Cognitive Behavioral Therapy (CBT) Worksheet for AA

Patient Information

• Name: AA
• Age: 20
• Condition: Diagnosed with Autism Spectrum Disorder (ASD) at age 5
• Main Concern: Walking fast, impacting friendships
• Current Mood: Experiencing symptoms of depression
• Support System: Limited social circle with few friends sharing the same hobbies
• Medications: None
• Previous Therapy: Unknown

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Goals for Therapy

1. Increase Awareness: Help AA recognize how their walking speed may impact social interactions and relationships.
2. Social Skills Development: Improve communication and engagement with peers.
3. Mood Enhancement: Work on lifting depressive symptoms through increased social interaction and enjoyment of hobbies.

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Section 1: Identifying Thoughts and Feelings

Use this section to reflect on your daily experiences and emotions. Journaling helps in recognizing the connection between thoughts, feelings, and behavior.

Daily Reflection

• Date: __

• What emotions did you feel today?

  • [] Sad
  • [] Anxious
  • [] Frustrated
  • [] Happy
  • [] Other: __

• What thoughts accompanied these emotions?

  • ---

  • ---

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Section 2: Behavior Tracking

Track your walking behavior and social interactions to identify patterns and areas for change.

Walking Speed and Social Interaction Log

• Date: __

• Walking Speed (1-10):

  • 1 = Very Slow
  • 10 = Very Fast
  • Rating: __

• Interactions with Friends Today:

  • How many friends did you see? __
  • What activities did you engage in? __

• How did your walking impact these interactions?

  • ---

  • ---

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Section 3: Challenging Negative Thoughts

Now that you’ve identified some thoughts, let’s work on challenging them. This is crucial for modifying your behavior.

Thought Challenge

• Negative Thought:

  • ---

• Evidence Supporting This Thought:

  • ---

  • ---

• Evidence Against This Thought:

  • ---

  • ---

• Re-framed Thought:

  • ---

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Section 4: Behavioral Experiment

We will engage in a behavioral experiment to better understand your feelings and improve social interaction.

Experiment Plan

• Goal: To walk at a slower pace for a social activity (e.g., walking with a friend).
• Activity: __
• Date of Experiment: __
• Expected Outcome:
  • What do you hope to achieve? __

After the Experiment

• What went well?

  • ---

• What challenges did you face?

  • ---

• What did you learn from this experience?

  • ---

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Section 5: Future Planning and Support

• Short-term Goals:
  • ___ (Example: Join a new hobby club)

  • ---

• Long-term Goals:
  • ___ (Example: Establish deeper friendships)

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Seeking Support

• Consider discussing your experience with professionals or peers. List any potential support systems or resources below prior to your next session.
• Support Systems:

  • ---

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Final Thoughts

Reflect on how the process of identifying thoughts, feelings, and behaviors can lead to positive change. Remember, the goal is gradual progress, not perfection.

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Note: This worksheet serves as a guide to support you in your journey. Share this with your therapist to discuss your insights and strategies during your sessions.