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Appendix 1
Automatic Thoughts Checklist
Instructions: Place a check mark beside each negative automatic
thought that you have had in the past 2 weeks.
_____ I should be doing better in life.
_____ He/she doesn’t understand me.
_____ I’ve let him/her down.
_____ I just can’t enjoy things anymore.
_____ Why am I so weak?
_____ I always keep messing things up.
_____ My life’s going nowhere.
_____ I can’t handle it.
_____ I’m failing.
_____ It’s too much for me.
_____ I don’t have much of a future.
_____ Things are out of control.
_____ I feel like giving up.
_____ Something bad is sure to happen.
_____ There must be something wrong with me.
Adapted with permission from Wright JH, Wright AS, Beck AT:
Good Days Ahead: The Multimedia Program for Cognitive
Therapy. Louisville, KY, Mindstreet, 2004. Permission is
granted for readers to use this item in clinical practice.
Appendix 2. Questions for thought scheme
1) How real is my thought?
2) Does this thought help me to solve my problems or does
thinking about it make it more difficult?
3) What are proofs that the thought is true? What is the idea
based on? What evidence do I have?
4) What are proofs that the thought is not true?
5) Are there other possible explanations?
6) What's the worst that could happen? Would I get over this?
What is the probability of this catastrophe?
7) What is the best thing that could happen?
8) What is most likely to happen?
9) What is the impact of my faith in this believe?
10) What would be the effect if I could change this thought?
11) Can I change something about it?
12) How can I know what others think?
13) How can I predict the future?
14) Don’t I forget to look at the positive side?
15) What would someone else think in my situation?
16) Am I the only responsible one in this situation?
17) What would I say to a friend in a comparable situation?
18) Is this idea really realistic? What is a more viable option?
19) What would I have thought before I got these complaints?
20) Am I not making logical fallacies (thought errors)?
Appendix 3.
Appendix 4. The thought schedule
1. Event
When was it? Where was you? What were you doing? Who was /
were there?
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………..
2. Feelings (and behavior)
Describe the feeling or feelings you had in one word. How
intense was / were this / these feeling(s) on a scale of 0 to
100%?
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………..
3. Automatic thoughts (or images)
Answer the following question: what thoughts (or images)
popped up before you started to feel this way? (If necessary
make use of the following recalls: what does that tell about me?
What are the consequences of this in my life/ future life? What
could happen in the worst case, what would others think about
me?)
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………..
Select the main Negative Automatic Thought (= NAT):
What idea or thought is most responsible for the feeling that
gave rise to complete this schedule? How credible this idea was
on a scale of 0 to 100%?
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………..
4. Arguments that support NAT
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………..
5. Arguments contrary to NAT
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………..
6. The effect of the New Balanced Thought
Note here the feeling that you have researched and score the
intensity again by imagining the event again while thinking
about your new balanced thought. Indicate how credible the
NAT is at this point (0 to 100%).
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………..
7. Imagine a future similar situation and let the balanced new
thought pass your mind and tell what feelings you would have
and how strong they are?
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………..

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Appendix 1 automatic thoughts checklist instructions place

  • 1. Appendix 1 Automatic Thoughts Checklist Instructions: Place a check mark beside each negative automatic thought that you have had in the past 2 weeks. _____ I should be doing better in life. _____ He/she doesn’t understand me. _____ I’ve let him/her down. _____ I just can’t enjoy things anymore. _____ Why am I so weak? _____ I always keep messing things up. _____ My life’s going nowhere. _____ I can’t handle it. _____ I’m failing. _____ It’s too much for me. _____ I don’t have much of a future. _____ Things are out of control. _____ I feel like giving up. _____ Something bad is sure to happen. _____ There must be something wrong with me.
  • 2. Adapted with permission from Wright JH, Wright AS, Beck AT: Good Days Ahead: The Multimedia Program for Cognitive Therapy. Louisville, KY, Mindstreet, 2004. Permission is granted for readers to use this item in clinical practice. Appendix 2. Questions for thought scheme 1) How real is my thought? 2) Does this thought help me to solve my problems or does thinking about it make it more difficult? 3) What are proofs that the thought is true? What is the idea based on? What evidence do I have? 4) What are proofs that the thought is not true? 5) Are there other possible explanations? 6) What's the worst that could happen? Would I get over this? What is the probability of this catastrophe? 7) What is the best thing that could happen? 8) What is most likely to happen? 9) What is the impact of my faith in this believe? 10) What would be the effect if I could change this thought? 11) Can I change something about it?
  • 3. 12) How can I know what others think? 13) How can I predict the future? 14) Don’t I forget to look at the positive side? 15) What would someone else think in my situation? 16) Am I the only responsible one in this situation? 17) What would I say to a friend in a comparable situation? 18) Is this idea really realistic? What is a more viable option? 19) What would I have thought before I got these complaints? 20) Am I not making logical fallacies (thought errors)? Appendix 3. Appendix 4. The thought schedule 1. Event When was it? Where was you? What were you doing? Who was / were there? ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………..
  • 4. 2. Feelings (and behavior) Describe the feeling or feelings you had in one word. How intense was / were this / these feeling(s) on a scale of 0 to 100%? ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ……………………………………………………………….. 3. Automatic thoughts (or images) Answer the following question: what thoughts (or images) popped up before you started to feel this way? (If necessary make use of the following recalls: what does that tell about me? What are the consequences of this in my life/ future life? What could happen in the worst case, what would others think about me?) ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ……………………………………………………………….. Select the main Negative Automatic Thought (= NAT): What idea or thought is most responsible for the feeling that gave rise to complete this schedule? How credible this idea was on a scale of 0 to 100%? ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………..
  • 5. 4. Arguments that support NAT ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ……………………………………………………………….. 5. Arguments contrary to NAT ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ……………………………………………………………….. 6. The effect of the New Balanced Thought Note here the feeling that you have researched and score the intensity again by imagining the event again while thinking about your new balanced thought. Indicate how credible the NAT is at this point (0 to 100%). ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ……………………………………………………………….. 7. Imagine a future similar situation and let the balanced new thought pass your mind and tell what feelings you would have and how strong they are? ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… ………………………………………………………………………… …………………………………………………………………………