CBT week 3: testing your thoughts

This is week 3 of our six-week, self-guided course in cognitive behavioral therapy (CBT). In week 1 you mapped the cycle of thoughts, feelings and actions. In week 2 you learned to catch automatic thoughts (quick thoughts that pop up on their own) and name common thinking traps.

This week you will treat an upsetting thought like a guess, not a fact, and check it. This is often called cognitive restructuring. It is one of the main skills in CBT.^1,6

Why this step matters

CBT is built on the idea that how you see a situation shapes how you feel and act.³ When a thought is too harsh or not quite accurate, it can pull your mood down and push you toward unhelpful actions.¹

CBT therapists help people spot distorted thinking and check it against what is really true.^2,3 Over time, you learn to do this for yourself.²

A large review described testing and challenging unhelpful thoughts as a core part of how CBT works.⁶ For depression, a 2023 analysis of 409 trials found that about 4 in 10 people (42%) improved a lot with CBT, compared with about 2 in 10 (19%) in comparison groups.⁷ The same skill is used in cognitive processing therapy for PTSD, where people check whether the facts support their upsetting thoughts about a trauma.⁹

Evidence: CBT for depression Strong evidence

Facts versus feelings

When you weigh evidence, count only things a fair observer would agree on. These are facts. Things you did, said or saw count. So do things other people did or said.

Feelings and guesses do not count as evidence. "I feel like a failure" tells you how you feel. It does not prove you are a failure. "She probably thinks I'm boring" is a guess about someone else's mind.

A strong feeling can make a thought seem true. Writing it down puts a little space between you and the thought.

How to test a thought

1. Pick one thought. Choose a thought from your week 2 record that came with a strong feeling. Start with one rated about 50 to 80 out of 100, not your most painful one.
2. Rate how much you believe it. Write the thought at the top of a page. Rate how true it feels, from 0 to 100. Rate the main feeling, too.
3. List the evidence for it. Write the facts that seem to support the thought. Be fair. This is not about pretending.
4. List the evidence against it. Write facts that do not fit the thought, including times it was not true and things you may be leaving out because you feel upset.
5. Ask the helper questions. Use the questions in the box below. Write short answers.
6. Write a balanced thought. Look at both lists. Write a new thought that fits all the facts, not just the bad ones. It often uses the word "and" or "but."
7. Rate again. How much do you believe the old thought now? How strong is the feeling now? Even a small drop, such as from 80 to 60, is progress.
8. Decide on one small action. Ask, "What would I do if I believed the balanced thought?" Pick one small step you can take.

Therapists call this guided discovery: you find your own answer by asking good questions.³

A worked example

Here is how one moment might look on paper. This is a made-up example to show the steps.

Situation: At the store, you cannot remember the name of a neighbor you have known for years.

Automatic thought: "My memory is going. I'm getting dementia." Belief 85 out of 100. Feeling: scared (80).

Balanced thought: "I forgot a name when I was tired and rushed, and it came back later. I'm still handling my daily life. If I keep worrying, or if things start to change, I can ask my doctor about a memory check."

After: Belief in the old thought 35. Feeling: worried (30).

Action: Write a note to bring up memory at the next checkup, instead of lying awake worrying.

The balanced thought does not wave the worry away. It points to a sensible next step. If you or your family notice real changes, see getting a dementia diagnosis for what a memory check involves.

Your worksheet

Copy this onto paper, or use the free thought check tool on this site.

Notes for later life

CBT can help at any age. The American Psychological Association recommends group CBT for depression in older adults, usually in 7 to 15 weekly meetings. Part of that work is learning to question your own assumptions.⁸ Mental health problems in later life can be treated, and a primary care provider is a good place to start.¹⁰

Some thoughts in later life are about real losses, such as health changes, the death of a spouse or giving up driving. CBT does not ask you to pretend these are not hard. It helps you notice when a thought, such as "I'm useless now," adds extra pain, and look for a view that is both true and kinder. See depression in later life and anxiety in later life.

If writing two lists is tiring, try one question a day: "What would I tell a friend?" A helper can read the questions aloud and write your answers.

Common problems

The evidence for my thought is real. Now what?

Sometimes a thought is partly or mostly true. Then the question changes from "Is it true?" to "What can I do about it?" and "Is it the whole picture?" You might shift to problem solving or asking for help. Thinking more flexibly does not make real problems go away, but it can help you face them.⁵

I know the balanced thought is true, but I don't feel it.

This is very common. Your head may believe it before your heart does. Small drops in your ratings count. Testing a thought with action, in week 4, often helps the new thought feel real.

This feels like I'm arguing with myself.

Act like a fair judge or a curious scientist, not a lawyer trying to win. You are trying to see clearly, not to prove yourself wrong. If you cannot change a thought, that is fine.⁵

Should I keep doing this alone?

Many people learn this skill on their own, but it is hard to see your own thoughts clearly when you feel very low. A therapist can coach you as you learn to check your thoughts.³ If your mood or worry is not improving, see how to find a therapist. Keep taking any medicine as prescribed. Talk with your doctor before changing anything.

Next step

In week 4: behavior experiments, you will test thoughts in real life. You will make a prediction, try a small step and compare what you expected with what happened. You can go back to week 2 or the CBT course overview any time.

When to get help

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.