You can use any set of questions to help clients evaluate their thinking, but the lists can be helpful as they guide you and the client to

• examine the validity of the automatic thought,
• explore the possibility of other interpretations or viewpoints,
• decatastrophize the problem situation,
• recognize the impact of believing the automatic thought,
• gain distance from the thought, and
• take steps to solve the problem.

All-or-nothing thinking
Also called black-and-white, polarized, or dichotomous thinking. You view a situation in only two categories instead of on a continuum.
Example: “If I’m not a total success, I’m a failure.”
Catastrophizing (fortune-telling)
Also called fortune-telling. You predict the future negatively without considering other, more likely outcomes.
Example: “I’ll be so upset, I won’t be able to function at all.”
Disqualifying or discounting the positive
You unreasonably tell yourself that positive experiences, deeds, or qualities do not count.
Example: “I did that project well, but that doesn’t mean I’m competent; I just got lucky.”
Emotional reasoning
You think something must be true because you “feel” (actually believe) it so strongly, ignoring or discounting evidence to the contrary.
Example: “I know I do a lot of things okay at work, but I still feel like I’m a failure.”
Labeling
You put a fixed, global label on yourself or others without considering that the evidence might more reasonably lead to a less extreme conclusion.
Examples: “I’m a loser”; “He’s no good.”
Magnification/minimization
When you evaluate yourself, another person, or a situation, you unreasonably magnify the negative and/or minimize the positive.
Example: “Getting a mediocre evaluation proves how inadequate I am. Getting high marks doesn’t mean I’m smart.”
Mental filter
Also called selective abstraction. You pay undue attention to one negative detail instead of seeing the whole picture.
Example: “Because I got one low rating on my evaluation [which also contained several high ratings], it means I’m doing a lousy job.”
Mind reading
You believe you know what others are thinking, failing to consider other, more likely possibilities.
Example: “He’s thinking that I don’t know the first thing about this project.”
Overgeneralization
You make a sweeping negative conclusion that goes far beyond the current situation.
Example: “Because I felt uncomfortable at the meeting, I don’t have what it takes to make friends.”
Personalization
You believe others are behaving negatively because of you, without considering more plausible explanations for their behavior.
Example: “The repairman was curt to me because I did something wrong.”
“Should” and “must” statements
Also called imperatives. You have a precise, fixed idea of how you or others should behave, and you overestimate how bad it is that these expectations are not met.
Example: “It’s terrible that I made a mistake. I should always do my best.”
Tunnel vision
You only see the negative aspects of a situation.
Example: “My son’s teacher can’t do anything right. He’s critical and insensitive and lousy at teaching.”

What is the situation? You might be having thoughts about something that just happened in the environment or something that happened inside of you (an intense emotion, a painful sensation, an image, a daydream, a flashback, or a stream of thoughts—e.g., thinking about my future). I got a parking ticket.

• What am I thinking or imagining? I’m so stupid.

• What is the cognitive distortion? (optional) Labeling, overgeneralizing

• What makes me think the thought is true? I shouldn’t have lost track of time.

• What makes me think the thought is not true or not completely true? Other people get parking tickets. It doesn’t necessarily mean they’re stupid.

• What’s another way to look at this? I just made a mistake.

• If the worst happens, what could I do then? Just keep paying parking tickets, but it would be better to set an alarm on my phone so it doesn’t happen again.

• What’s the best that could happen? I’ll never get a parking ticket again.

• What will probably happen? I could get another ticket, but I’ll probably remember what happened this time and make sure I don’t.

• What will happen if I keep telling myself the same thought? I’ll keep being upset with myself.

• What could happen if I changed my thinking? I’d feel better.

• What would I tell my friend or family member [think of a specific person] Gabe if this happened to him or her? It’s not that big a deal. So you forgot and made a mistake. You know how to avoid doing this in the future.

• What would be good to do now? Get my mind off of this. Go for a walk.

Beck (1999) theorized that negative core beliefs about the self fall into two broad categories: those associated with helplessness and those associated with unlovability. A third category, associated with worthlessness (Figure 3.2), has also been described (J. S. Beck, 2005). When clients are depressed, their negative core beliefs may primarily fall into one of these categories, or they may have core beliefs in two or all three categories. Some have just one belief within a category; others have multiple beliefs within one category.

Sometimes it’s clear in which category a given negative core belief belongs, especially when clients actually use words such as “I am helpless” or “I am unlovable.” At other times, it’s not as clear. For example, depressed clients may say, “I’m not good enough.” You need to find out the meaning of cognitions like these to determine whether clients believe they are not good enough because they haven’t achieved enough (helpless category), or if they believe they’re not good enough for others to love them (unlovable category). Likewise, when clients say, “I’m worthless,” they may mean that they don’t achieve highly enough (helpless category) or that they won’t be able to gain or maintain love and intimacy with others because of something within themselves (unlovable category). The cognition “I’m worthless” falls in the worthlessness category when clients are concerned with their immorality or toxicity, not their effectiveness or lovability.

The goal of CBT is not to eliminate negative emotion. All emotions are important. Negative emotions frequently point to a problem that needs to be solved (which may or may not include changing one’s thinking)—or, if it can’t be solved, accepted. The goal of CBT is to reduce the degree and duration of negative emotion that doesn’t seem to be proportionate to the situation (given the client’s culture and circumstances), usually related to distorted or unhelpful perceptions. Acceptance of negative emotion (instead of avoidance) is key for some clients (Linehan, 2015; Segal et al., 2018). Acceptance and commitment therapy (Hayes et al., 1999) describes useful metaphors for accepting negative emotion and turning one’s attention to valued action.