Self-Help Skills in Cognitive Therapy
The Activation-Beliefs-Consequences (ABC) Model
The questions below can be completed in order to guide practice of basic cognitive therapy self-help skills. Try to pick one incident each day to apply these questions to in order to rehearse the procedure. Rating your level of satisfaction (0-100%) with your response to each question will help you to develop your skill in using the basic “ABC” model, distinguishing between and clearly defining the Activating event (A), your problematic Beliefs (B), and their emotional and behavioural Consequences (C).
Once you’re familiar with the first three (ABC) steps below, you should proceed to add the last two steps: Disputing (D) your beliefs and replacing them with a more Effective way of looking at things (E). Emotional disturbance best seen as the result of disturbing events combined with disturbing beliefs rather than due to events alone: A+B=C. As the philosopher Epictetus famously said: “It’s not events that upset us but rather our judgements about events that cause us distress.”
Cognitive Models of Emotion
Basic cognitive models of the emotions exist which can be used as a rough guide to help you identify the relevant beliefs (cognitions) with regard to different emotional responses experienced.
The three basic negative emotions are:
Anger: A personal rule or right has been violated, e.g., “You shouldn’t do that!”
Anxiety: An uncertain future threat is appraised as imminent, probable, and severe, e.g., “Something bad might happen!”
Sadness (Depression): A perceived loss of wellbeing, property or status has occurred or appears certain to occur, e.g., “Nobody likes me.”
Guilt: My individual actions have violated someone else’s rights or a personal rule, e.g., “I’ve done something awful!”
Shame: I perceive myself, as a person, as failing to meet some standard or to compare well with others, e.g., “I’m not as good as other people!”
The A, C and B Steps
1. (A) Describe the activating event or situation as objectively as possible, including the specific triggers.
Normally this will be a description of external events or other people’s behaviour but it may also include reference, in some cases, to internal bodily sensations or symptoms that trigger distress. (Internal thoughts, images, and memories, may also function as triggers in some cases but your initial focus should be on external triggers.) Particularly avoid any use of rhetoric, mind-reading, value judgements, or emotive language at this stage: stick to the plain facts.
Are the situation and triggers described objectively and specifically enough?
2. (C) Describe the emotional (and behavioural) consequences as specifically as possible.
Try to specify the type of emotion, particularly considering the three basic categories of negative emotion: anger, fear, sadness. See the section describing cognitive models of emotion below.
Also try to specify exactly what immediate behaviour you exhibited in response to the thoughts and feelings above.
Does the consequence include a clearly defined category of emotion rather than a thought or metaphor? Does it include a description of any immediate behaviour or coping attempts?
3. (B) Identify the specific beliefs that explain your initial emotional reaction.
Try to recall, or infer, what you were actually thinking in that situation in order to feel those emotions and want to engage in that behaviour.
Is the belief adequate to explain the emotional reaction and behaviour?
The D and E Steps
4. (D) Dispute the negative beliefs.
What evidence is there for and against these beliefs?
What alternative explanations are there for any pieces of evidence you listed “for” the negative belief?
How thoroughly have you evaluated the evidence for and against the negative belief and considered alternative perspectives?
5. (E) Practice adopting a more effective set of beliefs.
Based on the above, what would be a more rational and constructive belief to adopt regarding the activating situation?
How helpful and convincing is your proposed new belief?