Automatic Thought Response


Month Day Year


Situation
What led to the unpleasant emotion?
What distressing physical sensations did you have?


Automatic Thoughts
What thought/s or image/s went through your mind?
How much did you believe the thought at the time (0-100%)
Scale: 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Emotions
What emotion/s did you feel at the time?
How intense was the emotion (Scale 0-100%)





Scale: 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Adaptive Response
Which thinking styles did you engage in?
Use questions below to respond to the automatic thought/s
How much do you believe each response (0-100%)


Outcomes