How to use a core beliefs worksheet with clients

How you use a core beliefs worksheet with your clients ultimately depends on the clients’ needs and preferences, and your therapeutic style. Some therapists incorporate CBT principles in a regimented way, while others take a more organic approach. If you’re familiar enough with the framework of core beliefs, you can easily incorporate the principle in and out of session, and with or without worksheets.

Introduce it with automatic thoughts

Understanding the relationship between core beliefs and automatic thoughts can help your clients better address unhelpful thought patterns. Typically, a person has a few core beliefs at the basis of all their automatic thoughts. 

That’s why Mike Arevalo, PsyD, a private practice therapist and Headway’s clinical product lead, always takes time to share a helpful analogy during therapy. “Negative automatic thoughts can be seen as the leaves and branches of a tree, and many of them all originate from the same trunk, which is a core belief,” he says. 

Address different belief areas

Core beliefs not only affect how we see ourselves, but also other people and the world around us. Your client may have different core beliefs about these areas. For example, they may believe they’re not lovable and the world is a bad place, which can affect different emotions and actions. So you might consider doing exercises or introducing a worksheet for each one.

Incorporate cognitive restructuring

Just as you would with cognitive distortions, take time to work through critical questions that help your client realize they don’t have evidence to support their core belief. This may include the use of Socratic questioning, which helps your clients reflect on their own belief systems and what assumptions they may be making to uphold them. 

Amanda Reagan, a private practice therapist and Headway’s clinical quality lead, typically lists out a client’s core beliefs and then lists information that doesn’t support that belief. “On a whiteboard, I’ll draw out the core belief and list what supports it and what doesn’t, and then use that as our tool for restructuring,” she says.

Create a safe environment

Because core beliefs often develop from adverse childhood experiences, you may want to explore and address them in session with your client rather than sending the worksheet as homework. “I’d rather go through these beliefs in session, when I can help a client to regulate or de-escalate, than leave someone with it alone,” says Tague.

Revisit the principle as needed 

Core beliefs are deeply held and often rigid. Disrupting the automatic thoughts they cause inherently takes time, just like any other area of growth. Be patient as your client becomes more self-aware, and be open to bringing out core beliefs worksheets at different times when new triggers surface. 

“Because of how these beliefs were installed in the first place, based on our experiences, we have to come back and challenge them over time to disrupt them,” says Anita Owusu, a Toronto-based private practice therapist.