Managing Bipolar Disorder: Workbook: A cognitive-behavioural approach
Michael Otto et al.
https://doi.org/10.1093/med:psych/9780195313376.001.0001
Published: 2008 Online ISBN: 9780190230302 Print ISBN: 9780195313376
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CHAPTER
4 Session 4: Cognitive Restructuring—Part II
Michael W. Otto, Noreen A. Reilly-Harrington, Jane N. Kogan, Aude Henin, Robert O. Knauz, Gary S. Sachs
https://doi.org/10.1093/med:psych/9780195313376.003.0004 Pages 23–28
Published: December 2008
Abstract
Chapter 4 provides an outline for the fourth session of the treatment and focuses on further cognitive
restructuring. The process of evaluating or challenging thoughts using the Thought Record is
presented, along with alternative strategies for evaluating thoughts and methods for generating ideas
for activity planning.
Keywords: bipolar disorder, cognitive restructuring, evaluating thoughts, challenging thoughts, Thought
Record, alternative strategies, cognitive-behavioral therapy, CBT
Subject: Psychosocial Interventions and Psychotherapy
Series: Treatments That Work
Collection: Oxford Clinical Psychology
Goals
■ To continue cognitive restructuring by learning to accurately evaluate your thoughts
■ To come up with ideas of responsibility-based activities that you can add to your life
Evaluating or Challenging Thoughts
For homework last week, you were instructed to monitor your thoughts using the Thought Record. This
week you will learn to evaluate these thoughts. Once you are able to identify thoughts that are related to
feelings of depression, then you can question the accuracy of these thoughts. Review with your therapist the
thoughts you recorded on the Thought Record and look for common themes. Your goal is to discover how
depression distorts your thoughts and to systematically challenge these thoughts so that they no longer
have an e ect on your mood. For each thought, ask yourself the following:
■ “What evidence do I have that this thought is true?”
■ “What evidence do I have against this thought?”
Thought Record
Write down your answers to these questions on the Thought Record in the column marked “Evaluation of
Automatic Thought.” Your therapist will help you practice this step of the process until you feel comfortable
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doing it on your own. Figure 4.1 shows an example of a fully completed Thought Record with the evaluation
p. 24 column lled out.
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Figure 4.1 Example of Completed Thought Record
p. 25
Activity Planning
The previous session focused on pleasant activities that help bu er stress. This session will focus on adding
mastery activities to your schedule. Mastery activities are those that are responsibility based; those things
that need to get done, such as doing the laundry, going grocery shopping, and tidying up your home.
Activity scheduling is an important strategy that can be used to enhance your mood. When you are
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depressed, you may be more likely to stay in bed and less likely to engage in a regular schedule of activities.
This restriction of activity is likely to contribute to you feeling even more depressed. The goal of activity
scheduling is to devise a plan that allows a gradual reintroduction of regular activity, including both
responsibility-based and fun activities.
Work with your therapist to generate ideas for both pleasant and mastery activities that you can add to your
p. 26 life. Record your ideas in the space provided.
Homework
• Continue using the Thought Record to monitor thoughts and feelings on a daily basis. You may now
begin completing the evaluation column to challenge negative thinking.
• Continue adding pleasurable and mastery activities to the My Activities List.
• Continue monitoring your daily activities using the Weekly Activity Schedule provided at the end of this
chapter.
My Activities List
Weekly Activity Schedule
p. 27
p. 28
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