ATR TEMPLATE

Automatic Thought Record Situation 1. Actual event leading to unpleasant emotion, or 2. Stream of thoughts, daydream, or recollection, leading to unpleasant emotion Feelings Specify sad, anxious, angry etc. Rate 1-100 Automatic Thought(s) Write automatic thought(s) that preceded emotion(s). Rate belief in automatic thought(s), 0-100%. Rational Response 1. Write rational response to automatic thought(s). 2. Rate belief in rational response, 0-100% Outcome 1.

Re-rate belief in automatic thought(s), 0- 100%.

2. Specify and rate subsequent feelings, 0-100.