Lesson Plan: Introduction to Cognitive Behavioral Therapy (CBT)

Duration: 1 hour

Objective: By the end of the lesson, participants will understand the basic principles of Cognitive
Behavioral Therapy, how thoughts affect emotions and behavior, and will learn practical techniques to apply
CBT in their daily lives.

Materials Needed:

• Whiteboard/flipchart and markers

• Handouts with key points and exercises
• Projector and slides (optional)
• Pens and notebooks for participants

Lesson Outline

1. Introduction (10 minutes)

o Greeting and Warm-Up (5 minutes)
▪ Welcome the participants.
▪ Briefly introduce yourself and the topic.
▪ Quick icebreaker: Ask participants to share one thing they hope to learn from the
session.
o Overview of CBT (5 minutes)
▪ Define CBT: “Cognitive Behavioral Therapy is a type of psychotherapeutic treatment
that helps people understand the thoughts and feelings that influence behaviors.”
▪ Explain the purpose and effectiveness of CBT.
2. Core Principles of CBT (10 minutes)
o Thoughts, Emotions, and Behaviors Triangle (5 minutes)
▪ Draw the CBT triangle on the whiteboard: Thoughts ↔ Emotions ↔ Behaviors.
▪ Explain how each component affects the others.
o Automatic Thoughts (5 minutes)
▪ Define automatic thoughts and give examples (e.g., “I’m not good enough,” “I always
mess things up”).
▪ Discuss how these thoughts can become habitual and affect emotions and behavior.
3. Identifying and Challenging Negative Thoughts (15 minutes)
o Identifying Negative Thoughts (5 minutes)
▪ Provide handouts with a list of common cognitive distortions (e.g., all-or-nothing
thinking, overgeneralization, catastrophizing).
▪ Discuss a few examples with the class.
o Challenging Negative Thoughts (10 minutes)
▪ Introduce techniques for challenging negative thoughts, such as questioning the
evidence, considering alternative perspectives, and realistic thinking.
▪ Provide a handout with these techniques.
 4. Practical Application and Exercises (15 minutes)
o Thought Record Exercise (10 minutes)
▪ Distribute thought record sheets.
▪ Explain how to use them: Identify a situation, the automatic thought, the emotion it
triggered, evidence for and against the thought, and a balanced thought.
▪ Work through an example together.
o Pair Work (5 minutes)
▪ Have participants pair up and share a recent negative thought they’ve had.
▪ Use the thought record technique to challenge these thoughts with their partner’s help.
5. Q&A and Discussion (5 minutes)
o Open the floor to any questions about CBT.
o Encourage participants to share their thoughts or experiences related to the exercises.
6. Conclusion and Homework (5 minutes)
o Recap the key points covered in the lesson.
o Homework Assignment: Ask participants to use the thought record sheets to challenge at
least one negative thought per day for the next week.
o Provide additional resources for those interested in learning more about CBT (e.g., books,
websites, local therapy options).

Handouts

1. Cognitive Distortions List: A list and explanation of common cognitive distortions.

2. Thought Record Sheet: A template for recording and challenging negative thoughts.
3. CBT Techniques: A summary of techniques for challenging negative thoughts.

Additional Resources

1. Books:
o"Feeling Good: The New Mood Therapy" by David D. Burns
o"Mind Over Mood: Change How You Feel by Changing the Way You Think" by Dennis
Greenberger and Christine A. Padesky
2. Websites:
o NHS - Cognitive Behavioral Therapy (CBT)
o Psychology Today - CBT

This lesson plan provides a comprehensive introduction to CBT, focusing on practical understanding and
application, which can be beneficial for adults looking to improve their mental health and coping strategies.
Overview of CBT

Definition of CBT

Cognitive Behavioral Therapy (CBT) is a type of psychotherapeutic treatment that helps individuals
understand the thoughts and feelings that influence behaviors. CBT is based on the concept that our
thoughts, emotions, and behaviors are interconnected, and that changing negative thought patterns can lead
to changes in feelings and behaviors.

• Cognitive: Relates to our thoughts, beliefs, and attitudes.

• Behavioral: Relates to how we act and respond to situations.

Purpose of CBT

The primary purpose of CBT is to identify and challenge negative thought patterns and behaviors and
replace them with more positive and realistic ones. It aims to:

1. Identify Distorted Thinking: Recognize the thoughts and beliefs that are inaccurate or harmful.
2. Challenge Negative Thoughts: Question the validity of these thoughts and beliefs.
3. Change Behavioral Patterns: Develop healthier ways of thinking and behaving.

Effectiveness of CBT

CBT is one of the most researched and widely used forms of psychotherapy. It is considered effective for a
variety of mental health issues, including:

1. Depression: CBT helps individuals identify and change negative thoughts that contribute to their depression.
2. Anxiety Disorders: It teaches coping skills to manage and reduce anxiety.
3. Post-Traumatic Stress Disorder (PTSD): CBT helps process and reduce the impact of traumatic memories.
4. Phobias: It assists in facing and reducing irrational fears.
5. Obsessive-Compulsive Disorder (OCD): CBT helps manage compulsive behaviors and obsessive thoughts.
6. Eating Disorders: It addresses unhealthy eating patterns and body image issues.
7. Addictions: CBT helps modify the behaviors and thought patterns associated with addiction.

Key Principles of CBT

1. Problem-Focused and Goal-Oriented: CBT is structured and focuses on specific problems faced by the
individual. Goals are set collaboratively between the therapist and the client.
2. Short-Term Treatment: CBT is usually a short-term therapy, with sessions typically ranging from 5 to 20
sessions.
3. Homework Assignments: Clients are often given tasks to complete between sessions to practice skills
learned in therapy.
4. Empirical Approach: CBT is evidence-based, meaning its techniques and strategies are supported by research
and clinical trials.

Why CBT is Effective

• Empowerment: Clients learn skills that they can use long after therapy ends.
• Self-Awareness: Individuals become more aware of their thought patterns and how these affect their
emotions and behaviors.
• Practical Techniques: CBT provides practical tools for dealing with life's challenges.
• Flexibility: CBT can be adapted to suit individual needs and different mental health conditions.

By understanding the principles and effectiveness of CBT, individuals can better appreciate how this form of
therapy can help them make meaningful changes in their lives.
Core Principles of CBT

Thoughts, Emotions, and Behaviors Triangle (5 minutes)

Visual Aid: Draw the CBT Triangle on the whiteboard with "Thoughts," "Emotions," and "Behaviors" at
each corner, with arrows pointing both ways between each component to indicate the interconnections.

Explanation:

1. Introduction to the Triangle:

o The CBT Triangle illustrates the core principle that our thoughts, emotions, and behaviors are
interconnected and influence one another.
o Understanding this relationship helps us see how negative thoughts can lead to negative emotions
and unhelpful behaviors, and vice versa.
2. Components of the Triangle:

Thoughts:

o These are the beliefs and interpretations we have about ourselves, others, and the world.
o Thoughts can be automatic and often go unnoticed.
o Example: Thinking, "I will fail this exam."

Emotions:

o These are the feelings that arise in response to our thoughts.

o Emotions can vary in intensity and duration.
o Example: Feeling anxious or fearful about the upcoming exam.

Behaviors:

o These are the actions we take in response to our thoughts and emotions.
o Behaviors can be adaptive or maladaptive.
o Example: Avoiding studying because of the fear of failing.
3. How Each Component Affects the Others:

Thoughts → Emotions:

o Our thoughts directly impact our emotional state. Negative or distorted thoughts can lead to
negative emotions.
o Example: If you think, "I’m not good enough," you may feel sad or hopeless.

Emotions → Behaviors:

o The emotions we experience influence how we behave. Strong emotions can drive our actions.
o Example: Feeling anxious might lead you to procrastinate or avoid tasks.

Behaviors → Thoughts:

o Our actions can reinforce our thoughts, creating a cycle. For instance, avoiding a task due to anxiety
can lead to self-critical thoughts.
o Example: Avoiding studying reinforces the thought, "I’m going to fail," leading to a cycle of anxiety
and avoidance.

Emotions → Thoughts:
 o Emotions can also influence our thoughts, often leading to cognitive distortions.
o Example: Feeling upset might cause you to think, "Nothing ever goes right for me."

Behaviors → Emotions:

o Our actions can affect how we feel. Positive actions can improve our mood, while negative actions
can worsen our emotions.
o Example: Engaging in a hobby you enjoy can elevate your mood, while withdrawing from activities
can increase feelings of loneliness.
4. Practical Example:

Scenario:

o You have a presentation at work.

o Thought: "I’m going to mess up and everyone will think I’m incompetent."
o Emotion: Anxiety, nervousness.
o Behavior: Procrastination, avoiding preparation, or over-preparing obsessively.

Breaking the Cycle:

o By identifying and challenging the negative thought ("I’m going to mess up"), you can reduce the
anxiety and adopt more helpful behaviors (preparing adequately and calmly).
5. Interactive Discussion:
o Ask participants to think of a recent situation where they experienced a strong emotion. Have them
identify the thought and behavior associated with it.
o Encourage a few participants to share their examples, and discuss how altering the thought could
change the resulting emotion and behavior.

This detailed explanation helps participants understand the interconnections between thoughts, emotions,
and behaviors, forming the foundation for applying CBT techniques in their lives.

Automatic Thoughts

Definition of Automatic Thoughts

Automatic thoughts are the spontaneous, involuntary thoughts that occur in response to specific situations.
These thoughts often pop into our minds without conscious effort and can be either positive or negative. In
CBT, the focus is often on identifying and challenging negative automatic thoughts, as these can contribute
to emotional distress and unhelpful behaviors.

• Characteristics of Automatic Thoughts:

o They are brief and fleeting.
o Often occur in shorthand or telegraphic style (e.g., “I’m a failure”).
o Can be distorted or unrealistic.
o Typically, they are believed without question.

Examples of Automatic Thoughts

1. Negative Automatic Thoughts:

o “I’m not good enough.”
o “I always mess things up.”
o “No one likes me.”
o “I’ll never be successful.”
o “Something bad is going to happen.”
 2. Positive Automatic Thoughts (less common focus in CBT, but equally important):
o “I did a great job.”
o “People appreciate my work.”
o “I can handle this challenge.”
o “Things will turn out well.”

How Automatic Thoughts Become Habitual

• Repetition: Automatic thoughts often become habitual through repetition. When a particular thought
repeatedly occurs in similar situations, it becomes ingrained in our thinking patterns.
o Example: If every time you make a mistake, you think, “I’m such a failure,” this thought becomes a
habitual response to any perceived shortcoming.
• Cognitive Distortions: Negative automatic thoughts are often a result of cognitive distortions, which
are biased ways of thinking about oneself and the world. Common cognitive distortions include:
o All-or-Nothing Thinking: Viewing situations in black-and-white terms (e.g., “I have to be perfect, or
I’m a complete failure”).
o Overgeneralization: Making broad interpretations from a single event (e.g., “I failed this exam, so I’ll
fail all exams”).
o Catastrophizing: Expecting the worst possible outcome (e.g., “If I make a mistake, everyone will
judge me harshly”).
• Emotional Reasoning: Interpreting situations based on emotions rather than objective reality. If you
feel anxious, you might automatically think, “Something must be wrong,” even if there is no
evidence to support this.

Impact on Emotions and Behavior

1. Affecting Emotions:
o Negative automatic thoughts can lead to negative emotions such as sadness, anxiety, anger, or guilt.
o Example: Thinking “I’m not good enough” can lead to feelings of inadequacy and depression.
2. Influencing Behavior:
o These thoughts can result in behaviors that reinforce the negative thought cycle.
o Example: If you think “I always mess things up,” you might avoid taking on new challenges, which in
turn prevents you from experiencing success and reinforces the belief that you are incompetent.
3. Creating a Vicious Cycle:
o Automatic thoughts can create a self-fulfilling prophecy where the thought influences behavior,
which then influences the outcome, reinforcing the original thought.
o Example: Thinking “I’ll never be successful” can lead to giving up easily, which results in failure,
further reinforcing the belief that you can’t succeed.

Interactive Discussion

• Example Scenario:
o Ask participants to think about a recent situation where they felt stressed or upset. What automatic
thoughts did they notice?
o Discuss a few examples provided by participants.
• Breaking the Cycle:
o Encourage participants to challenge their automatic thoughts by asking:
▪ “What evidence do I have that this thought is true?”
▪ “Is there an alternative explanation?”
▪ “What would I say to a friend who had this thought?”
Identifying and Challenging Negative Thoughts

Identifying Negative Thoughts (5 minutes)

List of Common Cognitive Distortions:

1. All-or-Nothing Thinking: Seeing things in black-and-white categories. If your performance isn’t

perfect, you see yourself as a total failure.
o Example: “If I don’t get an A on this test, I’m a complete failure.”
2. Overgeneralization: Viewing a single negative event as a never-ending pattern of defeat.
o Example: “I failed my driving test once; I’ll never pass.”
3. Mental Filter: Dwelling on a single negative detail, causing the whole perception of reality to
become darkened.
o Example: “I got one negative comment on my presentation, so it must have been terrible.”
4. Disqualifying the Positive: Rejecting positive experiences by insisting they don’t count.
o Example: “My boss said I did a good job, but he was just being nice.”
5. Jumping to Conclusions: Making negative interpretations without actual evidence.
o Mind Reading: Assuming someone is thinking negatively about you.
▪ Example: “She didn’t say hi; she must not like me.”
o Fortune Telling: Predicting things will turn out badly.
▪ Example: “I know I’m going to fail this interview.”
6. Magnification (Catastrophizing) or Minimization: Exaggerating the importance of things (such as
a mistake) or minimizing the importance of positive things.
o Example: “I made a typo in the report; I’m going to get fired.”
7. Emotional Reasoning: Assuming that negative emotions reflect the way things really are.
o Example: “I feel scared about this meeting, so it must be a disaster.”
8. Should Statements: Using ‘should,’ ‘ought,’ or ‘must’ statements to motivate yourself, leading to
feelings of guilt or frustration.
o Example: “I should always be able to handle things on my own.”
9. Labeling and Mislabeling: Labeling yourself or others based on mistakes or perceived
shortcomings.
o Example: “I’m such a loser for missing that deadline.”
10. Personalization: Seeing yourself as the cause of a negative event when you are not primarily
responsible.
o Example: “It’s my fault the team lost; I should have worked harder.”

Discussion:

• Example 1: “I failed my math test, so I’m never going to understand math.” (Overgeneralization)
o Discuss why this is a cognitive distortion.
o Encourage participants to share if they’ve had similar thoughts.
• Example 2: “My friend didn’t reply to my text right away; they must be angry with me.” (Mind
Reading)
o Discuss why this assumption might be unfounded.
o Ask participants how they might interpret the situation differently.

Challenging Negative Thoughts (10 minutes)

Techniques for Challenging Negative Thoughts:

1. Questioning the Evidence:

 o Ask yourself: “What is the evidence for and against this thought?”
o Example: Thought: “I’m a terrible public speaker.” Evidence: “I stumbled once, but I also received
positive feedback.”
2. Considering Alternative Perspectives:
o Think of different viewpoints or explanations for the situation.
o Example: Thought: “My friend didn’t reply; they must be mad at me.” Alternative: “They might be
busy or have missed the message.”
3. Realistic Thinking:
o Replace distorted thoughts with more balanced, realistic ones.
o Example: Thought: “I made a mistake; I’m incompetent.” Realistic thought: “Everyone makes
mistakes; I can learn from this.”
4. Cost-Benefit Analysis:
o Weigh the pros and cons of holding on to a negative thought.
o Example: Thought: “I should be perfect.” Cost: Stress and anxiety. Benefit: Motivates improvement
(but at what cost?).
5. Decatastrophizing:
o Ask yourself: “What’s the worst that could happen? How likely is it? Can I handle it?”
o Example: Thought: “If I fail this test, my life is over.” Reality: “It’s one test; I can retake it or find other
ways to succeed.”

Interactive Exercise:

1. Scenario-Based Practice:
o Present a scenario: “You have an important presentation tomorrow, and you think, ‘I’m going to mess
it up and everyone will judge me.’”
o Guide participants through using the techniques to challenge this thought:
▪ Questioning the Evidence: “What evidence do I have that I’ll mess up? Have I successfully
presented before?”
▪ Considering Alternatives: “Maybe they’ll appreciate my effort and the content of the
presentation.”
▪ Realistic Thinking: “It’s normal to be nervous, but I’ve prepared well and can handle this.”
2. Pair Work:
o Have participants pair up and share a recent negative thought.
o Use the handout techniques to help each other challenge the thought.

Practical Application and Exercises (15 minutes)

Thought Record Exercise (10 minutes)

Materials Needed:

• Thought record sheets (distributed to all participants)

• Pens

Steps:

1. Distribute Thought Record Sheets:

o Hand out the thought record sheets to each participant. Ensure everyone has a pen or pencil.
2. Explain How to Use Thought Record Sheets:
o Identify a Situation: Write down a specific situation or event that triggered a negative emotion.
▪ Example: “Gave a presentation at work.”
 o Automatic Thought: Record the automatic thought that came to mind in response to the situation.
▪ Example: “I’m going to mess up, and everyone will think I’m incompetent.”
o Emotion: Note the emotion(s) felt in response to the automatic thought.
▪ Example: Anxiety, fear.
o Evidence For the Thought: List any evidence that supports the automatic thought.
▪ Example: “I stumbled over a few words.”
o Evidence Against the Thought: List any evidence that contradicts the automatic thought.
▪ Example: “I received positive feedback from colleagues; I prepared thoroughly.”
o Balanced Thought: Develop a more balanced and realistic thought based on the evidence.
▪ Example: “I might have stumbled over a few words, but overall, I did a good job and my
colleagues appreciated my effort.”
3. Work Through an Example Together:
o Present a scenario to the class and guide them through filling out a thought record sheet.

Example Scenario:

• Situation: You had a meeting with your boss, and she seemed distracted.
• Automatic Thought: “She’s unhappy with my performance.”
• Emotion: Anxiety, worry.
• Evidence For the Thought: “She didn’t make much eye contact; she seemed preoccupied.”
• Evidence Against the Thought: “She said ‘good job’ at the end of the meeting; she might be busy with other
projects.”
• Balanced Thought: “It’s possible she was distracted because of other work pressures. She did say ‘good job,’
so she likely isn’t unhappy with my performance.”

Interactive Exercise:

• Ask participants to think of a recent situation that triggered a negative emotion.

• Have them individually fill out the thought record sheet for that situation.
• After a few minutes, invite volunteers to share their situations and thought records with the group (if
comfortable).

Discussion Points:

• Discuss how identifying evidence for and against automatic thoughts can help in forming more balanced
thoughts.
• Highlight the importance of regularly using thought records to challenge negative thinking patterns.