What do I do? What don’t I do? What do I need to do
less of, or stop?
What emotion/s do I feel when I’m distressed? What else?
What do I need to do more of, or start?
Name of Person or Problem
What sensations do I feel in my body? What’s the
Life Situation & Experiences
Thoughts & Images
What thoughts go through my mind? What keeps popping up? What meaning do I
give situations? What pictures do I see in my mind?
Carol Vivyan 2010, adapted from Cole, Macdonald, Carus, Howden-Leach 2005