decatastrophizing or asking themselves “what if?” will help your clients determine what is likely to happen, reduce irrational or unreasonable anxiety, and see that even the worst-case scenario is manageable. Use these decatastrophizing worksheets in your sessions.
Guided imagery
Visualization can be an extremely effective method of cognitive restructuring.
There are three main categories of guided imagery that therapists can guide their clients through using cognitive restructuring:
1. Life event visualization
This technique involves having the client identify a specific event or theme that is the focus of the therapy session (Edwards, 1989).
This event could be something recent and particularly salient, like an argument with a loved one, or something from the past that still has a strong impact on the client, like being bullied or a harsh rejection from childhood.
2. Reinstatement of a dream or daytime Image
This imagery technique focuses on a specific image that the client has already had. The image could be one that the client encountered in a dream, daydream, fantasy, or previous guided imagery session.
Wherever it came from, it will hold some inherent meaning for the client and may cause the client to feel anxious, sad, upset, or another emotion intensely.
3. Feeling focusing
Feeling focusing is characterized by the client focusing on a feeling they are experiencing in the session and letting an image arise from the feeling.
An image will usually arise spontaneously, but if not, a technique called multisensory evocation can help clarify it. For this technique, the therapist directs the client through an exploration of the senses to help sharpen the image and identify more detail.
Once the client has an image in mind, the therapist will move on to assessing the meaning that the image holds for the client.
Imagery assessment techniques
There are several assessment techniques therapists may use, including:
- Prompted soliloquy
The therapist directs the client to identify as an object or entity from an image and speak from the position of this object or entity. For example, a client who visualized a lake drying up is directed to be the lake and speak about how it felt to be the lake and what drying up felt like.
- Interview
In this technique the client will once again take on the role of an object or entity from an image, and the therapist will ask specific questions of the client in this role.
- Prompted dialogue
Similar to the previous techniques, this technique involves the client taking on a role and addressing one of the other objects or people in the imagery, such as the trees around the lake.
- Prompted descriptions
This basic technique simply refers to the therapist frequently asking the client what they see and feel.
- Prompted transformation
The therapist may suggest that the client shift or change the image; this can be especially helpful when the current image has reached the end of its usefulness as a discussion piece.
Once the therapist and client work together to identify the meaning attached to the image, the next step will help them challenge, restructure, or replace harmful assumptions and beliefs.
Restructuring techniques
Some of the techniques therapists may use to guide clients through restructuring include summary and reframing, directed dialogue, prompted dialogue, directed transformation, and prompted transformation (Edwards, 1989).
- Summary and reframing
Generally the first step in restructuring, this is when the therapist summarizes what they have learned from the client and suggests alternate beliefs or assumptions based on the client’s image.
- Directed dialogue
The client must take on the role of one of the objects or people from an image and deliver specified lines in that role. The client may speak to another object or person in the image or simply make statements to no one in particular.
- Prompted dialogue
Instead of telling the client exactly what to say in their role from the image, they must come up with their own words to capture a specific idea.
- Directed transformation
The therapist directs the client to change the image. The change may be to direct one of the individuals in the image to take a new action or to edit, enhance, or erase an object from the image.
- Prompted transformation
Instead of directing the client in exactly how to change the image, the therapist encourages the client to think of a way to change the image that will further a goal or help it become more positive.
What our readers think
These worksheets on thought restructuring are excellent tools for CBT therapy. Thank you!
I experienced CBT as a structured problem-solving method, assisting by getting to the problem, brainstorming solutions, and creating an action plan. It really helps to change behaviour using positive reinforcement and gain a fresh outlook on negative experiences. I found CBT to be realistic which really results in constructive outcomes. The resources have been very helpful for reflecting on myself and I’m confident to use them with my clients.