The exercise behind the app
How to write a
CBT thought record.
A thought record is a cognitive behavioral therapy (CBT) exercise for examining a situation, the thought you had about it, and the evidence for that thought. You write a response and rate how you feel afterwards.
This page explains the five-column format used in Balm. You can use the example below without the app, or print the blank worksheet and write by hand.
The five columns
-
Situation
Describe one event. “A friend hasn’t replied to my message” is enough to start. Keep what happened separate from what you think it means.
-
Emotion
Name the feeling and rate its intensity from 0 to 100. In Balm, each record has one main emotion. A rating records how it feels to you; it isn’t a clinical measurement.
-
Automatic thought
Write the thought that came with the feeling. It might be a sentence like “I’ve upset them.” Rate how much you believe it, again from 0 to 100.
-
Rational response
Look at the evidence for and against the thought. Write a response that takes both into account. “I don’t know why they haven’t replied” may fit the facts better than assuming the worst. Rate how much you believe the response, from 0 to 100.
-
Result
Rate the emotion and your belief in the original thought again. Keep the original ratings beside the later ones. They may go down, stay the same, or go up.
What can I write in the response column?
Start with one question. Your response can acknowledge uncertainty; it doesn’t have to make the situation sound positive.
- Which facts support my thought?
- Which facts don’t fit it?
- What else could explain what happened?
- What would I say to a friend in this situation?
Adapted from the CCI questions for examining thoughts. Other worksheets call the response a “balanced thought” or an “alternative thought.” CCI uses “hot thought” for the thought that brings up the most distress.
A few things that can get mixed up
- Feeling or thought? “Anxious” is a feeling. “They’re annoyed with me” is a thought you can examine.
- Event or interpretation? “No reply yet” describes what happened. “They’re ignoring me” adds an explanation.
- A response you don’t believe? Write one that fits the evidence, even if it leaves questions open. Rate how convincing it feels to you now.
Fictional example
A friend hasn’t replied
This example is made up to show what belongs in each column. The ratings are illustrative, not an expected outcome.
- Situation
- I sent a friend a message yesterday. It’s this afternoon and they haven’t replied.
- Emotion
- Anxious, 70 out of 100.
- Automatic thought
- “I must have said something wrong. They’re annoyed with me.” I believe this 80 out of 100.
- Rational response
- “I don’t have a reply, but I don’t know the reason. They sometimes take a couple of days to answer. Nothing in our last conversation suggested they were upset. I can wait, or check in with them.” I believe this response 60 out of 100.
- Result
- Anxious, 50 out of 100. Belief in the original thought, 40 out of 100.
The response leaves some uncertainty. It doesn’t require you to believe everything is fine; it records what you know and what you’re assuming.
Download a blank PDF, or print this sheet on your usual paper size. Only the worksheet is included when you print this page.
Date: Time:
| SituationWhat happened? | EmotionFeeling and intensity, 0–100 | Automatic thoughtThe thought and belief, 0–100 | Rational responseEvidence, response, and belief in it, 0–100 | ResultEmotion and belief afterwards, 0–100 |
|---|---|---|---|---|
For the response: Which facts support my thought? Which facts don’t fit it? What else could explain what happened? What would I say to a friend in this situation?
Prompts adapted from CCI, Back from the Bluez, Module 6. cci.health.wa.gov.au · Resources for examining thoughts.
Do I have to finish it all at once?
Balm saves a draft as you write. Once the situation, emotion, and automatic thought are filled in, you can save an open record. Add the response and result when you return. The same worksheet on paper can be completed in more than one sitting.
If you’re doing thought records with a therapist, follow the version of the exercise they’ve given you.
Why do some worksheets have seven steps?
Thought records come in different layouts. The NHS thought-record exercise uses seven prompts, with separate sections for evidence that supports and challenges a thought. Balm groups those questions into the rational-response stage of its five-column record.
The Centre for Clinical Interventions also publishes thought diaries and explanations of how to examine thoughts and write a balanced response.
Sources and scope
Written by Balm’s developer to explain the format used in the app. The sources below describe CBT thought-record exercises; they do not review or endorse Balm.
- NHS Every Mind Matters: Thought record — an explanation and seven-prompt worksheet.
- Centre for Clinical Interventions: Depression self-help resources — thought diaries and the “Detective Work and Disputation” and “End Result” modules.
Checked . This is self-help material, not therapy or medical advice. For urgent support, use the crisis resources.
Prefer to keep it on your phone?
Balm has prompts for each column, saved drafts, and a diary of completed and open records. Unlimited thought records are free on iPhone and Android.
See how Balm works