Printable mental health group therapy activities for adults

Common questions

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We have mostly covered some of the biggest and most mainstream forms of therapy, including Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Mindfulness-Based Cognitive Therapy, and Acceptance and Commitment Therapy.

In this piece, our goal is to provide a look at some other available alternative forms of therapy. For each type of therapy, we’ll give a brief description and provide some exercises and activities that can be found in each.

We will cover narrative therapy, reality therapy, couples and family therapy, occupational therapy, therapy for oppositional defiant disorder, therapy focusing on negative schemas, rational emotive behavior therapy, Imago therapy, and interpersonal therapy.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free. These science-based exercises will explore fundamental aspects of positive psychology including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

• 3 Narrative Therapy Worksheets
• 6 Couples, Group, and Family Therapy Worksheets
• 3 Occupational Therapy Handwriting Worksheets
• 3 Therapy Worksheets for Oppositional Defiant Disorder
• Schema Therapy
• 4 REBT Worksheets (PDF)
• 2 Imago Therapy Worksheets
• Interpersonal Therapy
• Most Suitable Therapies for Teens and Kids
• A Take-Home Message
• References

3 Narrative Therapy Worksheets

Narrative therapy is a type of therapy based on the idea that storytelling is inherent, therapeutic, and an important source of meaning for people. It is most effectively practiced with a trained therapist, but there are some resources available if you or your client would like to give it a try. These three worksheets are a great introduction to this type of therapy.

1. Healing Through Writing

This worksheet is designed to help clients focus on the most traumatic experience they have lived through. Writing expressively about the experience helps them explore the feelings that come along with it, and it is a gradual process that will help them discover meaning and resolution in it.

They are invited to recollect a personal experience that affected them significantly, and begin a journal about it. This journal should be kept somewhere private and safe, so your client feels safe expressing their deepest emotions and thoughts as they write.

Prompts for writing include:

• Linking the experience back to their family, friends, or meaningful others;
• Relating the writing to the client’s own past, present, and future;
• Connecting it to who they want to be, who they once were, or who they see themselves to be now.

Your client should aim to write fluidly, so it may be useful to ask others around for some quiet or privacy. They should be writing in their journal at a time that feels natural and comfortable, such as last thing at night or first thing when they wake up.

It is worth noting that expressive writing therapy can give rise to feelings of vulnerability as your client confronts their emotions. It may feel as though it is hard to continue, but it is a good idea to try and keep writing for a set amount of time and see it through. At the same time, however, it’s not necessary to write each day – do what feels comfortable and encourage your clients to give themselves a short break if they feel overwhelmed.

Completing this worksheet can help your client form a meaningful story about a traumatic event they have been struggling with. Research into the benefits of writing therapy has shown its positive impacts on feelings of physical and emotional wellbeing, as well as greater clarity of their thoughts and feelings.

After four days of writing in the journal, it can be beneficial to reflect on the exercise. Some questions to think about include:

• Did the writing process help to decrease the avoidance you might have been feeling?
• Have you discovered any potential areas of healing or personal growth through the exercise?
• If so, what positive actions and behaviors do you want to think about with regard to your post-traumatic growth?

You can find this Healing Through Writing worksheet and more debriefing questions in our Toolkit.

2. Letter of Self-Compassion

The next worksheet is adapted from Kirstin Neff’s considerable pioneering work into self-compassion. It can help people who are struggling to show themselves kindness, forgiveness, and compassion in the face of life’s difficulties.

In this context, narrative therapy encourages your client to take the perspective of a compassionate other and address themselves in an unconditionally loving, supportive way – by writing a Letter of Self Compassion.

The exercise is divided into three steps:

1. Your client will select an aspect of themselves that they are self-critical about. This might be a personal aspect that they makes them feel embarrassed, lacking, or powerless. They can think in terms of life ‘domains’ if this helps – family, relationships, fitness, and so forth. As they write a detailed account of how it makes them feel, they will note their emotions, memories, thoughts, and other internal experiences that come up.
2. They then take the perspective of someone who is entirely accepting, forgiving, and loving. From that perspective, your client will write themselves a letter that is empathetic and tender; the friend whose perspective they are writing from is kind and non-judgmental. What kind of things does that friend say? What tone does their writing take?
3. Encourage your client to put the completed draft to one side for a short while, coming back to it after fifteen or so minutes to read over it again. Invite them to open up to the compassion, forgiveness, acceptance, and understanding that it offers.

A self-compassion letter is often useful long after its initial writing. This exercise guides you through confronting your inner critic, encourages you to take a more adaptive approach towards acceptance, provides an opportunity for you to develop, enhances compassion for yourself, and helps you identify any cognitive distortions that may be popping up around this perceived problem.

These are all common and proven techniques for accepting problems or overcoming challenges. The best part of this exercise is that it can be repeated for any and all aspects of yourself that you disown or devalue. Use this link for the full instructions.

3. Increasing a Growth Mindset Through Writing

We are naturally inclined to reflect on past events, whether they are recent or have been with us for a while. Reflection in itself is helpful, can trigger learning, and often gives us insight into our strengths and opportunities for development.

Excessive or obsessive reflection on the negative aspects of events that have already occurred often has unhealthy impacts, however. It can prevent us from viewing experiences as growth opportunities, and lead to rumination.

This reflective writing exercise is intended to help clients adopt a growth mindset by reflecting mindfully on problematic past events. By guiding them through Gibb’s reflective cycle, it invites them to look positively instead at what could be done differently next time.

The six steps are:

1. Description – Writing here is focused on recounting the event in detail. What was the situation, the setting, and what happened?
2. Feelings – You or your client will explore the emotions that occurred before, during, and after the event, as well as through the lens of hindsight.
3. Evaluation – Narrative in this section will look at what was good and positive about the experience, as well as the negative.
4. Analysis is about sense-making. How might the situation have instead been more positive?
5. Conclusion – In Step Five, the worksheet offers prompts for writing about how things could otherwise have panned out. How could you or your client act differently next time, and what would you do if it arose again?
6. The last step is to develop an Action Plan, where distinct steps are identified for personal development. What can you do to make that positive outcome a reality?

This exercise can help people acknowledge their strengths and abilities, think about their hopes and dreams, and even identify their sources of support and development.

This link will take you to the worksheet itself.

4 Reality Therapy Worksheets for Adults

Rather than focusing on acceptance and finding meaning in storytelling, reality therapy is focused on problem-solving and finding practical solutions for specific goals. The foundation of this type of therapy is the idea that our problems stem from disconnection from people in our lives, and that creating or mending these connections will help to solve them (William Glasser Institute, 2010).

The most important question in reality therapy is one that should be constantly asked:

“Is what I am doing getting me closer to the people I need?”

If this type of therapy sounds like one that could be useful to you or your clients, read on to learn about three worksheets that can help.

1. Self-Contract

If you’ve ever thought that you would really love to change something about your life but are worried about sticking with it, this worksheet is for you. In reality therapy, a behavioral self-contract might be one way of enhancing a client’s commitment to a desired change.

Designed to help you or your client move toward a specific goal, this worksheet is laid out as one might expect a conventional contract to look.

There is space for your client’s name and the date, and a box in which to specify the precise goal which they will commit to working toward. It’s important to remember that this is a self-contract, and not a binding commitment between the therapist and the client. It should be a positive, time-bound goal: as such, there is also a dedicated space for writing down when your client wants to achieve their goal.

Invite your client to record the rationale behind their intention – what are their personal reasons for wanting to make this change? Is it a clear values-related goal? Is it going to help improve their wellbeing?

A signature box is provided, and a section in which they can plan their personal reward or celebration for achieving their goal.

While this isn’t necessarily a reality therapy worksheet, there is virtually no type of therapy in which this set of guidelines will not apply to the goal of making change.

Download the Self-Contract Worksheet here from our Toolkit.

2. WDEP Questions Worksheet

“WDEP” stands for Wants, Doing, Evaluate, and Plan. These four components are integral to reality therapy, and this system is used by reality therapists everywhere. This approach helps clients discover what they want and what they are doing to obtain or achieve what they want, evaluate whether what they are doing will contribute to their goals or not, and plan ways to achieve their goals and change problematic behaviors or aspects of their life.

The worksheet is divided into these four sections with space to answer the questions listed for each component. The questions are as follows:

• Wants: What do you want to be or do?
  • What do you want rather than this issue?
  • What does your ideal career, family life, relationship, etc. look like?
  • What do your loved ones/friends want for you?
  • What do you want to achieve from this therapy?
• Doing: What are you doing (behaviorally, mentally, emotionally, physically)?
  • What actions have you tried taking?
  • When you behave this way, what thoughts are occurring in your head?
  • What do you feel when you think these thoughts?
  • How do these thoughts/actions impact your wellbeing?
• Evaluate: Is your behavior working in helping you get what you want?
  • Are these actions taking you in your desired direction?
  • Are you content with how things are?
  • Is what you want attainable?
  • Is viewing things this way helpful?
• Plan: What plan do you have for moving in your desired direction?
  • What will you willingly change about your thoughts or actions to achieve this?
  • When? How frequently? Where?
  • Are you clear about what you will do? Is it realistic?
  • How will you know you have achieved it?
  • Can you start now? Is it in your control?
  • How committed are you doing it?

For each component, the reader should seriously consider each question and write a description of how they are doing in each area.

Going through this worksheet can help the client identify what it is they really want, assess how they are progressing toward achieving what they want, and draft a plan to achieve their goals. This worksheet is specifically created for reality therapy, but it has wide-ranging applications. Anyone who is hoping to make a positive change will find valuable information by completing this worksheet.

If you’d like to give this exercise a try, click to download the WDEP Questions Worksheet.

3. Finding Discrepancies

This worksheet is designed to help people who are struggling with problematic behaviors, and as such it is useful in therapy for addictions. The goal of this exercise is to assist your client in finding discrepancies between the potential outcomes of both stopping and continuing.

A two-page worksheet, it is divided into several sections to be filled out by the client. Each section compares the impacts on the client’s life if they continue with the behavior, to their life if they stopped using. For each section, the client can note multiple aspects of their life in each scenario.

1. The first section is “Impacts on my future goals”. Below this, there are two columns labeled “Impacts if I continue…” and “Impacts f I stop…” that are to be completed by the client.
2. Next, the client is instructed to imagine the differences in their life with or without the behavior in terms of their physical or mental health.
3. The third section is on how the problematic behavior affects their relationships with friends.
4. The fourth section is dedicated to comparing the effects on their closest relationships with or without that behavior; these may be with family or with a significant other.
5. In the fifth section, clients are instructed to compare the effects on their financial situation if they stop using vs. if they continue. For some people, this section alone can provoke a positive change!
6. Finally, the worksheet ends with a look at the potential outcomes on your client’s education, personal, and professional development.

Filling out these different domains will give your clients insight into their current and ideal lives – without the problematic behavior.

Click here to see this worksheet for yourself or download it for yourself or your clients.

4. Implementation Intentions

An important aspect of reality therapy is, unsurprisingly, managing expectations and setting realistic goals. You can use this 3-step exercise to help your client create an effective strategy for transforming their goals or intentions into behavior.

1. As a therapist, explain the background of the exercise. That is, that predetermining positive, concrete, goal-directed actions will enhance the likelihood of their achieving that goal. This worksheet contains useful background theory on the intention-action gap and using if-then planning to overcome common difficulties that are related to it.
2. Steer your client toward a clear and precise statement of their intention. You can write this in the space provided to make the rest of the exercise much easier.
3. Planning the specifics of the goal-directed behavior involves establishing the when, where, and how of the if-then plan. This is a technique where obstacles such as future events and cues are outlined, as well as the intended behavior. For instance, “If I eat cookies after lunch, then I’ll walk home from work instead of taking the bus.”

You’ll also find useful examples in this sheet to help you with Step One, and sample ‘if-then’ plans to keep you and your client on track.

Use this link to download the Implementation Intentions worksheet.

6 Couples, Group, and Family Therapy Worksheets

These worksheets are specifically designed for use within couples, groups, and families.

1. About Your Partner

This worksheet can be an excellent icebreaker for two people in a relationship who are looking to make changes and solve relationship problems. It fosters lighthearted conversation, while reaffirms the couple’s connection and invites them to discover more about both themselves and the other person.

Use this worksheet to guide some relaxed ‘interviewing’ where each will take turns asking a question from each section below.

There are six types of category:

1. Fun and Games – this looks at enjoyable things in your partner’s life, including what brings them happiness and brings about positive emotions;
2. The Future – these questions help couples discover their partner’s dreams, hopes, and ambitions;
3. You and Me – looking at their relationship together can encourage a couple to bond;
4. Other People – some general discovery questions about the other person’s relationships besides the two of you;
5. Careers – their professional aspirations, personal development, hopes for personal growth, and a little about their day-to-day; and
6. Feelings – these items explore your partner’s deeper emotions, thoughts, and psychological experiences.

Discussing these topics can bring a feeling of closeness between partners. They can discover more about one another and share their hopes for a shared, positive future.

Download this worksheet here.

2. Good Qualities

One nice exercise for couples in therapy is to reflect on their significant other’s good qualities; particularly if they are struggling with conflict or similar difficulties.

This is a simple exercise that can motivate partners to work on those difficulties, as well as reconnect with the reasons they love one another.
Each partner fills out four sections:

1. The good qualities which first drew me to my significant other were…
2. The most cherished memories of our time together include…
3. I appreciate my partner because…
4. My partner shows me they care by…

When helping clients with this sheet, encourage them to think of 3 items for each category. What are three reasons they appreciate their partner? Three ways they demonstrate show caring or affectionate behavior?

You’ll find this sheet here as a free PDF.

3. Appreciative Inquiry of Relationships

Difficulties in a romantic relationship sometimes lead us to focus overwhelmingly on what isn’t working, rather than what does work. Appreciative Inquiry of Relationships is an approach that takes a couple through a positive inquiry process where they will look at the positives of their relationship instead of their struggles.

This sheet provides positive questions that will help a couple look at their shared strengths and what gives real life to their relationship. Therapists can apply this technique to encourage couples to examine their successes, potential, values, and strengths together.

The five sections correspond with five different steps in the Appreciative Inquiry Model:

• Establish the relationship you are working with. This sheet can easily be applied to close professional, intimate, or family relationships. Drawing on AI principles, this definition phase is about considering the present nature of the relationship. What are your feelings about the relationship? About your partner?
• Discovering the good stuff is about recalling a past experience that you have had, which you would like to celebrate. What made it great? How come it was so good? You’ll look at these in depth and what enabled it to come to life. You will then look at your and your partner’s biggest positive contributions to keeping things going. Think about and explore the qualities, strengths, behaviors, attitudes, and everything that keeps it growing in a positive way.
• Dreaming about your ideal shared future follows this, during which couples envision the perfect potential future for both of them. They will explore their hopes and wishes, and descriptively note them beneath the prompts.
• The next step is to Design actionable steps for making that a reality. Each partner comes up with the ‘good stuff’, essentially, that they can bring to that dreamed future, before doing an identical thing for actions which they might both pursue.
• Last, Appreciative Inquiry of Relationships focuses on Destiny; in this last step, couples will make explicit intentions that they can commit to.

This positive psychology worksheet enables a couple to think about positive elements of a relationship, and engage with ways to create sustainable change for the better.

You’ll find this Appreciative Inquiry of Relationships exercise in our Toolkit, as well as a wider range of activities in this article: 21 Couples Therapy Worksheets, Techniques, & Activities.

4. Inside and Outside

Inside and Outside is designed for families in therapy. Developed for children, it is a starting point for discussion of the results. Kids can use it to understand, in turn, how their thoughts, feelings, and behaviors are related – useful insight for dealing with family problems.

On this sheet, you’ll find a silhouette of a child. The six boxes surrounding the figure are easy for kids to fill in, with three per side to be filled separately. Ask the child to complete the sentence stem “When I feel…” with an emotion you would like to discuss.

The child then recalls a specific context where they felt this emotion and completes the left column of three boxes:

1. I think…
2. I feel like this in my body…
3. I behave this way…

After the child has completed these left-hand boxes, the worksheet invites them to imagine that the situation is the same, but their thoughts change.

With this new thought instead, they should work their way down the right-hand side boxes – thoughts, feelings, and behavior.

This aims to help children compare their thoughts, feelings, and behaviors when they are struggling with an emotion, and when they change their thoughts. As well as providing the talking point described above, it offers insight into how changed – ideally positive – thinking can impact on their emotions.

In this way, Inside and Outside enables parents and others to understand what a child is experiencing.

You’ll find more group therapy resources in our article Group Therapy: 32 Activities, Worksheets and Discussion Topics for Adults and Teens.

5. Apologizing Effectively

This worksheet can be used to help couples apologize in a more meaningful, impactful way when they are attempting to resolve conflict. It gives a detailed outline of four steps that can help in reconciliation and forgiveness:

1. Acknowledging the offense – Regardless of whether the hurt was caused intentionally or not, effective apologies start with ownership and acknowledgement of the cause for that hurt. Using “I statements”, the person who is apologizing can start to communicate their wrongdoing.
2. Explaining, rather than trying to excuse, the violation – This handout instructs you or a client to explain that the hurt caused was unintentional. Clarify that you don’t intend to repeat the offense, without attempting to excuse or justify your behavior.
3. Expressing remorse – Verbalizing the feelings that you or your client has experienced is the next step to an effective apology. That might be regret, remorse, distress, or similar, and the aim of expressing it is to convey your acknowledgement for the transgression.
4. Making amends – An effective apology is not just verbalized. Rather, it is followed by behavior that seeks to repair the harm which was caused. The worksheet invites you to discuss what suitable amends might look like.

This worksheet details each step and offers tips and suggestions for you or your client to follow the next time there is a disagreement, argument, or other sort of conflict that is causing trouble in an important relationship.

To read more about these rules for apologizing effectively, download this tool.

6. Building Open-Mindedness in Relationships

This worksheet aims to develop a very important strength that couples in problematic relationships are not drawing on: open-mindedness.

Open-minded individuals are able to adopt a partner’s perspective on an issue, explore their opinions and motivations, and consider them in addition to their own personal stance on the same. The reverse is narrow-mindedness – or myside bias – which can often lie at the root of seemingly difficult conflicts.

The exercise for individuals contains four steps:

• In Step One, there is a space for you or your client to brainstorm the issue at hand. If a couple describes a recurring theme that they disagree upon, e.g. nagging or bossiness, and describe it from their perspective in the box provided.
• Next, the worksheet invites the individual to step into the other person’s shoes. It can be a close friend, relative, even a colleague. They are encouraged to close their eyes and mentally swap places with the person they are disagreeing with.
• Step Three challenges the client to list three reasons why that other person might have a valid point. Someone thinking about nagging might recognize that they genuinely haven’t made significant effort to help out the other.
• Lastly, this exercise should be followed up with a reflection. What impact did the activity have on your original point of view? Was it tougher or easier than you thought to step into their shoes?

By addressing myside bias through brainstorming and perspective-taking, individuals in a group or relationship may be able to move toward a more positive way of relating to one another. As this is a versatile approach, the worksheet offers one activity for individuals and another for groups.

Download the Building Open-Mindedness worksheet here to use for yourself, or with your clients.

3 Occupational Therapy Handwriting Worksheets

While we tend to think of therapy in terms of counseling, psychiatry, and clinical psychology, there is also a whole separate realm of therapy: occupational therapy.

This type of therapy is intended to help people with more physical problems than psychological problems—although the two can often go hand in hand. Occupational therapy can help people dealing with illness, injury, or disability to improve their health and promote a greater quality of life.

Handwriting is one area where many people with physical difficulties may face many challenges. Handwriting requires several fine motor skills as well as visual perception skills (Therapy Fun Zone, 2017).

Read on to discover three worksheets that can help children improve their handwriting.

1. Decorating Cookies

This worksheet is intended for kids around the K3 or 5-year-old level, although it will be helpful to child who wants to improve their handwriting. Completing this worksheet is as simple as putting pencil to paper and decorating the cookies.

It might seem overly simplistic, but pre-handwriting movement practice involves following paths with a pencil. Done on a regular basis, it can have a large, positive impact on handwriting ability.

In this Decorating Cookies worksheet, you begin with some example dotted lines, which kids can follow to practice creating circles and waves. There are guide lines and a prompt for children to write about their favorite cookies, then the second page provides basic ‘cookie’ outlines that they can decorate freehand.

Children will likely find this worksheet fun and engaging as well as useful. If you’d like to download it and give it to your child or client, click here.

2. Snowman Hangman

This worksheet takes the original “hangman” game and adapts it for children. The rules are the same, but the picture to be drawn is a snowman rather than a hanging man (which might be a bit morbid for children).

Player One chooses a word, and player Two tries to guess the letters in the word before player One has a chance to draw and dress the whole snowman.

Below the instructions for drawing each section of the snowman and the space for the drawing is a small writing exercise, inviting kids to write three more words related to winter.

Snowman Hangman will help the child to practice their writing and drawing skills while staying engaged and having fun.

3. What Does It Look Like Under the Sea?

This worksheet is a fun way for kids to practice both drawing and handwriting. It’s always easier to get kids to practice when they’re writing about something fun and using their imagination!

The worksheet asks a simple question: What does it look like under the sea?

Below this question, there are instructions for the child to imagine what the underwater world might look like and a space to draw what they imagine.

Below the drawing space, there is another instruction: for the child to write about their idea. They can write about what they think the ocean bed or marine life might look like, what animals or features it might include that would be difficult to draw, or anything else they are thinking about the topic.

You can view or download the worksheet here.

3 Therapy Worksheets for Oppositional Defiant Disorder

Oppositional defiant disorder (ODD) is a disorder found in children that involves an ongoing pattern of “uncooperative, defiant, and hostile behavior toward authority figures” that interferes with daily functioning (American Academy of Child & Adolescent Psychiatry, 2013).

This disorder can include symptoms like:

• Frequent tantrums
• Excessive arguing
• Deliberately upsetting or irritating others
• Being touchy or easily annoyed by others
• Mean and hateful talk when upset

If your child or client is suffering from ODD, these three worksheets may be able to help.

1. Making Good Decisions

This worksheet will help a child with ODD understand the importance of making good decisions, as well as the benefits and advantages that come with making good decisions.

This worksheet has seven sections for the child to fill in:

1. Write down 3 decisions you’ve made in the past 24 hours.
2. Here, write the best decision you believe you’ve ever made.
3. In what ways did this ‘best decision’ impact you?
4. Here, write the worst decision you believe you’ve ever made.
5. In what ways did this ‘worst decision’ impact you?
6. Write down 3 key decisions you’ll need to make as you get older.
7. What decision are you most excited for as you grow up?

Completing this activity can help children work through their thoughts on making decisions, and hopefully, lead them to make good decisions that will benefit them.

Click to download this Making Good Decisions PDF.

2. Responsibility

It is important for all children to develop a foundation of responsibility, but it can be especially important and especially difficult for children with ODD. This worksheet can help teach them about responsibility and show them that responsibility is an important part of life.

There are seven sections to this worksheet with a question or instruction to list examples for each one.

The questions are:

1. What does ‘being responsible’ mean?
2. What kind of responsibilities do you have in school?
3. What are some responsibilities you have at home?
4. List some responsibilities you have in your neighborhood?
5. Name some ways you show responsibility?
6. List some situations where you do not show responsibility.
7. What are some things you can do to show more responsibility?

Work through this Showing Responsibility activity with your child or client if they are struggling to answer the questions or having trouble focusing on them.

3. Something About Me

Sometimes children struggle with low self-esteem—causing them to lash out and behave in problematic ways. This worksheet can help them realize that they have good qualities and help them begin to appreciate them.

The worksheet includes seven boxes to fill in:

1. My friends think I’m awesome because…
2. My classmates say I’m great at…
3. I feel very happy when I…
4. Something that I’m really proud of is…
5. I make my family happy when I…
6. One unique thing about me is…

You can download and use the Something About Me with your own kids, students, or clients.

Schema Therapy

Schema-focused cognitive therapy, or schema therapy, is a kind of therapy that combines aspects of cognitive-behavioral, experiential, interpersonal, and psychoanalytic therapies into one comprehensive treatment approach (Pearl). It is intended to help people who are struggling with negative patterns of thought, behavior, or both.

The name comes from the idea that through living our lives, we develop schemas, or patterns, that guide our thinking and feeling. We rarely even notice that we have these specific schemas, but we all do. The problem stems not from following a pattern, but from following a negative or maladaptive pattern.

Some of the most harmful schemas or patterns of belief revolve around one’s negative feelings towards or about the self (e.g., “I’m a bad person,” “I will never be happy,” or “I am not good enough.”).

This type of therapy is conducted in three phases:

1. Assessment of the schemas
2. Working on bringing emotional awareness to the schemas
3. Making behavioral changes (Pearl, “What is schema therapy?”)

The Schema Therapy worksheets described below can help in one or all of these three phases, and can be used individually or with a therapist—they will likely be more effective when completed with a therapist.

1. Thought Record Worksheet

This worksheet can also help clients to identify some of the problematic thoughts they are having. There is space on this sheet for clients to write down thoughts that are troubling them. They can note when these occurred, and unpack them further in further detail in the next column.

It can be helpful when filling out this sheet to rate the perceived credibility of each thought as you record them, as well as the emotions that were associated with each.

The second column from the end is provided as a space where your client can come up with alternative thoughts, challenging the negative automatic thinking and the schemas they represent. You may find this list of cognitive distortions helpful when introducing your client to the exercise.

Lastly, your client is invited to reassess the perceived credibility of their original negative thought out of 100%. Ideally, coming up with an alternative will have helped to reduce this figure.

This exercise requires regular practice, but it is essential to help identify negative automatic thoughts you would like to stop.

Download and fill in this Thought Record Worksheet, or use it as a handout.

2. Compassionate Chair Work

While the worksheet above is a good place to start, this exercise (and worksheet) can provide a more comprehensive view of how schemas can impact you or your clients. Schema Therapy’s underpinning principles are an effective way to help clients relate in a more compassionate way to their inner critic and any associated maladaptive schemas (Young et al., 2003).

This Compassionate Chair Work exercise requires three empty chairs, placed in a triangle as if there were three people sitting in them talking to one another. Each will stand for a distinct viewpoint from which your client can perceive their inner critic.

First, the worksheet instructs your client to recall something which has recently caused them to criticize themselves.

• Chair 1 represents your client’s inner self-critic;
• Chair 2 stands for the feelings and emotions that come with that judgment.
• The third chair symbolizes a supportive friend or counsellor’s perspective. It can be very helpful for you as a practitioner to actually take this spot for at least the first walkthrough of this exercise.

Use the sheet to guide you through four steps. Throughout each, take time to think about the tone that voice takes, the feelings it gives rise to, and the associated physical sensations or body language adopted.

1. Your client first sits in Chair 1, taking the inner critic’s perspective. They will verbalize out loud how they think about the topic they find problematic. For instance, “I resent myself for being so selfish and never helping out at home.”
2. Next, they sit on Chair 2, which symbolizes the feeling of self-judgment. They will verbalize the feelings associated with receiving that criticism, e.g. “I feel unfairly treated.”
3. Third, they will start a discussion between themselves as the self-critic and as the critiqued – the previous two viewpoints they just took.
4. Last, they will sit on Chair 3, which is the perspective of the supportive friend or counsellor. They now take on a genuinely compassionate approach to address (vocally, out loud) both the critic and the critiqued. What sorts of things do they say? What counsel do they offer? How can they respond to each viewpoint from a rational, detached perspective?

Use this worksheet to help your client form an initial understanding of their problematic thinking patterns – this exercise comes complete with background theory and full instructions from our Positive Psychology Toolkit.

For further insights into Schema Therapy, these articles are recommended:

• Schema Therapy in Practice: 12 Worksheets & Techniques
• Schema Therapy For Practitioners: 7 Questionnaires and Tests

4 REBT Worksheets (PDF)

This type of therapy focuses on solving emotional and behavioral problems to help people improve their quality of life.

It grew out of Cognitive-Behavioral Therapy and encourages a more action-oriented approach to addressing cognitive, emotional, and behavioral problems (Albert Ellis Institute, 2014).

As such, the worksheets for this type of therapy are often not exclusive to REBT, but can also be used for clients in CBT and other similar forms of therapy.

See the worksheets below to get some ideas about REBT exercises and activities.

1. Dysfunctional Thought Record

This worksheet is one that should be filled out over the course of a few days or even weeks, depending on how “wordy” the client is!

It is a structured journal in which the client can note their dysfunctional thoughts and spot a pattern.

It is divided into seven columns with space for writing about multiple events.

1. In the first column, the client is to write down the date and time.
2. In the second column, client describes the situation they were in.
3. The third column is for writing down the automatic thought that arose.
4. In column four, clients should note the associated emotions they felt.
5. Column five is where the client should list any cognitive distortions that came up during this situation and automatic thoughts.
6. In the next column, the client should brainstorm effective alternative thoughts that can fight the dysfunctional automatic thoughts.
7. Finally, the seventh column is for writing down the outcome of the situation.

Keeping a record of these thoughts can help the client to organize their thoughts, make sense of the reaction they have in certain situations, and detect a pattern for the automatic negative thoughts.

Click to download the Dysfunctional Thought Record.

2. Costs and Benefits of Unhelpful Behavior

This worksheet is intended for people who are struggling with specific problematic behaviors; it particularly useful if those behaviors are avoidance related. Completing this worksheet can help clients identify and understand the damaging impact of habits, thought processes, or actions on their wellbeing, as well as how it really impacts their lives.

Costs and Benefits of Unhelpful Behavior aims to understand why a client continues with these behaviors by looking at their perceived obstacles. Designed for therapists to fill out, it’s a solid starting point for promoting more adaptive behavior.

The worksheet itself is divided into three steps and guidelines for the reflection process.

• The first section gives you background information that will help you set the scene for the exercise.
• Next, you will explain and invite your client to consider the concepts of costs and benefits. Short-term benefits and short-term costs yield direct positive outcomes and negative consequences respectively. Over a longer period of time, actions also lead to long-term benefits and consequences. Smoking, for example, might have a short-term benefit of satisfying cravings or tremors – the worksheet provides some examples which may be more relevant to your client.
• The third section is about analyzing your client’s behavior. A cost-benefit matrix provides some structure for understanding and comparing the costs and benefits of the short- and long-term problematic behaviors you’re targeting together. Prior to this, prompts are provided to help you as a therapist, including:
  • What is one thing your client would like to change? and
  • What are the perceived obstacles preventing this desired change?

You have likely noticed that the name for this worksheet is apt – completing these sections will help clients to see the costs and benefits of the problematic behaviors they now engage in. It invites some insight into how these behaviors may be self-perpetuating and how they can be changed for their benefit.

If you would like to see this worksheet for yourself or download it for yourself or your clients, click here.

3. REBT Formulation

This is another worksheet that takes a rational approach—connecting a situation to the following response and comparing the outcome to the outcome if a more positive response occurred. REBT focuses on solving emotional problems before moving on to thought or behavior problems.

The worksheet differentiates between two types of emotional responses: unhealthy (or problematic) responses and healthy (or desired) responses.

In the first section, the client is instructed to describe an activating event. This is an event that provokes an emotional response. Four subsections are to be completed here:

1. Describe the situation.
2. Isolate the critical factor (what it was about the event that affected you).
3. Notice and accept bodily sensations.
4. Invent a symbol/metaphor for the experience (one that explains how it felt).

Next, the client will describe the problematic response.

The client is instructed to name the emotion, then list the thoughts and images associated with it, (i.e., what was happening in your mind during the event?) and the actions and intentions that followed (i.e., how you reacted or wanted to react).

Finally, the client should describe what a healthy response would look like.

First, there is space to name the emotion. Next, there is space to list the cognitive objectives (i.e., how you would need to think in order to feel this way) and the behavioral objectives (i.e., what you would need to do in order to feel this way).

This worksheet can help guide clients through a comparison of two distinct types of responses and help them see that the healthy response is the better one. It can also help to develop a plan to react in a healthy way more often.

Download this REBT Formulation Worksheet.

4. Logging Positive Beliefs

The Logging Positive Beliefs worksheet facilitates the confrontation of negative beliefs and automatic thoughts by using reason to replace old, self-critical beliefs with new, positive beliefs.

At the top of the worksheet, there are two bubbles. In the first, write down the problematic, old belief, and in the right-hand box, create a new belief to replace it.

Underneath the two beliefs is space to write down 10 pieces of evidence that support the new belief or is inconsistent with the old belief. These can be experiences you have had, something someone else has said to you, or anything else you can think of that supports the new belief or sheds doubt on the old belief.

Use this link to download the Logging Positive Beliefs worksheet.

2 Imago Therapy Worksheets

It was developed as an alternative to more traditional methods of couples therapy and is based on facilitating effective dialogue.

Childhood experiences are important in this form of therapy, as imago therapy assumes a link between childhood relationships and adult relationships (Imago Relationships, 2016).

The main activity in Imago therapy is called the Dialogue, and combines three essential elements:

1. Mirroring, or repeating your partner’s words back to them.
2. Summarizing and expressing understanding of your partner’s words.
3. Empathizing with your partner.

If this type of therapy intrigues you, check out the information sheet and worksheet described below to give it a try.

The Imago Dialogue 101

This resource is not a worksheet, but a guide on how to implement the Imago Dialogue into your relationship.

This guide will provide background on the Imago Dialogue, describe the difference between dialogue and discussion, and walk the reader through the three phases described above.

It also includes directions and some suggestions for specific phrases you can use in each phase.

Click here to view or download this informational guide to the Imago Dialogue exercise.

The Imago Workup

This exercise is based on an Imago Workup exercise by therapist Dr. Pat Love, author of Imago Theory and the Psychology of Attraction (Love & Shulkin, 2001). It is a great way to prepare clients for thinking about how their childhood experiences have affected their adult relationships.

Part A requires the client to answer five questions or prompts:

1. List three negative qualities of the people who brought you up.
2. Now, think of three positive qualities of the same people.
3. As a child, what was your greatest unmet desire from your caregivers?
4. How did you want to feel as a child?
5. How did you behave in response to frustration?

Next, the client is instructed to copy these answers into Part B, using them to complete the following statements:

• I am drawn to somebody who is…
• But I desire them to be…
• So I can receive…
• And so I can feel…
• However, I sometimes prevent myself from receiving the love I desire by…

Many clients may be surprised at how neatly their responses fit into the five unfinished statements. It’s no secret that our childhood has an effect on who we become and how we live and love as adults, but it can be surprising to see how big this effect can be.

Here’s the Imago Workup for download.

Interpersonal Therapy

Unlike some of the other therapies we have described, interpersonal therapy (IPT) is a brief form of therapy that focuses on resolving interpersonal problems rather than individual problems and follows a very structured approach (Weissman, 2017).

IPT is based on the idea that attachments are integral to human development and flourishing, and that humans are happiest when they know there are trusted people they can turn to in times of trouble.

This type of therapy has been shown to be effective for depression, relationship problems, anxiety, eating disorders, and other problems in a variety of scenarios. It is a time-limited therapy (usually 12 to 16 weeks) that focuses on the issues the client is having connecting with others rather than on strictly internal problems. The goals are to eliminate or decrease the severity of symptoms, improve interpersonal functioning, and increase social support (“About IPT”, 2017).

There are few worksheets for this type of therapy, but if you’d like to learn more about IPT you can see a great source of information here or read our own article on Interpersonal Therapy.

Most Suitable Therapies for Teens and Kids

For example, CBT is excellent for treating depression and anxiety, while DBT has been found to be effective for bipolar disorder, and a specific type of CBT called Exposure and Response Prevention is the best tool for treating OCD.

The best type of therapy is often dependent on the diagnosis, but there are some types of therapy that have proven especially effective for children.

According to the American Academy of Child & Adolescent Psychiatry, the following types of therapies can be used in the specified situations:

• Cognitive-Behavioral Therapy (CBT): Can be applied to children dealing with mood problems, anxiety, or distorted thinking.
• Dialectical Behavior Therapy (DBT): Can be used with older adolescents with suicidal thoughts, self-harm, or borderline personality disorder.
• Family Therapy: Can be applied to whole families, including children or adolescents, parents, siblings, and grandparents.
• Play Therapy: Can be used with children to help them recognize, identify, and verbalize their feelings.
• Psychotherapy: Can apply to children to help understand what is driving their behavior and discover patterns of behavior.

A Take-Home Message

I hope this piece has given you a useful overview of the many different types of therapy available to you. Remember, if you try one and it doesn’t seem to help, there are many more that may better suit you!

Whether you are struggling with a DSM diagnosis, a new source of stress, or just the difficulties of everyday life, there is likely a type of therapy out there that will work for you.

Have you tried any of these types of therapy before? How did it go? Would you consider or reconsider any of them?

Let us know your thoughts in the comments.

Thank you for reading!

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free.

• www.aacap.org
• Albert Ellis Institute. (2014). Rational emotive & cognitive-behavior therapy. The Albert Ellis Institute. Retrieved from http://albertellis.org/rebt-cbt-therapy/
• American Academy of Child & Adolescent Psychiatry. (2013). Oppositional defiant disorder. AACAP. Retrieved from http://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Children_With_Oppositional_Defiant_Disorder_72.aspx
• Imago Relationships. (2016). What is Imago? Imago Relationships International. Retrieved from http://imagorelationships.org/pub/about-imago-therapy/what-is-imago/
• Interpersonal Psychology Institute. (2017). About IPT. IPT Institute. Retrieved from https://iptinstitute.com/about-ipt/
• Love, P., & Shulkin, S. (2001). Imago theory and the psychology of attraction. The Family Journal, 9(3), 246-249.
• Pearl, M. What is schema therapy. Schema Therapy Center of New Orleans. Retrieved from http://www.schematherapy-nola.com/what-is-schema-therapy
• Weissman, M. (2017). A history of IPT. IPT Institute. Retrieved from https://iptinstitute.com/about-ipt/
• William Glasser Institute. (2010). Reality therapy. WGI US. Retrieved from http://www.wglasser.com/the-glasser-approach/reality-therapy
• Young, J. E., Klosko, J. S., & Weishaar, M. (2003). Schema therapy: A practitioner’s guide. New York: Guilford Publications.

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