25 Meaningful CBT Worksheets (2023)

Challenge thoughts, manage anxiety, and deal with conditions like PTSD with helpful CBT worksheets

“Let’s look at this worksheet.”

If you are a CBT therapist (or have one) then this might be a familiar phrase.

That's because CBT worksheets are an effective way to reinforce skills learned in therapy. You can also learn the basic CBT techniques on your own for everyday challenges, even if you’re not in therapy.

Often I find that that typical therapy worksheets are written in dense, confusing language and filled with eye-watering charts to fill out. With that in mind, worksheets chosen are more accessible and readable.

All worksheets are printable PDFs, evidence-based, and curated by a CBT therapist. They work well for teens, adults, groups and telehealth.

The best one(s) will depend on your needs, so feel free to scan and find what will help you the most. All items are digital, which makes them great for in-person or telehealth sessions.

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

Article Highlights:

Worksheet Types:

CBT Triangle

Challenging Thoughts

Core Beliefs

CBT for AnxietyCBT for PTSD

Emotions Wheel & Regulating Emotions

Exposure Hierarchy

Trauma Narrative

Bundled Package for Anxiety and PTSD

Games and Activities:

Grounding Stone Activity

CBT L-I-N-G-O (Bingo-Like Game)

(Video) How Does Cognitive Behavioral Therapy Work?

CBT Digital Board Game (CBT Quest)

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.

You’ll find multiple free CBT therapy worksheets, in PDF form, along with premium options on this list. Some of these I created myself based on my training and experience providing therapy, and others I have reviewed and found helpful and consistent with research and best practices.

If you are a therapist, it’s ideal to have basic training and experience with the CBT approach to support your use of these tools with clients.

If you are looking for self-help, or tools for your clients, then learning the basic idea of reframing negative thinking can be helpful. However, if you’re dealing with mental health issues, then make sure to seek out professional help for these conditions rather than going it alone.

CBT Triangle Worksheets

The CBT triangle is a commonly used tool to describe the basic principles of this therapy.

CBT itself was developed by Aaron Beck. 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.

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).

The CBT triangle is a visual depiction of how thoughts impact our experience. It includes thoughts, feelings, and behaviors as a cycle that moves between points on the triangle, with the prompting event (trigger) in the middle.

These worksheets use this basic process, typically in triangle form. They either explain the process or include prompts to help you or your clients recognize and change the pattern.

CBT Triangle Worksheet

Fives pages, with explanations, colorful diagrams and examples by The Counseling Palette. Great for pre-teens, teens, college students, and adults.

Cognitive Triangle Worksheet

Three pages, with boxes and prompts, by University of Washington, good for adults.

CBT Cognitive Triangle Reflection worksheet

Two pages, with blanks and prompts, by Teachers pay Teachers, great for schools.

You can learn more about the triangle technique in this new article on using the triangle.

Challenging Thoughts Worksheets

The CBT triangle is a good place to start to explain how thoughts affect our feelings. The next step is to begin to challenge specific thoughts that tend to 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.

These worksheets have these types of thought patterns in mind, and help the user begin to challenge these beliefs. Terms often used include “stuck points,” “cognitive distortions,” or “negative thoughts.”

(Video) Cognitive Behavioral Therapy and Understanding Cognitive Distortions: Dr. Dawn Elise Snipes

Changing Thoughts (CBT) Worksheet

Three-pages, with explanation, examples, and prompts by The Counseling Palette. This is a good start for anxiety, trauma, and PTSD therapy.

Challenging Thoughts Worksheet

With prompts, by University of Washington, best for adults.

Prompts for Challenging Negative Thoughts Worksheet

Several prompts to walk through the process, by Psychology Tools, good for adults.

Core Beliefs Worksheets

Core beliefs exercises may go a level deeper than distorted thoughts worksheets. 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.”

These worksheets address thoughts from the perspective of these deep-seated, often harmful core beliefs.

Negative Core Beliefs

One page, with rating scales, by the Centre for Clinical Interventions, for kids and teens.

Core Beliefs Worksheet

One page, with blanks and prompts to challenge core beliefs from the Centre for Clinical Interventions, for teens and adults.

CBT for Anxiety Worksheets

While there are multiple types of anxiety conditions, all of them relate to our thoughts. Many are largely caused by our way of thinking. 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. These worksheets can help with coping while also addressing the root thoughts that perpetuate these fears.

Anxiety Plan Worksheet

Four pages, offers multiple coping skills including CBT prompts, by The Counseling Palette, for tweens, teens, and adults.

Anxiety Common Unhelpful Thoughts

Three pages with lists and boxes, by UW Medicine.

Worry Explanation Pages

One page, with prompts, by TherapistAid.

10 Minute Worksheets (for middle/high school)

Multiple pages, by Teachers Pay Teachers

CBT for PTSD and Trauma Worksheets

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. The worksheets below are consistent with the CBT therapies used to help with this, including CPT, Prolonged Exposure, and TF-CBT.

(Video) 3 Instantly Calming CBT Techniques For Anxiety

Reframing Trauma Thoughts (Distortions)

Three pages, explanation, examples, and prompt worksheet, by The Counseling Palette.

PTSD Symptoms Worksheet

Two pages, prompts, by The Counseling Palette.

Dissociation Record

One page, columns with boxes, by Psychology Tools.

Emotions Wheels & Regulating Emotions Tools

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.

Feelings worksheets help with recognizing, regulating, and coping with emotions. Feelings wheels and emotion management worksheets can help support this difficult part of mental health.

Emotion Wheel Kit

Includes multiple emotion wheels, also called feelings wheels. This set has a focus on coping skills and includes both full and blank versions to fill out. By the Counseling Palette, great for kids, teens, and adults.

Emotions Motivate Action

These worksheets focus on understanding the science behind emotions, and teaching the concept. By Psychology Tools, good for adults.

Dealing with Strong Emotions

Strong feelings can be overwhelming. This guide takes a look at how to rate, ride out, or cope with difficult emotions. By the Counseling Palette, best for older teens, college students, and adults.

Exposure Hierarchy Handout

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.

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.

These worksheets used a variation of exposure hierarchies.

Anxiety Hierarchy and Exposure

Three pages, with explanation, hierarchy page, and exposure homework sheet. By The Counseling Palette, for adults and teens, in conjunction with trauma therapies.

Fear and Avoidance Worksheet

One page with chart. By Oxford University Press, for adults.

Trauma Narrative Worksheet

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.

Trauma Narrative

Five pages, including writing space, which walks through the trauma narrative activity commonly used in PTSD therapies such as CPT and TF-CBT. By The Counseling Palette, for kids and teens in PTSD/trauma therapy.

Grounding Stone Activity

If you’re looking for a fun mindfulness activity to use with CBT, the grounding stone exercise may be a good fit. This worksheet and digital kit includes prompts, posters and even an audio meditation.

Grounding Stone Kit

Five page worksheet, plus posters, audio, and templates you can change in Canva. By The Counseling Palette, for all groups, ages, and telehealth.

(Video) 35 Cognitive Behavioral Therapy Tools | Trauma Informed Counseling Skills

Bundled Worksheet Package

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.

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 like CBT 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 Board Game: PDF and Printable

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.

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. What techniques and CBT worksheets do you find helpful? Include your recommendations below.

Sources:Beck Institute for Cognitive Behavioral Therapy. 2021, https://beckinstitute.org/

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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