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10 Top CBT Worksheets for Learning Cognitive Behavioral Therapy

Updated: Sep 28, 2023

These worksheets cover the most important skills from cognitive behavioral therapy (CBT)

CBT worksheets and other therapy worksheets work great for teens, adults, therapy groups, and telehealth.

The magic of CBT worksheets is that they take vague concepts and make them real.

Ironically, you need to do more than think about CBT -- your skills must be put into practice!

CBT worksheets help teach and reinforce skills learned in therapy. They are often used by therapists specialized in cognitive behavioral therapy and related treatments.

Below are the 10 top CBT worksheets focused on dealing with anxiety, restructuring thoughts, and addressing trauma and fears.

They can help treat issues like anxiety, post-traumatic stress disorder (PTSD), phobias, depression, and more.

Need resources right away? Skip ahead to here take a look at the CBT for anxiety and PTSD bundle.

CBT worksheets use strategies like challenging distorted thinking and addressing negative feelings towards yourself. This infographic includes a set of CBT worksheets that also come in a workbook format.

Article Contents:

1. CBT Triangle Worksheet

2. Challenging Thoughts Worksheets

CBT worksheets and tools are typically very structured, and follow the cognitive behavioral therapy approach. The basic idea of CBT, or cognitive behavioral therapy, is that patterns of thinking impact everything else. How we think about things can make life better or worse, regardless of the circumstances.

Our thoughts influence our feelings, which lead to our behaviors. The printable worksheets below start with the basic approach and expand into specialized areas, such as using CBT to treat PTSD.

Here are 10 top CBT worksheets focused on thoughts, feelings, and behaviors.

1. CBT Triangle Worksheet

Learn and teach thoughts, behaviors and feelings with this free CBT triangle worksheet.

The CBT triangle is a commonly used tool to describe the basic principles of this therapy. This worksheet walks you step by step through the most basic process of CBT. It includes examples as well as space to write your own thoughts and begin to challenge them.

The cognitive (CBT) triangle came out of the early work of Aaron Beck, who developed CBT. He noticed that many people in therapy continued to suffer from mental health conditions such as depression, even as therapy progressed.

He termed the phrase “automatic thoughts,” to describe the thinking pattern many people experience. Most significantly, Dr. Beck found that how people thought about a situation resulted in how they experienced it, regardless of the situation itself.

Most significantly, Dr. Beck found that how people thought about a situation resulted in how they experienced it, regardless of the situation itself.

For example, someone may be running late for work. If they begin to think about getting fired and all of the things that would result from that, they might feel panicked or frustrated, and start driving erratically.

This diagram of the CBT triangle shows the three points of thoughts, feelings, and behaviors.

Alternatively, the same person may think differently, coaching themselves in a positive way. They may think, “I rarely run late, and my boss is very understanding, so it will be okay.”

With this change in thinking, they are likely to think more clearly and avoid feeling anxious. They may then calmly text their boss and drive carefully but efficiently toward work.

This process demonstrates the event (running late), the thought (catastrophizing versus positive self-talk) and the behavior (erratic driving versus planning).

2. Challenging Thoughts Worksheet

This CBT worksheet focuses on reframing thoughts. It addresses cognitive distortions, and walks the user through how to change a particular thought.

The challenging thoughts worksheet is a cognitive restructuring worksheet. It walks you through challenging everyday negative thoughts, at a bit of a deeper level than the CBT triangle. It can also be an alternative format to learning the triangle.

Negative thoughts are sometimes called core beliefs, Negative core beliefs are thoughts that tend to pervade our everyday lives. They’re the “issues,” or “triggers,” you just can’t seem to get over. While most negative core beliefs are also distorted beliefs, the reverse isn’t necessarily true.

Negative core beliefs tend to involve shame, and how the person feels about themselves as a whole. This often relates to their abilities and worthiness.

Negative core beliefs tend to involve shame, and how the person feels about themselves as a whole. This often relates to their abilities and worthiness.

For example, a basic distorted belief might be, “I’ll never pass my algebra class,” while a negative core belief might state, “I’m too stupid to succeed at anything.”

Once you understand the basics of CBT, the next step is to begin to challenge specific thoughts that happen regularly. For example, someone may think, “I mess everything up,” or “I can’t keep any friends.” These thoughts become a habit, and are likely to affect self-esteem, and even become a self-fulfilling prophecy. Because someone thinks they can’t keep friends, they stop trying to make them.

This worksheet keeps these thought patterns in mind, and help the user begin to challenge these beliefs. Terms often used include “stuck points,” “cognitive distortions,” or “negative thoughts.”

3. Anxiety Management Worksheet

This worksheet covers how to cope with anxiety symptoms. Understand what your triggers are, and develop a set of coping skills.

While there are multiple types of anxiety conditions, all of them relate to our thoughts. Meanwhile, many CBT therapists start with anxiety management skills. These include steps like mindfulness or self-soothing.

This anxiety management worksheet includes multiple ideas to deal with anxiety, as well as a page to outline your plan for future anxiety spells.

Ongoing anxiety is usually caused by thinking patterns. Ruminating thoughts, catastrophizing, and assuming the worst are common symptoms of multiple conditions. These thought patterns, combined with the hypervigilance that come along with them, can make it difficult to cope day to day.

These anxious thoughts are common, and likely originate from the human need to prepare for the worst and avoid danger. After all, if our ancestors hadn’t been a bit paranoid we may not be here today.

However, frequently thinking negatively can lead to overwhelming anxiety and nearly constant feelings of anxiety. Anxiety worksheets can help with coping while also addressing the root thoughts that perpetuate these fears.

4. Dealing With Strong Emotions Worksheet

Strong feelings can be overwhelming. This guide takes a look at how to rate, ride out, or cope with difficult emotions.

For example, if your emotion is simply uncomfortable, it's usually best to wait it out and allow the feeling to move through you. Otherwise it's likely to just keep coming back.

If a feeling is more significant and seems to interfere with your daily life, it may be best to work with a therapist on processing the emotion. Sometimes it's good to face the feeling head on, which will allow your body to learn the difference between the worry about danger and actual danger.

For example, worrying about danger might be thinking about a dog attacking you. It could cause your nervous system to become really alarmed, not realizing that there's no dog in sight.

By staying with that fear, your body will have the experience of getting to the other side and start to figure out that the fear is a feeling and not an event.

In other cases, if you have a history or pattern of self-harm, it's best to work closely with a therapist so you can fine-tune your plan. In some cases you may want to face your emotions while in other cases you may need some soothing to get through the moment.

This CBT worksheet on dealing with strong emotions is a great resource for therapists and their clients to work on feelings together.

5. Trauma-Focused CBT Worksheet

This CBT worksheet for PTSD covers cognitive distortions, or stuck points, related to PTSD. It’s appropriate for CPT (cognitive processing therapy) or TF-CBT for teens or adults.

This worksheet is created for trauma focused CBT Therapies. It includes the most common steps used in therapies like TF-CBT (trauma-focused CBT) and CPT (cognitive processing therapy).

Many people think of PTSD as simply a result of trauma. While trauma is at the core of it, it goes beyond that. The majority of people experience trauma at some point. At first, it causes feelings of worry, confusion, and sometimes self-blame for what happened.

However, within a few weeks to a month, most people come to terms with what happened. They understand that the trauma was an isolated event, and that there wasn’t anything they could do to change it.

A percentage of people, however, aren’t able to get through this process. This could be due to still being in danger, to past trauma complicating their ability to process, or simply having too much going on to deal with it initially.

This lack of processing leads to “stuck points,” or cognitive distortions relating to the trauma. They typically run along the lines of people blaming themselves, or feeling they can’t deal with difficulties in the world.

The most effective trauma therapies all deal with processing of the traumatic event, and this worksheet walks through the typical steps.

6. Exposure Hierarchy Worksheet

This worksheet includes a client-friendly version of the anxiety, or exposure hierarchy. This method is commonly used in CBT. It also includes a homework page for exposure sessions.

Many people develop avoidance as a way to deal with anxiety, phobias, and PTSD. An exposure hierarchy helps people measure which fears are the worst, and how they progress over time.

This worksheet includes a simple but effective way to create an exposure hierarchy, as well as homework sheets to record your exposure activities.

Exposure, or fear, hierarchies are commonly used in CBT, CPT, and TF-CBT therapies.

Fears are sometimes measured by numbers, called SUDS (subjective units of distress). Over time the fear is tracked, to see if it becomes better or worse.

Most often, exposure hierarchies are used along with homework assignments to help people face their fears. This exposure helps them overcome avoidance that may be interfering with their daily life.

The avoidance hierarchy worksheet includes the basic steps to get started.

7. Trauma Narrative

The trauma narrative is an activity that involved writing down your memories of your trauma. It’s a tool to help people face fears and overcome avoidance of memories, so they can process and heal them.

The trauma narrative is a technique commonly used in therapies like cognitive processing therapy (CPT), or trauma-focused cognitive behavioral therapy (TF-CBT). This worksheet is written with the client in mind, and should generally be used under the direction of a trained therapist.

A trauma narrative is sometimes used as a part of cognitive behavioral PTSD therapies. It involves writing about memories of a difficult situation.

When someone is experiencing PTSD, it's because their brain is confusing the memory of a bad event with the actual event. Your brain continues to think about what happened, and it keeps your brain on high alert, creating a cycle.

One of the ways to interrupt that process is to write about the difficult memories so that you can integrate them into your life, rather than continue to re-experience them. As mentioned, it's recommended that you work through a trauma narrative as part of trauma-focused CBT therapy.

8. Kids Anger Worksheet

The kids anger worksheets follow the concepts of cognitive behavioral therapy and work great with treatments such as TF-CBT for kids.

One of the most common struggle kids deal with are angry outbursts. This is because they haven't had the time to understand and learn how to cope with strong emotions.

Although it doesn't say it outright, this set of kids anger worksheets address the CBT triangle. It uses the anger iceberg as a way to illustrate feelings underlying anger.

It actually is a set of three worksheets covering identifying emotions, recognizing harmful behaviors, and creating more positive behaviors. The worksheets are kid-friendly and work well with TF-CBT therapy for kids.

9. Emotions Wheel Worksheet

Emotions wheels can help with the "feelings" part of the CBT triangle. This kit includes multiple versions with coping skills.

Emotions are a sometimes overlooked part of CBT treatment. Sometimes people think they should or shouldn't be having certain feelings. They might also be unsure of what they're feeling and when.

However, feelings worksheets help with recognizing, regulating, and coping with emotions. This makes it easier to move into the next step of recognizing how thoughts can relate to ongoing emotional struggles.

Common difficult emotions relating to anxiety, depression, or trauma include:

  • Frustration

  • Shame

  • Anger

  • Sadness

  • Disappointment

The emotions wheel set includes multiple handouts and worksheets based on feelings wheels. It covers both comfortable and uncomfortable emotions like those above. It also has sections that recognize the physical sensations of emotions, and sections to create your own emotional coping wheel.

10. Mindfulness for CBT Worksheet

This worksheet includes the grounding stone acticitu which helps with anxiety, mindfulness, and stress.

New waves of cognitive therapies, including CBT, incorporate mindfulness. It's an important part of the regulating step, and helps you soothe the flight-or fight response.

It can also make it easier to move onto the next steps of recognizing thoughts and emotions. When your brain is in survival mode it can be difficult to work through challenging thoughts or exposure techniques.

Mindfulness takes it down a notch, much like medication would. It also is a great skill in and of itself, and can prevent mental health, and even some physical conditions, down the road.

CBT Therapy Worksheet Bundle

Over the years, I've found that many of the same strategies overlap for conditions like anxiety and PTSD. At the same time, there are some additional steps necessary when processing trauma. I've bundled all of my related pages into this set.

This bundle includes 8 CBT worksheets for therapy, students, and individual use. They cover topics of anxiety, PTSD, trauma distortions, and cognitive behavioral therapy (CBT).

More CBT Resources

In addition to worksheets, CBT-based games can be a great way to teach important concepts. Here's a list of some of our other activities. You can find them all together in our Giant Store Bundle.

CBT Coping Jeopardy-Like Game

If you're looking for a fun, interactive game for classrooms or telehealth, check this out! It covers many of the CBT concepts in the worksheets. It's a great way to reinforce all of the concepts you're learning. Learn more.

CBT Lingo (Bingo-Like Game)

CBT Lingo is a fun, interactive, educational game that helps you teach concepts of CBT. It goes beyond the typical "novelty" cards often created for therapy and other classroom games. The game is compatible with real bingo, so you can actually "call" the game with numbers, either in-person or via telehealth.

CBT Lingo, which works similar to bingo, includes 75 prompts focused on topics like thoughts, feelings, and behaviors, and skills used in cognitive behavioral therapy. It has various options, so it works with teens, college students, and adults.

It can even help with teaching CBT concepts to therapy students.

Here are some sample prompts included in the game:

  • What does all or nothing thinking mean?

  • What's one physical symptom of anxiety?

  • What are the three points of the CBT triangle?

  • What is ruminating?

Want to give it a go? You can download and use it in-person or via telehealth. Get more details here.

CBT Quest Board Game

CBT board games are another less intimidating way to teach skills. This downloadable board game, called CBT quest, can be printed and used in person, or adapted for online use. It includes 32 prompts with reusable questions, such as:

  • Give an example of a challenging thought

  • Describe or show a grounding technique

  • Describe or name a cognitive distortion

Interested in trying this fun activity? Download it here.

Finding Peace from PTSD Book

If you're working specifically with PTSD, this book is helpful. It lays out the most common strategies used in trauma-focused CBT therapies. Such therapies include:

  • Prolonged Exposure

  • Cognitive Processing Therapy

  • Trauma-Focused CBT

The book was also created to go along with the worksheets in the CBT for PTSD and Anxiety bundle, so the two make great companions! Learn more about the book.

Obviously games and worksheets can’t replace other types of therapy. However, these tools can help you learn to identify thinking patterns, challenge everyday negative thoughts, question your anxiety thoughts, and understand your thoughts relating to PTSD.

For more helpful tools, download it all with our giant store bundle. It includes all of the activities above plus many more great resources.

Sources: Beck Institute for Cognitive Behavioral Therapy. 2021,

Chand SP, Kuckel DP, Huecker MR. Cognitive Behavior Therapy. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.


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