Cognitive Therapy of Anxiety Disorders

555

From

Cognitive Therapy of Anxiety Disorders: Scienc

e and Practice

by David A. Clark and Aaron T. Beck. Copy

right 2010 by The Guilford Press. Permission to photocopy

this appendix is granted to purchasers of this book fo

r personal use only (see copyright page for details).

aPPENDIX 12.2

Cognitive Restructuring Form for Trauma Intrusions

Name:

Date:

from

to:

Instructions:

Please use this form to work on challenging unhelpful thoughts a

nd beliefs about the personal significance of intrusive thoughts,

images, or memories related to the trauma and its consequences. Try to c

omplete the form around the same time that you re-experienced

symptoms related to the trauma in order to increase the effectivene

ss of therapy.

Date and Time

Briefly Describe the Intrusive Thought, Image, or Memory

Label

and Rate Severity of associated Emotions (0 –100)

Initial Evaluation of the

Intrusion

[What makes this thought/

memory threatening, upsetting

for you? What makes it personally significant or

important to you?]

Reevaluating Initial Thoughts and Beliefs about the Intrusion

[What’s the evidence, what are the consequences of this

evaluation, am I catastrophizing

the intrusion?]

alternative More Helpful Evaluation

[What’s a more helpful

way to think about these trauma-related

intrusions?]