1. EVENT (Date, Time, What Happened):
2. THOUGHTS AT THE TIME ("IDENTIFICATION"):
A. FEELINGS AT THE TIME (and level of intensity of these feelings):
B. BEHAVIORS AT THE TIME:
C. COGNITIVE DISTORTIONS (see Checklist of Cognitive Distortions):
3. EVALUATION OF ORIGINAL THOUGHTS (What is the evidence?):
4. RESPONSE TO ORIGINAL THOUGHTS (More helpful thoughts):
5. FEELINGS NOW (and level of intensity of these feelings) :