Create a Cognitive Behavioral Therapy worksheet for a patient dealing with mentioned issue(s) and aiming for behavioral changes. Take into a...
aidemia--modules-cbt_worksheet_requestCreate a Cognitive Behavioral Therapy worksheet for a patient dealing with mentioned issue(s) and aiming for behavioral changes. Take into account the details listed further.
Full nameTeagan
AgeChild
Patient condition detailsptsd and domestic violence from an early age
Patient conditionInsomnia
Relevant challengesNothing in particular
Therapy experienceExtensive (21+ sessions)
MedicationAntidepressants
Needed behavioural changeNo particular
How many pages1
Emergency contactmom
Any other preferences

Cognitive Behavioral Therapy Worksheet for Teagan

Patient Name: Teagan
Age: Child
Date: [Insert Date]
Therapist: [Insert Therapist's Name]


Patient Overview

Condition Summary:
Teagan is a child who has experienced trauma related to PTSD and domestic violence from an early age. This history has significantly affected her emotional and psychological well-being, leading to issues such as insomnia. Teagan is currently on antidepressants and has had extensive therapy experience, with over 21 sessions completed.

Emergency Contact

Emergency Contact Name: Mom
Emergency Contact Number: [Insert Contact Number]


Section 1: Understanding Your Thoughts and Feelings

1.1 Identify Your Thoughts

Take a moment to think about your day-to-day experiences. Write down any negative thoughts that may arise, especially those that might contribute to your insomnia.

Date Negative Thought

1.2 Identify Your Feelings

After identifying your thoughts, consider the feelings associated with them. Use the following scale to describe your feelings on a scale from 1 (not at all) to 10 (extremely).

Negative Thought Feeling Intensity (1-10)

Section 2: Challenging Your Negative Thoughts

2.1 Examine Evidence

For each negative thought you recorded, ask yourself the following questions to gather evidence for and against the thought.

Thought: [Insert Thought Here]

2.2 Alternative Thoughts

Based on the evidence you've gathered, create alternative, more balanced thoughts.

Negative Thought Alternative Thought

Section 3: Behavioral Interventions

3.1 Sleep Hygiene Practices

Reflect on the practices you can adopt to improve your sleep. Use the checklist below:

3.2 Coping Strategies

Consider effective coping strategies that you can employ during difficult moments or when you’re feeling anxious.

Coping Strategy When to Use
Deep breathing When feeling anxious or restless
Visualization Before bed or during stress
Journaling At the end of the day
Talking to someone Whenever you feel overwhelmed

Section 4: Reflection

At the end of each week, reflect on your progress. Consider the following prompts:


Additional Notes

Use this section to jot down any insights, reminders, or personal notes.


Therapist Signature: ____
Date: [Insert Date]

Note: This worksheet is a tool to support you in your journey toward better mental health. Be kind to yourself, and remember that healing takes time.