PTSD  cognitive restructuring worksheet

What is the theory behind this PTSD Cognitive Restructuring worksheet?

Post Traumatic Stress Disorder is a serious mental condition that occurs after an individual experiences a direct or indirect traumatic event which was characterised by a threat to their physical, emotional or psychological health. Along with other symptoms, individuals with PTSD report intrusive thoughts about the traumatic event along with heightened arousal and negative emotional reactions when faced with their trauma triggers. 

Cognitive Restructuring is an essential technique used in Cognitive Behavioural Therapy (CPT) to help individuals with PTSD identify, challenge and modify their problematic thought processes that are contributing to their symptoms. It aims to help them understand the impact of  their negative thoughts on their symptoms and how addressing them can help alleviate distress. 

How will the worksheet help?

The worksheet will help clients identify their automatic thoughts, assumptions and feelings in response to trauma triggers. It will help them challenge those thoughts and replace them with helpful alternatives. This technique  also allows clients to feel in control of their thoughts and eventually their symptoms.  

How to use the worksheet?

Instruct the client to fill the table from left to when they experience a negative mood  after a trigger event. It is important to instruct them to use relaxation techniques to calm down first. As practice they can be guided to fill the worksheet in the therapy sessions before assigning it as a homework assignment. 

PTSD cognitive restructuring worksheet

Situation/TriggerWhat triggered my negative emotions/memories/thoughts?FeelingWhat emotion(s) am I feeling?How strong are they?Do I notice any physical sensations?Automatic thought/imagesWhat are the thoughts/image that immediately came to my mind?Evidence for my thoughtsWhat objective evidence do I have to prove this thought is in fact true? Evidence that contradicts my thoughtsWhat objective evidence do I have against my thoughts?Alternative thoughtBased on my analysis, what could be a fai, realistic and helpful alternative thought?Evaluate your emotionsHow do I feel now? Do I notice a difference?


Beck, J. S. (2020). Cognitive behavior therapy: Basics and beyond 3rd Ed. Guilford Publications.

Mueser, K. T. et al.. (2015). Evaluation of cognitive restructuring for post-traumatic stress disorder in people with severe mental illness. The British journal of psychiatry : the journal of mental science, 206(6), 501–508. 

You can download this worksheet here.

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