Automatic Thought Observation Form
Reflect on your automatic thoughts, emotions, and responses to better understand your thinking patterns.
Date and Time of Observation
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Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Briefly describe the situation or event that triggered your automatic thought.
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What was your automatic thought in this situation?
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What emotions or feelings did you experience? (Select all that apply)
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Anxiety
Sadness
Anger
Guilt
Shame
Happiness
Other
How intense were these emotions? (0 = Not at all, 10 = Extremely intense)
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Not at all
0
1
2
3
4
5
6
7
8
9
Extremely intense
10
0 is Not at all, 10 is Extremely intense
Did you notice any physical sensations? If yes, please describe.
What was your immediate behavioral response?
What evidence supports your automatic thought?
What evidence does NOT support your automatic thought?
What could be an alternative or more balanced thought in this situation?
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Looking back, how do you feel now about the situation?
Submit Observation
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