Fillable Form 1: Thought Diary A Activating Event B (Services Australia)

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Form 1: Thought Diary A Activating Event B (Services Australia)

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Services Australia, (previously DHS - Department of Human Services) is responsible for delivering services relating to health and welfare of Australian citizens. It processes payment of child support other services.

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Thought Diary
1
A Activating Event
This may include an actual event or
situation, a thought, mental picture or
physical trigger.
B Beliefs
1. List all self-statements that link A to C. Ask you
rself: “What was I
thinking?” “What was I saying to myself?” “What was going through my
head at the time?”
2. Find the most distressing (hot) thought and mark it with an asterisk (*).
3. Rate how much you believe this thought between 0 to 100.
C Consequences
1. Write down words describing how you
feel.
2. Mark the one that is most associated with
the activating event using an asterisk (*).
3. Rate the intensity of this feeling between
0 to 100.
4. Jot down any physical sensations you
experienced or actions carried out.
C
entre for
C
linical
I
nterventions
•Psychotherapy•Research•Training
This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at
http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information.
See website www.cci.health.wa.gov.au for more handouts and resources.
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Form 1: Thought Diary A Activating Event B (Services Australia)

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Completed 22 September 2021

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