Self Management -
Unhelpful Thought Record-Form

Self Management Unhelpful Thought Record - Printable PDF

SITUATION:
(Give details of situation including who you were with, what happened, when it happened, etc.)

 

 

 

 

 

THOUGHTS

FEELINGS- MOOD Rating

Alternative Thoughts-Countering Evidence

EFFECTS

Change in Mood Rating

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Helpful questions: What was going on in my mind at the time? What immediate images or memories did I have? What was I saying to myself at the time?  What does this mean about how I view myself, my future and the world around me? Are my thoughts “out of proportion” to the event.
 

One word description of your mood with a 0-100 intensity rating focusing on your strongest emotional response.

What is the evidence that this thought is true? What would other people say? What would I tell a friend in the same situation?

How did these alternative thoughts affect my mood?


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