CBT Case Formulation Worksheet

Client Name		Date
Presenting problem/symptoms
Triggers
Predisposing factors
Perpetuating factors
Strengths/Protective Factors
Treatment goals
Significant events	Automatic thoughts	Emotions	Behaviour

Schemas
Working Hypothesis

Reference

Persons, J. (2012). The case formulation approach to cognitive-behavior therapy (guides to individualized evidence-based treatment).Guilford Press.

You can download more Mental Health worksheets here.

Please note: There may be a more up-to-date and editable version of this worksheet available here which may be more suitable to present to clients if you are a therapist or to use in a classroom as a teacher or guidance counsellor.