COGNITIVE BEHAVIORAL LOG

FIRST AND LAST NAME:

First NameLast Name

PATIENT E-MAIL (OPTIONAL): enter your email address if you want a copy of this emailed to you

example@example.com

ACTIVATING EVENT: (What was the trigger, what did you hear, see, feel, taste, smell that triggered the undesired emotions and behaviors)

BELIEF: (Belief About the Activating Event Experienced, remember you may have to dig deep for this and it doesn't have to be true to belief it...if we believe something it still impacts our emotions and behaviors)

EMOTIONAL CONSEQUENCE: (What emotions did you feel? Remember we need to learn to identify and express our emotions with our words..."I felt scared, worried, lonely, sad, angry, enraged, irritated.")

BEHAVIORAL CONSEQUENCE: (What physical behaviors did we experience as a result of the emotions...we are not just looking for voluntary things. We are also wanting to learn to be mindful of a change in heart rate, breathing, gritting of our teeth, blood pressure change, tearfulness, muscle tension)

LOOK BACK AT THE BELIEF YOU IDENTIFIED. CAN YOU DETERMINE IF THIS BELIEF WAS TRUR OR NOT? LETS DISCUSS THIS DURING OUR SESSION. IF WE DETERMINE THE BELIEF IS TRUE THEN WE HAVE TO EXAMINE OUR POSSIBLE CONTROLLED RESPONSES (DO NOT REACT OUT OF IMPULSE OR COMPULSION....VERY VIEW THINGS ACTUALLY REQUIRE AN IMMEDIATE RESPONSE THAT PREVENTS US FROM TAKING A FEW MINUTES TO DETERMINED HOW WE WILL RESPOND).

IF WE DETERMINE THE BELIEF IS NOT TRUE THEN WE CAN WORK ON CHANGING THIS BELIEF USING COGNITIVE RESTRUCTURING OR CHALLENGING THIS BELIEF.