Cognitive Behavioral Therapy Worksheet for Monica

Patient Information

• Name: Monica
• Age: 55-64
• Condition Summary: Distress, anxiety, fear, frustration in her relationship
• Marital Situation: Stay-at-home wife, controlled by her husband, facing verbal abuse and domestic violence
• Therapy Experience: Brief (1-5 sessions)
• Medication: None
• Goal: Stress management and improved emotional well-being

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Understanding Your Issues

1. Identifying Distress Triggers

Instructions: Identify situations or thoughts that trigger feelings of distress, anxiety, and fear. Write down your thoughts and feelings related to these triggers.

• Trigger 1:
  Situation:
  Thoughts:
  Feelings:

• Trigger 2:
  Situation:
  Thoughts:
  Feelings:

• Trigger 3:
  Situation:
  Thoughts:
  Feelings:

2. Analyzing Your Thoughts

Instructions: For each trigger listed above, challenge and reframe the negative thoughts you have.

Trigger	Original Thought	Reframed Thought
Trigger 1
Trigger 2
Trigger 3

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Coping Strategies

3. Stress Management Techniques

Instructions: Below is a list of stress management techniques. Choose at least three that resonate with you, and write down how you can incorporate them into your daily routine.

• Technique 1: Deep Breathing Exercises

  • How to incorporate:

• Technique 2: Journaling

  • How to incorporate:

• Technique 3: Mindfulness Meditation

  • How to incorporate:

4. Social Support

Instructions: List individuals or groups you can reach out to for support. This could include friends, family members, community resources, or support groups. Write down at least three options.

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Setting Goals for Behavioral Change

5. Short-term Goals

Instructions: Identify two to three short-term goals you would like to achieve in the next few weeks. These should be realistic and manageable.

• Goal 1:
  Action Steps:
• Goal 2:
  Action Steps:
• Goal 3:
  Action Steps:

6. Long-term Goals

Instructions: Identify one or two long-term goals that you would like to work toward over the next few months.

• Goal 1:
  Action Steps:
• Goal 2:
  Action Steps:

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Reflection

Instructions: Spend a few moments reflecting on your current situation and what you hope to achieve through therapy. Write your thoughts below.

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Next Steps

7. Preparing for Future Sessions

Instructions: Reflect on what you would like to discuss in your upcoming therapy sessions. List topics or concerns that you want to address.

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Self-Care

8. Daily Self-Care Routine

Instructions: Create a daily self-care routine that prioritizes your mental and emotional health. Incorporate at least three activities you enjoy.

• Activity 1:
• Activity 2:
• Activity 3:

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Closing Thoughts

Take a moment to acknowledge the effort you are putting into your healing process. Remember, change takes time and commitment, so be gentle with yourself. Validate your emotions and remind yourself that seeking help is a brave step towards a healthier, more fulfilling life.

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Note: It may be beneficial to discuss this worksheet with your therapist in your next session to track your progress and adapt your approach as needed.