Cognitive Behavioural Therapy (CBT) doesn't have to mean spending every session completing worksheets.
Some of the most useful CBT activities are interactive, practical, and designed to help clients see their patterns in action.
CBT activities can help clients identify automatic thoughts, recognise cognitive distortions, understand the connection between thoughts, emotions and behaviours, test predictions, reduce avoidance, build coping skills, and practise responding differently to difficult situations.
Below are 30 CBT activities therapists can use in individual or group therapy sessions, with ideas that can be adapted for teens and adults.
1. Catch the Automatic Thought
Ask the client to think about a recent situation that triggered a strong emotional reaction.
Slow the moment down and ask:
"What went through your mind just before you started feeling that way?"
Write down the first thoughts that appear without trying to challenge them yet.
Why use it: Helps clients become better at recognising automatic thoughts before moving into cognitive restructuring.
2. The CBT Triangle
Choose a recent situation and map out three parts:
Thought → Emotion → Behaviour
Then explore how changing one part of the triangle might influence the others.
For example:
Thought: "I'm going to embarrass myself."
Emotion: Anxiety.
Behaviour: Avoid the event.
Now ask:
"What might happen if the behaviour changed?"
Why use it: Gives clients a simple visual explanation of the core CBT model.
3. Thought Detective
Turn cognitive restructuring into an investigation.
Choose one difficult thought and look for:
- Evidence supporting it
- Evidence against it
- Information that might be missing
- Other possible explanations
Finish by developing a more balanced conclusion.
Why use it: Makes thought challenging feel curious rather than confrontational.
4. Cognitive Distortion Hunt
Give the client a list of common cognitive distortions such as:
- All-or-nothing thinking
- Catastrophising
- Mind reading
- Overgeneralisation
- Mental filtering
Take several recent thoughts and see which thinking patterns appear.
Why use it: Helps clients recognise recurring thinking habits.
5. Two Commentators
Imagine two commentators describing exactly the same situation.
The first gives the client's automatic interpretation.
The second offers another possible interpretation.
For example:
Commentator 1: "She didn't reply because she's annoyed with me."
Commentator 2: "She hasn't replied yet. I don't actually know why."
Compare how each interpretation changes the emotional response.
Why use it: Demonstrates that situations can have more than one interpretation.
6. Thought or Fact?
Write different statements on cards or sticky notes.
Examples:
- "My presentation starts at 10am."
- "Everyone will think I'm terrible."
- "My friend hasn't replied."
- "They're ignoring me."
Ask the client to sort them into:
FACT
or
THOUGHT / INTERPRETATION
Then discuss the difficult-to-sort examples.
Why use it: Helps clients separate observable information from assumptions.
7. What Would You Say to a Friend?
Choose a thought the client frequently directs towards themselves.
Ask:
"If your best friend said this about themselves, what would you tell them?"
Compare their response with how they speak to themselves.
Why use it: Helps uncover harsh self-talk and encourages a more balanced perspective.
8. The Belief Thermometer
Choose a difficult thought and rate how strongly the client believes it from 0–100%.
Explore the evidence together.
Then rate the belief again.
The goal isn't necessarily to reach 0%.
Even moving from 95% to 70% can demonstrate that thoughts aren't always fixed facts.
Why use it: Makes cognitive change visible and measurable.
9. Best Case, Worst Case, Most Likely
Take a feared situation and explore three possibilities:
Worst case: What are you afraid will happen?
Best case: What could go surprisingly well?
Most likely: Based on the evidence, what is most likely to happen?
Then discuss how the client could cope even if something difficult occurred.
Why use it: Useful for catastrophising, worry, and anticipatory anxiety.
10. Complete the Thought Bubble
Draw a simple character in a situation and leave their thought bubble blank.
Ask:
"What might this person be thinking?"
Generate several different possibilities.
Then discuss how each thought might create a different emotional or behavioural response.
Why use it: Introduces cognitive flexibility without immediately focusing on the client's own thoughts.
11. Behavioural Experiment
Choose a prediction the client believes strongly.
For example:
"If I ask a question, everyone will think I'm stupid."
Create a small real-world experiment.
Write down:
Prediction → Experiment → What Actually Happened → What I Learned
Review the results at the next session.
Why use it: Helps clients test assumptions through experience rather than reassurance.
12. Prediction vs Reality
Before completing an activity, ask the client to predict:
- How difficult will it be?
- How anxious will I feel?
- What do I think will happen?
Afterwards, compare those predictions with reality.
Over several experiments, look for patterns.
Why use it: Helps clients recognise when anxiety consistently overestimates threat or difficulty.
13. The Avoidance Cycle
Choose something the client has been avoiding.
Map the cycle:
Trigger
↓
Anxiety
↓
Avoidance
↓
Immediate Relief
↓
Fear Remains
Ask:
"What does avoidance give you right now—and what does it cost you later?"
Why use it: Helps clients understand why avoidance can maintain anxiety.
14. Build a Fear Ladder
Choose a fear or avoided situation.
Brainstorm related situations and rate each from 0–10 for difficulty.
Arrange them from easiest to hardest.
The client can gradually practise approaching situations beginning with manageable steps.
Why use it: Provides structure for graded exposure work.
15. Behavioural Activation Menu
Create three categories:
Low Energy
Medium Energy
Higher Energy
Brainstorm meaningful activities for each.
For example, a low-energy activity might be opening the curtains or stepping outside for five minutes, while a higher-energy activity could involve meeting a friend.
Why use it: Gives clients realistic options when depression makes activities feel difficult.
16. Pleasure and Achievement Experiment
Choose several activities for the week.
Before each activity, predict:
Pleasure: 0–10
Achievement: 0–10
Afterwards, rate both again.
Compare the predictions with what actually happened.
Why use it: Helps clients test depressive predictions that activities will feel pointless or unrewarding.
17. Action Before Motivation
Choose one small task the client has been waiting to "feel motivated" to complete.
Instead of waiting, agree on a tiny first action.
After completing it, record:
Motivation before → Motivation after
Why use it: Demonstrates that action can sometimes create motivation rather than requiring motivation first.
18. Break It Down
Choose one task that feels overwhelming.
Break it into the smallest possible steps.
Instead of:
"Clean the house."
Try:
- Put dirty clothes in the basket.
- Clear one surface.
- Wash five dishes.
- Take a break.
Why use it: Helps with overwhelm, procrastination, depression, and all-or-nothing thinking.
19. Problem-Solving Map
Write one current problem at the top of the page.
Then work through:
What is the problem?
What can I control?
What are my options?
What are the pros and cons?
What is one next step?
Why use it: Helps clients move from repetitive worrying into practical problem solving.
20. Circle of Control
Draw two circles.
In the inner circle, write:
Things I Can Control
In the outer circle:
Things I Can't Control
Sort current worries into the two areas.
Then focus the session on actions available within the client's control.
Why use it: Useful when clients are spending significant energy trying to solve things outside their influence.
21. The Worry Sorting Game
Write worries onto individual cards or sticky notes.
Sort them into:
Problem I Can Act On
Hypothetical Worry
For actionable problems, create a next step.
For hypothetical worries, explore strategies for disengaging from repetitive thinking.
Why use it: Helps clients distinguish problem solving from unproductive worry.
22. Reframe the Headline
Imagine the client's automatic thought is a dramatic newspaper headline.
For example:
EVERYTHING IS A DISASTER
Now become the editor.
Rewrite the headline so it remains truthful without exaggerating.
TODAY WAS DIFFICULT, BUT NOT EVERYTHING WENT WRONG
Why use it: A creative way to practise balanced thinking and recognise catastrophising.
23. Core Belief Iceberg
Draw an iceberg.
Above the water, write automatic thoughts such as:
"They're judging me."
Underneath, explore deeper assumptions:
"I have to impress people."
And deeper beliefs:
"I'm not good enough."
The goal isn't necessarily to change the belief immediately—first, simply understand the pattern.
Why use it: Helps clients see how surface-level thoughts can connect with deeper beliefs.
24. Rules I Live By
Complete sentences such as:
- I must...
- I should...
- I can't...
- If I don't ___, then...
- People will only like me if...
Choose one rule and explore where it came from, how it once helped, and whether it still works today.
Why use it: Helps identify rigid assumptions and underlying beliefs.
25. The Perfectionism Experiment
Choose something the client normally feels must be done perfectly.
Agree to intentionally complete it to a "good enough" standard.
Beforehand, predict what will happen.
Afterwards, compare the prediction with reality.
Why use it: Helps clients test perfectionistic rules through behavioural experience.
26. Coping Card Challenge
Choose a situation that regularly triggers an unhelpful pattern.
Create a small coping card containing:
My usual thought
What I want to remember
What I can do next
The client keeps the card somewhere accessible and uses it when the situation occurs.
Why use it: Helps transfer learning from therapy into everyday situations.
27. Past Evidence Board
Choose a belief such as:
"I can't cope with difficult situations."
Look for real examples from the client's life when they:
- Managed something difficult
- Asked for help
- Recovered from a setback
- Tried despite feeling afraid
- Solved a problem
Build an evidence board that challenges the original belief.
Why use it: Helps clients recognise evidence their negative beliefs may be filtering out.
28. Stop, Check, Choose
Teach a simple three-step response:
STOP
Notice the automatic reaction.
CHECK
What am I thinking? What am I feeling? What evidence do I have?
CHOOSE
What response would be most helpful right now?
Practise using imaginary situations before applying it to real ones.
Why use it: Turns several CBT concepts into one simple strategy clients can remember outside therapy.
29. Future Me Experiment
Ask:
"If you responded differently to this pattern for the next three months, what might change?"
Then identify one small behaviour the client's future self would benefit from starting now.
Make the action specific enough to practise during the coming week.
Why use it: Connects CBT behaviour change with meaningful longer-term goals.
30. From Pattern to Choice
Choose one recurring difficulty and map the client's usual sequence:
Situation → Automatic Thought → Emotion → Body Response → Behaviour → Outcome
Then create a second pathway.
Keep the situation the same, but identify one point where the client could make a different choice.
Compare the two possible outcomes.
Why use it: Brings the whole CBT model together and reinforces the idea that change often begins with one small interruption to an existing pattern.
How to Choose the Right CBT Activity
Not every client needs the same activity.
Some clients may benefit from first learning to recognise automatic thoughts. Others may already understand their thinking patterns but need behavioural experiments, exposure, behavioural activation, or problem-solving strategies to create change.
The goal isn't to fit as many CBT activities as possible into a session.
It's to choose an activity that matches the pattern you're working on and the client's current readiness to work with it.
💡 Therapist Tip
When introducing a new CBT activity, explain why you're doing it before explaining how to complete it.
Instead of simply saying:
"Let's fill in a thought record."
you might say:
"We've noticed that your anxiety rises very quickly in these situations. This activity can help us slow those moments down and see what your mind is telling you."
Clients are much more likely to engage with an activity when they understand its purpose.
CBT Activities Aren't Just Worksheets
One common misconception about CBT is that every intervention involves completing a worksheet.
Worksheets can provide useful structure, but CBT can also involve conversation, games, behavioural experiments, role-play, exposure, problem solving, activity scheduling, observation, and real-world practice.
The activity is simply the tool.
The real goal is helping clients recognise patterns, experiment with different responses, and discover what happens next.
Where to Go Next
If you're building CBT sessions, these activities naturally connect with deeper CBT skills and techniques:
- What Is Cognitive Behavioural Therapy (CBT)?
- Thought Records: A Complete Guide
- Automatic Thoughts Explained
- Cognitive Distortions: A Complete Guide
- Behavioural Activation: A Complete Guide
- Behavioural Experiments: A Complete Guide
- Exposure Therapy: A Complete Guide
- Best CBT Worksheets for Structured Sessions
Each activity can be adapted to suit the client's age, goals, presentation, and stage of therapy. The aim isn't to complete every activity on this list.
It's to find the activity that helps the client see one pattern a little more clearly—and gives them one meaningful opportunity to respond differently.