ATR TEMPLATE

ATR TEMPLATE
DYSFUNCTIONAL THOUGHT RECORD 1. Situation Who? What? When Where? 2. Moods a. What did you feel? b. Rate each mod (0-100%) 3. Automatic Thoughts (Images) a. What was going through your mind just before you started to feel this way? Any other thoughts? Images? b. Circle the Hot Thought. 4. Evidence That Supports the Hot Thought 5. Evidence That Does Not Support the Hot Thought 6. Alternative/Balanced Thoughts a. Write an alternative or balanced thought. b. Rate how much you believe in each alternative or balanced thought? (0-100%) 7. Rate Moods Now Rate moods listed in Column 2 as well as any new moods (0-100%) Wednesday night, 7:45 p.m. Just got off the phone talking to my parents. They told me they were inviting my sister to come with them when they visit tomorrow. Anger 100% Fear 100% Abandoned 100% Alone 100% They know I don’t get along with my sister. They know I don’t really want to see her. They don’t care about my feelings, aaaah. They don’t love me. This will never get better. I can’t tolerate the pain. I need to stop this pain. Image of cutting my wrists. I need a tranquilizer. I don’t like these feelings and I wish I didn’t have them. Cutting my wrists helps the pain go away. Tranquilizers help me feel calmer. I have tolerated more pain than this in the past. Cutting my wrists or talking a tranquilizer in the past has only temporarily stopped the emotional pain. Cutting my wrists or taking a tranquilizer will not help me in the family meeting tomorrow. Although I prefer to deal with these feelings, I have to learn how sooner or later. 45% I might as well learn while I am in the hospital and somewhat protected. 40% I can take a tranquilizer in one hour if I haven’t calmed down. 60% Anger 100% Fear 80% Abandoned 90% Alone 70%
ATR TEMPLATE
Automatic Thought Record Situation 1. Actual event leading to unpleasant emotion, or 2. Stream of thoughts, daydream, or recollection, leading to unpleasant emotion Feelings Specify sad, anxious, angry etc. Rate 1-100 Automatic Thought(s) Write automatic thought(s) that preceded emotion(s). Rate belief in automatic thought(s), 0-100%. Rational Response 1. Write rational response to automatic thought(s). 2. Rate belief in rational response, 0-100% Outcome 1. Re-rate belief in automatic thought(s), 0- 100%. 2. Specify and rate subsequent feelings, 0-100.