Cognitive conceptualisation

Link early experience, core beliefs, rules and strategies to the specific situations that trouble the patient now.

From session 2 onward, built with the patient and revised as evidence accrues.14 fieldsCognitive Therapy Rational Emotive Behavior Therapy Schema Therapy

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Build the bottom half first. Three current situations with their automatic thoughts, emotions and behaviours give you the pattern; the core belief is an inference from the pattern, not a starting assumption. Trainees who begin at the top produce elegant diagrams that the patient does not recognise.

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Title this document

Shows why each item is asked

Current situations (build these first)

Situations

Three specific, recent moments.

Underlying structures

Core belief about self*Core belief about othersCore belief about the world / futureConditional assumptions and rules*Compensatory strategies*

What the person does to stop the core belief being confirmed — perfectionism, avoidance, pleasing, control.

Belief in the core belief right now

0 — not at all100 — completely—

Origins

Relevant early experience*How the belief was a reasonable conclusion at the time

Framing the belief as once-adaptive is what makes the work feel like understanding rather than correction.

What keeps it alive now — attention, memory, behaviour, environment*

Treatment implications

Candidate alternative belief, in the patient’s words

Belief in the alternative

0100—

Behavioural experiments that would test the old belief*

Drawn together with the patient?

YesNo

6 required fields outstanding: Core belief about self; Conditional assumptions and rules; Compensatory strategies …

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What Praxical.Psych is, and is not