Cognitive restructuring
Cognitive restructuring is the CBT skill of catching an upsetting thought, checking it against the facts, and finding a view that fits them better. It isn't positive thinking, and it isn't talking yourself out of a feeling. The goal is a thought you can believe, even if it's only a little kinder than the first one.
The thought record is cognitive restructuring on one page. Try it on a thought from today. Nothing you type leaves your device.
The moment
Just the facts, as a camera would record them.
If writing this out leaves you feeling worse, it's fine to stop and come back later, or to talk to someone you trust. If you're thinking about harming yourself, call or text 988 in the US, or see crisis resources.
Catch it, check it, change it
Iony Ezawa and Steven Hollon define cognitive restructuring as a set of techniques that help people identify, evaluate and correct inaccurate beliefs. It goes back to Aaron Beck's 1979 manual for depression.1 It's used in CBT for depression, panic, social anxiety, OCD and PTSD.1
Most teaching versions boil it down to the three moves in this heading.
- The moment: Your partner says "We need to talk tonight."
- Catch the thought: "They're going to break up with me." Believed 80 out of 100.
- Check it: Last week they planned a trip with you. "We need to talk" has also meant money and family before.
- A fuller view: "I don't know what it's about. It's been about ordinary things before, and I can ask."
- Rate again: Believed 40. Anxious went from 75 to 45.
Five steps on one thought
1. Catch the thought
Write the automatic thought in the exact words it came in. Rate how much you believe it, from 0 to 100.
"I'm going to embarrass myself in this presentation." Believed 85.
2. Name the pattern, if one fits
Many thoughts follow a known shape, such as catastrophizing or all-or-nothing thinking. Naming it may let you see it as a habit. Treat the name as a guess.
"That's the 'one mistake ruins everything' shape again."
3. Check it with questions
Ask questions you can answer from your own life. What fits the thought? What doesn't? What would I tell a friend? The Socratic questions page has a fuller list, and the evidence for stepping outside a thought.
"I've given three presentations this year. One went badly. The other two were fine."
4. Write a fuller view
Write a version that fits everything you found, in your own words. It doesn't need to be cheerful. It needs to be believable.
"I might stumble in places. I've done this before and got through it."
5. Rate it again
Rate the first thought and the feeling again. A drop from 85 to 60 counts. The numbers aren't a score; they show whether anything moved.
When the fuller view feels like a lie
At first, it often does. You write it and some part of you says "Sure, but it's still true that I'm hopeless." That's a sign the fuller view went too far.
Pull it back to something smaller you can believe.
You may also notice that checking works better on some thoughts than others. Thoughts about yourself or something that already happened can be weighed. A worry about tomorrow can't be settled by weighing, because the facts haven't happened yet.
How well it works
Restructuring helps many people, and it's one tool among several. Most pages on it stop at the first half of that sentence.
More restructuring within sessions went with better results across 4 studies with 353 clients, pooled by Ezawa and Hollon, a correlation of r = .35.1 That's a link, and it can't show cause.
On a worksheet, it works at least in the short run. One session with a thought record lowered belief in a negative thought compared with a control in a study of 91 adults, though a behavioral experiment changed belief sooner and the change spread further.2
The trial that took the thought work out
Here's the finding the top pages leave out. In a 1996 trial, 150 people with depression had either full cognitive therapy, its behavioral part alone, or the behavioral part plus work on automatic thoughts.3
The full treatment did no better than either part, at the end or 6 months later.3
A 2007 review of component studies found little evidence that cognitive techniques add to CBT's effect.4 A 2015 review read the evidence differently, concluding that cognitive work does help and that thinking changes with symptoms, however that change comes about.5
For some thoughts, then, a behavioral experiment or behavioral activation may do more than another round on paper.
Repeating a positive line you don't believe is a different thing again, and the mixed research on it is on the positive affirmations page.
Which check for which thought
- About you or the past: Weigh what fits the thought and what doesn't, then write a fuller view.
- A worry about the future: Write what you fear and when you'll know, then check what happens.
For worries, checking what happens has more to offer than arguing the odds, and the worry time page shows why. The thought record has a separate path for them.
When the same thoughts keep winning
If you've tried restructuring for a few weeks and the same thoughts keep winning, a CBT therapist can help you find what's in the way.
Write one thought that weighed on you today and rate it from 0 to 100. Then write two facts that fit it and two that don't. What's a version you could believe?
Answer this with JoyQuestions people ask
What is an example of cognitive restructuring?
Someone thinks "I failed the interview, so I'll never get a job." They check: they got a second interview last month, and one rejection isn't every rejection. Their fuller view: "This one didn't work out. I've had interest before, and I can apply again."
What are the three C's of cognitive restructuring?
Catch it, check it, change it. It's a teaching shorthand: catch the thought, check it against the facts, and change it to a fuller view you can believe.
What are the five steps of cognitive restructuring?
There's no single official list. A common version is: catch the thought, name the pattern, check it with questions, write a fuller view, and rate it again. That's the order used on this page.
Is cognitive restructuring the same as reframing?
They overlap. Reframing usually means looking at a situation from a different angle. Cognitive restructuring is more structured: it checks the specific thought against evidence before finding a new view.1
Related
- Thought record: the worksheet that walks you through the steps.
- Socratic questions: the questions used in the "check it" step.
- Behavioral experiments: testing a thought by doing something.