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Daily Record Of Dysfunctional
Thoughts
This form is usually attached to
a carbonised copy, so that both therapist and patient can keep a copy of recorded thoughts.
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DATE |
SITUATION
Describe
1. Actual event leading
to unpleasant emotion,
or
2. Stream of thoughts,
daydream, or
recollection, leading
to unpleasant emotion |
EMOTION(S)
1. Specify sad/
anxious/angry
etc.
2. Rate degree of
emotion
1 100 |
AUTOMATIC THOUGHT(S)
1. Write automatic thought(s) that
preceded emotion(s)
2. Rate belief in automatic thought(s),
0 100% |
RATIONAL RESPONSE
1. Write rational response to
automatic thought(s)
2. Rate belief in rational response,
0 100% |
OUTCOME
1. Re-rate belief in
automatic thought(s)
0 100%
2. Specify and rate
subsequent emotions,
0 - 100 |
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EXPLANATION: When you experience
an unpleasant emotion, note the situation that seemed to stimulate the emotion (If the emotion occurred while you were thinking,
daydreaming, etc, please note this.) Then note the automatic thought associated
with the emotion. Record the degree to which you believe this thought: 0% = not
at all, 100% = completely. In rating degree of emotion: 1 = a trace, 100 = the
most intense possible. (Ref: Blackburn I., Davidson K. (1998) Cognitive Therapy
for Depression and Anxiety, Blackwell Science)
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