Automatic Thoughts Questionnaire

1 Medical and Social ServicesMedical and Social ServicesMedical and Social TOOLC ognitive behavioral Therapy WorksheetAutomatic Thoughts I feel like I m up against the I m no Why can t I ever succeed?4. No one understands I ve let people I don t think I can go I wish I were a better I m so My life is not going the way I want it I m so disappointed in Nothing feels good I can t understand this I can t get What s wrong with me?15. I wish I were somewhere I can t get things I hate I m I wish I could just What s the matter with me?

2 21. I m a My life is a I m a I ll never make I feel so Something has to There must be something wrong with My future is It s just not worth I can t finish 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3

3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 51 2 3 4 5 Name: _____ Date: _____Instructions:Listed are a variety of Thoughts that pop into people s heads. Please read each thought and indicate how frequently, if at all, the thought has occurred to you over the past week.

4 Please read each item carefully and circle the appropriate answers on the answer sheet in the following fashion: 1 = not at all 2 = sometimes3 = moderately often4 = often5 = all the timeFor more information, contact your local mental health authority or behavioral health