CBT “Thought Record” Challenge

I have been mulling over Cognitive Behavioral Therapy techniques and what it is like for clients to engage in this therapy.  If you are in healthcare as a therapist this is a mainstay of therapy.  One of the cornerstones of this techniques is the assignment of  “thought log” or “though record” or “thinking report” as homework assignments.  In these exercises you ask clients to identify a trigger (situation), an emotion (and intensity level), actions, and the automatic thoughts that are experienced.  After these “hot thoughts” are identified you ask people to find alternative realistic thoughts and/or behaviors.

When used these can be very effective.  When is the operative word.  Like any homework given to a depressed or anxious person they often are not completed and trigger a whole wave of feelings and avoidance.  Some therapists choose to discard this type of homework all together as it creates “resistance” that they deem unnecessary.  Others embrace this not doing homework and ask clients to examine this action using a thought log in session, or do a chain analysis to understand this behavior.

I have been thinking about these two views.  Mostly I have attempted to use these logs, examined the not doing them, and sometimes concluded after discussing with the client that they just do not work for the client at this time.

To gain a new perspective I want to delve into this experience personally.  I want to commit to doing a daily thought log for the next week and see how it goes.  How effective is it?  How much do I want to avoid it?  What will I learn about what a client goes through.  Granted I will not have the same experience as I’m not dealing with a dyadic therapeutic relationship, but I bet you I will still feel some guilt and pressure to doing it just by making this post here and knowing that a few lone souls will check back and see if I actually did what I endeavored to do.

Wish me luck!

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2 thoughts on “CBT “Thought Record” Challenge

  1. Interesting post. I don’t know more than about 2 therapists, locally, and neither one do I know more than casually. How many therapists “practice what they preach” on themselves, as you are suggesting? Perhaps they (like the rest of us) don’t think of themselves as being in need of therapy. “That’s for sick people,” we might argue. But I am reminded immediately of Jesus’ statement: “It is not those who are healthy who need a physician, but those who are sick.” In context, this statement was targeted at the Pharisees, and is dripping with sarcasm. Why sarcasm? because Jesus knows that everyone is sick. We all need therapy.I have a suggestion for you. Your clients, by definition, have something specific to work on, to “log.” But what about the rest of us? What are we to work on, if we’re not experiencing panic attacks or some phobia, and generally seem to get along in life reasonably well? St. Ignatius had an answer in the Examen prayer. The fact that this prayer method has survived for 450 years and is still very popular testifies to its usefulness. Ignatius did not invent it, but he certainly contributed to its widespread use. (In fact, Socrates said many years prior to Ignatius that the unexamined life was not worth living.)In the Examen, a person sets aside some time, usually at the beginning or end of the day, to review and reflect upon the previous 24 hours. There is a method to this review that is described in many, many places, but Hamm does a good job here. George Aschenbrenner wrote what is considered a classic article on the Examen that is worth reading, particularly if you have an academic bent. I practice the Examen and find it useful. Without it, my life would be essentially unexamined. I thought of the Examen after reading your post because you referred to a “log.” I keep a prayer journal where I record what happened during my Examen prayer. I’m not working on a psychological problem, but daily, issues arise that are worthy of attention. As a sinner, there is always something to bring before God, and that was Jesus’ point.

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