CBT techniques, with worked examples

By CBT Guide USA editorial team · Updated 2026-11-08 · Editorial policy

Three of the most widely used CBT techniques, each shown with an original worked example so you can see how they work in practice.

Short answer: A thought record helps you catch a distressing thought and test it against evidence. Behavioral activation uses activity tracking and scheduling to break the cycle of low mood and withdrawal. Structured problem solving breaks an overwhelming problem into steps you can act on. They are most useful when practiced regularly, ideally with a therapist's feedback.

The people and situations below are hypothetical, written by us to illustrate the techniques. They are not real clients or case studies, and this page is not a substitute for treatment. If you are thinking about suicide or self-harm, call or text 988 (US) or call 911.

Why techniques matter in CBT

CBT is a practical therapy. The NHS describes it as helping you change how you think and act, with practice between sessions often tracked in worksheets or a diary. The National Institute of Mental Health describes CBT as helping people notice inaccurate or harmful automatic thoughts, question them and change self-defeating patterns. The techniques below are the tools for doing that. For background, see what is CBT.

1. Thought record

A thought record is a structured worksheet for slowing down a moment of strong emotion. You note the situation, the emotion, the automatic thought, then weigh the evidence and arrive at a more balanced view.

Worked example (hypothetical). Priya, 29, gets a short email from her manager: "Can we talk tomorrow at 10?"

Column	Priya's entry
Situation	Tuesday 5pm, manager emails asking to talk tomorrow, no reason given.
Emotion (0-100)	Anxious 80, dread 70.
Automatic thought	"I messed up the report. I'm going to be let go." Belief: 75%.
Evidence for	I submitted the report late last week. Short emails feel cold.
Evidence against	She thanked me for the report on Friday. She sends short emails to everyone. There's a team reorganization being discussed. Nobody is fired over one late report here.
Balanced thought	"I don't know what it's about. It could be the reorganization or a new project. If it is about the late report, I can explain and say how I'll avoid it next time."
Emotion after (0-100)	Anxious 45, dread 30. Belief in original thought: 35%.
Next step	Write two lines about the report delay to have ready; go for my usual walk tonight instead of rereading the email.

What to notice: the anxiety did not vanish, and that is fine. The aim is a more accurate, less extreme view and a useful next action.

Common thinking patterns to look for: jumping to conclusions ("she's going to fire me"), all-or-nothing thinking ("if it's not perfect it's a failure"), catastrophizing (assuming the worst outcome), and discounting the positive ("she only thanked me to be polite").

2. Behavioral activation and activity scheduling

When mood is low, people tend to withdraw and do less, which removes sources of pleasure and achievement and keeps mood low. NICE guidance describes behavioral activation as focusing on the link between a person's activities and their mood, helping them recognize patterns and plan practical changes that reduce avoidance. A 2014 meta-analysis of 26 trials found it more effective than control conditions for depression, though most trials were of low quality (Ekers et al., 2014).

Worked example (hypothetical). Marcus, 41, has felt flat for months. He works from home and has stopped seeing friends.

Step 1: Track for a week. Marcus notes what he does each part of the day and rates mood (0-10).

Time	Activity	Mood
Mon morning	Work in bed, skipped breakfast	3
Mon evening	Scrolled phone 3 hours	2
Wed lunchtime	Walked to the store	5
Sat afternoon	Brother called, talked 20 minutes	6

Step 2: Spot patterns. Mood is lowest during long, unstructured screen time and higher when he moves or has contact with people.

Step 3: Choose small, specific activities tied to what he values (health, connection, music):

10-minute walk after lunch, Monday, Wednesday, Friday.
Text one friend on Thursday to suggest coffee.
Play guitar for 15 minutes on Saturday morning.

Step 4: Schedule and review. He puts them in his calendar like appointments. At the end of the week he does 4 of 5 planned activities and notes mood after each (5, 6, 5, 7). He does not wait to feel motivated first; acting first and noticing the effect is the point. Next week he adds one slightly bigger step.

Plan activities that are small enough to do on a bad day. "Clean the whole apartment" is a recipe for avoidance; "wash the dishes in the sink" is not.

3. Structured problem solving

Some distress comes from real, practical problems that feel too big to tackle. Problem solving breaks them into steps. A 2018 meta-analysis of 30 trials found problem-solving therapy is probably an effective treatment for depression, with effects comparable to other psychological treatments when only higher-quality studies were counted (Cuijpers et al., 2018).

Worked example (hypothetical). Dana, 52, is overwhelmed by unpaid medical bills and has stopped opening mail.

Define the problem specifically: "I have three unopened bills and I don't know the total I owe."
Brainstorm options without judging: open them all tonight; open one a day; ask my sister to sit with me; call the billing office; ask about a payment plan; check if I qualify for financial assistance at the hospital.
Weigh pros and cons: opening all at once feels too much; one a day is manageable; calling the hospital could lower the amount.
Pick and plan: "Open one bill each evening at 7pm, Monday to Wednesday, with tea. Thursday lunchtime, call the billing office and ask about payment plans and assistance."
Do it and review: Dana opens all three by Wednesday. The total is lower than she feared. The call sets up a monthly payment plan. Her review: "Breaking it into one a day worked. Avoiding it made it feel bigger."

Tips for practice

Write it down. Doing it in your head is easier to skip and harder to review.
Start small. One thought record or one planned activity a day is plenty at first.
Expect unevenness. Some days the techniques help a lot, some days barely. Look at trends over weeks.
Get feedback. A therapist can spot patterns you miss and adjust the technique. Research on CBT for depression shows it works across formats including unguided self-help, but guided formats tend to do better for moderate to severe symptoms (see therapy vs apps).
Know when to get more help. If you are not improving, are getting worse, or have thoughts of self-harm, talk to a clinician. See crisis resources.

If you are dealing with low mood, our online therapy for depression guide covers when therapist support makes sense. To see how these techniques fit into a course of therapy, read online therapy week by week and prepare with our first session checklist. Some online services, such as Online-Therapy.com, build their programs around worksheets like these; see our review.

Frequently asked questions

What are the main CBT techniques?

Common ones include thought records (examining and testing thoughts), behavioral activation and activity scheduling (planning activities to lift mood), structured problem solving, gradual exposure for anxiety, and relaxation or breathing skills. Not every CBT course uses all of them.

Can I do CBT techniques on my own?

Many people use CBT worksheets and self-help materials, and research shows unguided CBT self-help can help. Support from a trained practitioner tends to help more, particularly when symptoms are moderate or severe. If you are struggling, it is worth getting support rather than going it alone.

How long does a thought record take?

Often just a few minutes once you are used to it. It tends to work better soon after a strong emotion, while the details are fresh. Short and regular beats long and rare.

What if the negative thought turns out to be true?

Sometimes the evidence supports the worry. Then the focus shifts from changing the thought to coping with the situation, often with problem solving. CBT is about accuracy, not forced positivity.

Is behavioral activation the same as just keeping busy?

No. It is targeted: you track how activities affect your mood, then plan specific, small activities linked to what matters to you or what gives a sense of pleasure or achievement, and gradually reduce avoidance.