The Positive CBT Triangle Explained (+11 Worksheets)

Cognitive behavioral therapy (CBT) is a popular and highly effective intervention model for dealing with multiple mental health conditions (Early & Grady, 2017; Yarwood et al., 2024).

Its success relies on the ability of the mental health practitioner to support clients in identifying their thoughts, feelings, and behaviors and recognizing how they connect and influence one another.

The CBT triangle visually represents the CBT model, highlighting how changes to one element impact the two others (Early & Grady, 2017).

This article discusses the CBT triangle and its potential to combine with positive psychology to support positive behavioral 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.

The CBT Triangle Briefly Explained

Cognitive behavioral therapy is an evidence-based approach to treating anxiety, depression, eating disorders, and many other mental health conditions (Yarwood et al., 2024; American Psychological Association, 2017).

“The CBT model proposes that dysfunctional thinking (which influences the patient’s mood and behavior) is common to all psychological disturbances” (Beck, 2011, p. 3).

As an approach, it’s been largely successful in helping reduce individuals’ suffering (relatively quickly) and helping them stay well (Beck, 2011).

The research backs up its continued use. A 2024 review examined clients’ experiences of CBT for anxiety and depression, with many studies reporting long-term improvements in mood and increases in confidence (Yarwood et al., 2024).

The basic premise of CBT

The essence of CBT involves recognizing that (Wilding, 2015):

• What you think (cognition or thoughts)
• Determines how you feel (physical and emotional feelings)
• Which affects what you do (behaviors)

Put simply, this means that if your thoughts are negative or unhelpful regarding a situation, event, or person, your feelings and behavior are also likely to be negative, harmful, or maladaptive.

The CBT triangle

Mental health professionals use the CBT triangle to help clients better understand the CBT approach. It creates an opportunity to explore its terms and key elements, how psychological problems are often based (at least in part) on faulty or unhelpful ways of thinking, and that it is possible to learn better ways of coping (Early & Grady, 2017; American Psychological Association, 2017).

We can visualize CBT as a triangle consisting of three interconnected points (Early & Grady, 2017):

CBT interventions can focus on any or all of these three components according to the client’s needs and the specific situation (Early & Grady, 2017).

We’ve identified several videos that reflect on how we can learn to transform our thinking, manage our emotions, and change our behavior.

What Are the Parts of the Cognitive Triangle?

The CBT triangle provides the client with a visual representation of how the three components (thinking, feeling, and behaving) of human experience interconnect and influence one another (Early & Grady, 2017).

The CBT triangle supports the work of the therapist by demonstrating how changing one side (a single element of the triangle) influences the other two and the importance of considering the interplay between all three components in therapy.

Thoughts

In CBT, “thoughts are seen as products of the mind,” vital to influencing emotions and behaviors (Early & Grady, 2017, p. 43). When thinking is negative, distorted, or unhelpful, it contributes to upsetting emotions and maladaptive behaviors.

CBT practitioners work with clients to identify and challenge unhelpful thoughts, replacing them with more realistic and adaptive ones (Beck, 2011).

Feelings/emotions

Emotional experiences or feelings that result from various situations and events can be positive, such as joy, excitement, and happiness, or negative, including fear, anger, and sadness (Beck, 2011).

The belief that such emotions result from our thoughts and how we interpret events is central to CBT (Early & Grady, 2017).

CBT-trained health professionals support their clients in identifying, understanding, and addressing their underlying thoughts and beliefs to help them develop more healthy responses.

Behaviors

According to CBT, we act, react, and behave (overtly or covertly) in response to our thoughts and emotions. When our thinking and feelings are negative, our behaviors may be maladaptive — sometimes avoidant or self-destructive (Early & Grady, 2017; Beck, 2011).

CBT can help clients identify and modify these harmful behaviors and replace them with more helpful ones.

Positive Psychology & the CBT Triangle

“Positive psychology is the scientific study of optimal human functioning, the goals of which are to better understand and apply those factors that help individuals and communities thrive and flourish” (Magyar-Moe et al., 2015, p. 509).

Positive psychology and the CBT triangle can be used together to enhance therapeutic interventions, promote overall wellbeing, and increase the likelihood of positive treatment outcomes (Beck, 2011; Seligman & Csikszentmihalyi, 2000; Snyder & Lopez, 2011).

Therapists can combine such approaches, techniques, and mental health strategies to create a comprehensive and holistic approach to promote psychological wellbeing. In doing so, mental health professionals help clients identify and recognize challenges while they work toward valued-led goals.

Clients are encouraged to identify their signature strengths and how they can support them as they overcome negative thinking and harmful behaviors within the CBT framework while enhancing motivation, resilience, and self-efficacy to create a flourishing life (Beck, 2011; Seligman, 2011).

Positive reappraisal is also helpful. Therapists can encourage clients to challenge and restructure negative thoughts and beliefs, promoting a more optimistic and constructive perspective through an increased focus on recognizing and cultivating positive emotions (Seligman, 2011).

Positive psychology interventions, such as gratitude exercises or promoting acts of kindness, can combine with CBT to help clients shift their focus toward positive experiences and feelings that improve mood, resilience, and overall wellbeing.

Additionally, goal-setting and meaning-making exercises help clients align their thoughts, emotions, and behaviors with their values and aspirations, providing an optimistic yet realistic sense of meaningful living and fulfillment (Beck, 2011; Seligman, 2011).

Combining positive psychology principles with the CBT triangle helps therapists create a comprehensive and holistic approach that addresses individuals’ challenges and strengths.

How to Use the Triangle With Clients

The CBT triangle is a powerful tool for supporting clients in understanding and applying the CBT method and has the potential to increase or improve (Early & Grady, 2017; Beck, 2011; Dobson & Dozois, 2021):

1. Psychoeducation
   Clients may benefit from recognizing and understanding the importance of the interplay between thoughts, emotions, and behaviors. Psychoeducation promotes an understanding that each component is part of an overall system that contributes to the client’s wellbeing.
2. Identifying thoughts
   Therapists can use the visual aspect of the CBT model to encourage clients to become more aware of their thoughts and beliefs in various situations. Exercises and homework may include completing thought records and daily journaling and practicing how to identify automatic negative thoughts and cognitive distortions.
3. Challenging thoughts
   Having identified negative thoughts, the mental health professional guides their clients toward challenging and questioning their accuracy and validity. The CBT triangle supports exploring alternative perspectives and a more balanced and realistic way of thinking.
4. Emotion regulation
   Clients learn to identify and label emotions associated with their thoughts and behaviors. They can develop emotional regulation strategies through deep breathing exercises, mindfulness, and progressive muscle relaxation.
5. Behavior activation
   Clients are encouraged to identify and reflect upon behaviors that maintain or reinforce negative thoughts and feelings. They can work with counselors to form plans that engage alternative behaviors aligned with their goals and values. Bigger goals are broken down into achievable chunks and tracked toward desired outcomes.
6. Homework assignments
   Homework exercises are essential. Tasks that practice the skills learned in therapy sessions can be combined with the CBT triangle to identify and understand difficult feelings, thoughts, and unwanted behaviors.
7. Monitoring progress
   Successful outcomes can be tracked, supporting the client’s understanding of CBT theory and practice. When setbacks occur, they can return to core principles and psychoeducation.
8. Integration of positive psychology
   Positive psychology principles can combine with the CBT triangle to focus on the client’s strengths, positive emotions, positive relationships, meaning, achievement, and goal setting.

The therapist should tailor the use of the triangle to the specific needs of the client and their situation; flexibility and collaboration remain critical to successful therapeutic outcomes.

4 Helpful Positive CBT Techniques for Therapy

The following exercises and worksheets are examples of positive CBT techniques that support successful therapeutic outcomes with clients:

1. The Event Visualization Worksheet offers a safe and supportive approach to exploring future challenges and situations.
2. The Replacing ‘What If’ Statements exercise encourages clients to evaluate negative statements and convert them into more positive ones.
3. The If-Then Planning Worksheet prepares individuals for what could go wrong, reducing the likelihood of cognitive distortion or catastrophizing.
4. The Capitalizing Positive Emotions With Active Constructive Responding exercise supports sharing positive events and taking turns to identify appropriate responses.

Helpful CBT Triangle Worksheets for Behavior Change

CBT has incredible potential to support positive behavioral change. The CBT triangle helps clients identify and understand the connection between thoughts, feelings, and how they behave (Early & Grady, 2017; Beck, 2011).

Two CBT triangle-based worksheets include:

1. Identifying alternative thoughts

This worksheet uses the CBT triangle to capture the thoughts, feelings, and behaviors associated with a negative situation.

The client then tries out more helpful, alternative thoughts and assesses their potential outcome.

The exercise helps individuals recognize other more positive ways of seeing a difficult situation.

2. Positive experience reflections

Positive thoughts, emotions, and behaviors are vital to mental wellbeing.

In the positive experience worksheet, the client uses the CBT triangle to identify the links between positive thoughts and the resulting feelings and actions.

They then reflect on how they could be adapted and used in future situations.

The exercise encourages individuals to adopt a more mindful and proactive approach while building positivity in their lives.

CBT Triangle Activities for Kids and Teenagers

These activities are an easy way to teach children from a young age how their thoughts and actions correlate.

Understanding the consequences of their behaviors and how not to be controlled by their emotions can give them a valuable grounding as they become young adults.

1. Feelings garden CBT triangle activity for kids

The feelings garden activity helps children playfully identify, understand, and express their thoughts, feelings, and behaviors.

Ask the child to remember and draw pictures related to their thoughts, feelings, and behaviors when they were annoyed, upset, or frustrated, then repeat for a happy time.

Using color and drawing pictures associated with both situations will help them become more familiar with how different elements of their garden interact.

2. Social media scenario CBT triangle activity for adolescents

In the social media scenario CBT triangle activity, adolescents are encouraged to explore how their thoughts, feelings, and behaviors interact within the context of social media use.

By understanding how their thoughts impact how they react to the world around them, they can learn to manage the effect of social media on their lives.

Useful Resources From PositivePsychology.com

We have many resources available for mental health practitioners adopting a CBT approach to support individuals and groups in overcoming and recovering from mental health issues.

Our free resources include:

• Simple Thought Diary
  This simple spreadsheet captures thoughts for later evaluation.
• Core Beliefs CBT Formulation
  We can challenge negative thoughts by identifying and reflecting upon core beliefs.
• Cognitive Restructuring of an Event
  With practice, we can learn to prevent our thoughts from worsening a situation that has already taken place.

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

• The ABC model of helpful behavior

This exercise supports the therapist using the ABC model to analyze why helpful (rather than problematic) behavior occurs by exploring what triggers or reinforces the behavior (antecedents) and the client’s reactions to the behavior (consequences).

Try out the following four steps with clients to help them understand why constructive behavior occurs and how it can be encouraged:

• • Step one – The therapist explores and explains the ABC model to the client.
  • Step two – Next, the client is encouraged to focus on helpful behavior.
  • Step three – Then they reflect on problems they successfully handled.
  • Step four – The client then recalls the triggers and the details behind associated positive behavior and its outcomes.
• Behavioral activation

Behavioral activation is a valuable technique aimed at decreasing a client’s depressive symptoms. It involves planning and engaging in positive events to increase a sense of overall control.

Try out the following four steps in order:

• • Step one – Keep track of daily activities in an activity planner.
  • Step two – Categorize each activity as either energy giving or draining.
  • Step three – Identify whether each energy-giving activity is performed for pleasure or mastery.
  • Step four – Add more pleasure and mastery activities to a new activity planner to ensure they happen.

If you’re looking for more science-based ways to help others through CBT, check out this collection of 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

Cognitive behavioral therapy is a powerful tool that has proven highly effective in treating various conditions across many client groups (Dobson & Dozois, 2021).

While the essential elements of CBT are relatively straightforward, the CBT triangle provides a visual framework for new practitioners and clients to understand the connections between thoughts, feelings, and behaviors (Early & Grady, 2017).

Crucially, the CBT triangle highlights the ability of each core element to influence the others. Awareness of such interplay helps individuals working with therapists understand the link between unhelpful thinking and unwanted behavior.

The therapist collaborates with clients to help them focus on all three components (thinking, feeling, and behaving) depending on their needs and the reason for attending therapy.

Clients are then actively encouraged to identify unhelpful thoughts that contribute to distressing emotions and unwanted behaviors and replace them with more positive and realistic ones while supporting their active role in their treatment (Beck, 2011).

Educators and therapists can adopt the CBT triangle to support those new to CBT to learn the core principles and become more adept at challenging their thoughts, emotions, and behaviors.

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