35+ Powerful CBT Exercises & Techniques for Therapists

For many clients, cognitive behavioral therapy (CBT) has been life changing, enhancing their psychological wellness, workplace performance, and relationships (Werson et al., 2022).

CBT’s widely researched and structured approach to addressing negative thought patterns and maladaptive behaviors has proven invaluable for helping clients overcome challenges, take control of their lives, and learn to flourish (Dobson & Dozois, 2021; Geschwind et al., 2019).

The challenge, however, is how to bridge theory and practice to help clients translate cognitive behavioral concepts into these meaningful life improvements.

As a positive and performance psychologist, I’ve collaborated with various mental health professionals in developing ways to overcome this challenge. In this article I will share powerful CBT exercises, techniques, and worksheets and offer actionable insights to foster resilience and lasting positive change.

Before you continue, we thought you might like to download our three Positive CBT Exercises for free. These science-based exercises will provide you with detailed insight into Positive CBT and give you the tools to apply it in your therapy or coaching.

What Is Cognitive Behavioral Therapy?

CBT has three foundational propositions (Dobson & Dozois, 2021):

• Our thoughts (cognitive activity) influence our behavior.
• We can observe and adjust our thought patterns.
• Changing how we think can lead to desired behavioral changes.

While many very different interventions are built upon these foundational principles, they all share the idea that “cognition influences how an individual feels and behaves, and that cognition can be altered to mediate behavior change” (Dobson & Dozois, 2021, p. 6).

Many of the CBT tools and exercises that are effective in therapy can also be helpful in everyday life.

The nine techniques and tools listed below are some of the most common and powerful CBT practices.

Cognitive distortions

Many of the most popular and effective cognitive-behavioral therapy techniques are applied to what psychologists call cognitive distortions: “systematic information processing biases that distort incoming information to fit the pre‐existing schema” (Puri et al., 2021, p. 1974).

Inaccurate thoughts reinforce our negative thinking patterns and emotions in various forms, several of which are captured in the following infographic (Pittard et al., 2020).

Some of the tools and techniques found in cognitive behavioral therapy are intended to address or reverse cognitive distortions, such as catastrophizing, overgeneralization, and jumping to conclusions (Pittard et al., 2020).

The following CBT exercises can help restore the balance between reality and our inner mental landscape:

• Decatastrophizing
  Identify the harmful and excessive worry associated with a problem or situation and focus on what will most likely happen.
• Decatastrophizing Worksheet
  Examine a potential catastrophe causing you to become overwhelmed and capture the most reassuring or positive thing you would like to hear.
• Cataloging Your Inner Rules
  Create a list of unhelpful or judgmental rules that impact you daily, then challenge and replace each one.
• WDEP Questions Worksheet
  Build more clarity surrounding your inner thoughts by understanding what you want, what you are doing, and what your plan is.
• Disputing Irrational Beliefs
  Recognize and challenge irrational beliefs by asking if they’re working for you.
• Dysfunctional Thought Record
  Record and analyze negative thoughts in this seven-column worksheet to help identify cognitive distortions.
• Challenging Catastrophic Thinking Worksheet
  Capture thought processes associated with catastrophic thinking to encourage a more balanced perspective.

Our article Cognitive Distortions: 22 Examples & Worksheets (& PDF) digs deeper into our tendency to make inaccurate connections from overly simplistic assumptions and offers CBT exercises and techniques to help.

7 Best CBT Techniques for Therapists

Recent and ongoing research confirms the value of CBT, behavioral therapy, and cognitive therapy for treating anxiety and mood disorders such as depression, and is often considered the treatment of choice (Yarwood et al., 2024; Dobson & Dozois, 2021).

Several CBT exercises are included below:

For anxiety

• Graded Exposure Worksheet
  Understand your fears by rating them and reducing them incrementally through graded exposure.
• Progressive Muscle Relaxation – Early Basics
  Use progressive muscle relaxation to relax the physical tension and tightness we feel as part of our stress response. This version is particularly suited to younger clients.
• The Downward Arrow Core Beliefs
  Negative beliefs increase our anxiety. Identify which situations bring up negative emotions, what thoughts accompany them, and what they mean to you.

For depression

• Activity Schedule
  Depression can make planning and performing even the simplest tasks challenging. Create a schedule to establish a baseline of meaningful and enjoyable tasks and activities and build in new ones.
• Behavior Contract
  Create a contract with trusted and supportive friends, colleagues, and family members that commits to healthy behaviors and limits unhealthy ones.
• Recognizing Rumination
  Persistent negative thinking is a key risk factor for depression (Yarwood et al., 2024). Identify recurring unhelpful thoughts and when they happen to change the narrative.
• Challenging Unhelpful Thoughts Arising from Grief Worksheet
  Working through grief can be overwhelming and, if not dealt with, lead to longer-term mood disorders. Help clients replace destructive thoughts with more constructive alternatives.

9 Powerful CBT Exercises & Interventions

CBT-inspired exercises and techniques can be valid in many different contexts and various populations, including supporting those with attention deficit hyperactivity disorder (ADHD), phobias, and anger management issues (Pan et al., 2019; Dobson & Dozois, 2021; MacMahon et al., 2015).

The following CBT exercises may have more than one use:

For ADHD

• If–Then Planning
  Create plans for managing challenging situations and taking control of the unexpected.
• Problem-Solving Self-Monitoring Form
  Use problem-solving to tackle challenges, plan and prioritize tasks, and meet deadlines.
• Getting the Facts Worksheet
  Practice differentiating between assumptions and facts when making decisions.

CBT exposure exercises

• Imagery-Based Exposure Worksheet
  Practice recalling difficult memories and accepting them to reduce avoidance behaviors.
• Interoceptive Exposure
  Expose yourself to panic-related physiological symptoms and thoughts and learn how to become more comfortable with them.
• Event Visualization Worksheet
  Use visualization as a flexible, safe, and controlled environment to explore future challenges or situations that heighten fears.

For anger management

• Anger Exit and Re-Entry Routines: The Pause That Refreshes
  Understand the thoughts and signals that warn when you are about to lose control of your anger.
• Evaluating Your Thoughts, Thought Diary Worksheet
  Identify and understand thoughts leading to overly emotional responses and consider how else a situation might be interpreted.
• Pleasant Activity Scheduling Worksheet
  Schedule enjoyable activities to help manage extreme emotions and provide a sense of mastery over situations and events.

6 Evidence-Based CBT Worksheets

CBT’s cognitive restructuring is one of the most vital techniques for behavioral and cognitive transformation (Dobson & Dozois, 2021).

Cognitive restructuring

Once you identify the distortions you hold, you can explore how they took root and why you came to believe them. When you discover a destructive or harmful belief, you can begin challenging it — known as cognitive restructuring (Dobson & Dozois, 2021).

CBT exercises that directly or indirectly support cognitive restructuring include:

• Thought Record Worksheet
  Identify faulty thinking styles, such as self-blame and rigid thinking.
• Behavioral Experiments to Test Beliefs Worksheet
  Test negative thoughts to reevaluate underlying beliefs and assumptions.
• Cognitive Restructuring of an Event
  Reflect on how each negative situation can be reframed more positively or accepted for what it is and the positives it may offer.
• Cognitive Restructuring Worksheet
  Use Socratic questioning to challenge whether irrational thoughts are based on evidence or opinion.
• ABC Functional Analysis Worksheet
  Explore the antecedents of behavior to understand whether they are unhelpful and inaccurate.
• Replacing “What If” Statements Worksheet
  Reduce anxiety by identifying distorted thinking and replacing it with more helpful thought patterns.

6 More Cognitive Behavioral Activities for Your Clients

CBT has evolved over the years to meet the needs of various groups and support multiple issues. However, despite their broad applicability, CBT interventions typically fit into one or more of the following (Dobson & Dozois, 2021):

1. Cognitive restructuring
2. Coping skills
3. Problem-solving

The following CBT exercises are helpful as standalone activities and in conjunction with other therapeutic approaches and expand on coping and problem-solving:

• Coping Styles Formulation Worksheet
  Help clients and therapists reach a shared understanding of the presenting problem and develop more adaptive coping strategies.
• Coping With Stress
  Identify the life situations that leave you stressed and find more adaptive, helpful coping mechanisms.
• I Will Survive
  Focus on past events to understand personal coping skills and support systems that can help future challenges.
• Reverse the Rabbit Hole Worksheet
  Problem-solving with positive outcomes rather than focusing on what can go wrong can help manage and avoid worry and anxiety.
• Problem-Solving Worksheet for Adults
  Clearly describing problems, weighing their potential consequences, and capturing possible solutions is a powerful approach for managing and controlling unhelpful thinking.
• Core Beliefs Suitcases Worksheet
  Understanding core beliefs supports coping and problem-solving in existing and new situations.

In recent years, CBT has increasingly been combined with multiple aspects of positive psychology. The following infographic compares and contrasts the two approaches (Vazquez et al., 2018):

6 Common Challenges & Tips to Overcome Them

As with all therapy, CBT has its challenges.

Building a solid therapeutic alliance

A strong therapeutic alliance is vital to successful client outcomes and overcoming challenges such as (Ardito & Rabellino, 2011; DeAngelis, 2019):

• Clients who do not wish to engage in therapy, either because they lack motivation or trust
• Barriers to communication that prevent a collaborative relationship

Tips

• Patiently build a solid alliance based on transparency, clarity, and trust.
• Share the rationale behind interventions to increase client understanding and confidence.
• Work together to identify therapeutic objectives, fostering an open partnership.
• Obtain and act upon feedback from the client.

Overcoming resistance

Clients aren’t always ready for the therapeutic process and may display signs of resistance, for example (Clay, 2017; Dobson & Dozois, 2021):

• They may be unwilling to open up during sessions.
• Communication may be abrupt or argumentative.
• Clients may not complete homework assignments.

Tips

• Spend time building rapport and trust.
• Engage in active listening and display empathy.
• Openly discuss any fears or concerns the client may have.
• Repair any ruptures or breakdowns in the alliance.

Tailoring exercises to fit clients’ needs

CBT exercises and tools must be specific to the situation and the client to maximize their effectiveness. Otherwise, clients may struggle to change unhelpful thoughts and beliefs (Dobson & Dozois, 2021).

Tips

• Tailor interventions and CBT exercises to the clients’ needs and make them appropriate to their situation.
• Listen to what the clients say and remain flexible with the techniques adopted.
• Educate and involve the clients in the therapy process, explaining the purpose of each activity.

Helpful Cognitive Behavioral Therapy Manuals & Workbooks

There are many manuals and workbooks that help therapists apply cognitive behavioral therapy exercises in their work. The following are three of our favorites of the most popular resources available:

1. Handbook of Cognitive Behavioral Therapies – Keith Dobson and David Dozois (Editors)

This is a vital resource for students and mental health practitioners wishing to understand CBT, adopt its key principles, and introduce related interventions to therapy sessions.

The editors have collated essential chapters that explain CBT alongside related therapies and how to apply them to specific populations.

Find the book on Amazon.

2. The Comprehensive Clinician’s Guide to Cognitive Behavioral Therapy – Leslie Sokol and Marci Fox

This vast knowledge base captured in a spiral-bound form provides comprehensive and up-to-date information on CBT and its exercises.

The authors have packed the manual with worksheets, plans, and exercises covering various issues, including anger management, post-traumatic stress disorder, depression, and psychosis.

Find the book on Amazon.

3. The CBT Toolbox – Jeff Riggenbach

In this book, Jeff Riggenbach turns his 20 years of clinical practice into a valuable collection of 185 CBT-based tools.

This practical book offers a vital resource for counselors and therapists helping clients address unhelpful thinking patterns.

Find the book on Amazon.

For other resources, see our article 12+ Best CBT Books to Master Cognitive Behavioral Therapy.

Resources From PositivePsychology.com

We have many CBT exercises available for therapists wishing to support individuals and groups facing emotional and behavioral challenges.

More extensive versions of the following tools are available with a paid subscription to the Positive Psychology Toolkit©, but they are described briefly below.

• Behavioral Activation
  Behavioral activation offers an effective technique for decreasing depressive symptoms by encouraging clients to embrace activities that provide them with experiences of pleasure or a sense of mastery. Try out the following four steps:
  • Step one – Log existing activity levels.
  • Step two – Categorize each one as energy giving or draining.
  • Step three – Identify which activities offer pleasure or a sense of mastery.
  • Step four – Find opportunities to engage in more energy-giving activities throughout the week.
• Daily Exceptions Journal
  This exercise combines traditional CBT with positive psychology by encouraging clients to focus on what is right, rather than wrong, in their lives.

The technique enables the client and therapist to better understand the problems the client faces and the contexts in which they occur.

Complete a daily exceptions journal by answering a series of questions, including:

What has improved today, even if just a little bit?
What did I do differently to improve things?
When didn’t I experience the problem today?
When was the problem less of a problem?
What could I continue to do to make improvements?

If you’re looking for more science-based ways to help others through CBT, this collection contains 17 validated positive CBT tools for practitioners. Use them to help others overcome unhelpful thoughts and feelings and develop more positive behaviors.

A Take-Home Message

Therapists, clients, and researchers confirm the value of CBT for supporting individuals, couples, and families wishing to move away from unhelpful or even harmful feelings and behaviors.

CBT is diverse and evolving. It represents a convergence of behavioral strategies and cognitive processes continually integrating insights from neuroscience, positive psychology, and mindfulness-based interventions to enhance its effectiveness and adaptability.

The ongoing transformation enables CBT to address various mental health challenges while working alongside and complementing other therapeutic approaches (Dobson & Dozois, 2021).

Such versatility and broad applicability mean it is highly valued in various populations, including those facing depression, mood disorders, anxiety, post-traumatic stress disorder, eating disorders, and anxiety.

CBT exercises and techniques take many forms and have a range of purposes, including managing stress, replacing unhelpful thoughts, goal setting, boosting performance and self-esteem, and improving resilience (Riggenbach, 2021).

But like other therapies, it has its challenges. Ultimately, the therapeutic alliance is vital. The therapist and client must see the work as a partnership built on trust where open dialogue is essential.

Whether you are a trained cognitive behavioral therapist or other mental health practitioner, it is vital to understand the potentially damaging impact of clients’ unhelpful thoughts. Once recognized, it is possible to bridge theory and practice by designing practical CBT exercises that help clients overcome these unwanted thoughts and make meaningful life improvements.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free.

ED: Rewrite Apr 2025