THOUGHT RESPONSE RECORD


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) :