# data[].attributes.body
How did you feel about doing this?
I felt pretty confident about completing the task. I've been through the process before and found it helpful the last time.
How easy was it to complete this?
In general when I got into it I found the process of filling out the tables straightforward. I also found that I was quite aware of my thoughts, so identifying negative ones was not hard. Though, I did find it quite effortful to take the time and write/type everything out so I often didn't bother with challenging some thoughts (even though I knew I would benefit from the process). There were also a couple of times where I experienced a negative thought but I was so caught up in the emotions of it that it didn't even cross my mind at the time to record it.
Were there any barriers to completing this?
A barrier was definitely the sheets. I didn't want people to see me carrying them around so I used my phone instead. Time/effort was also a large barrier. As I've mentioned already I found the recording process effortful so I regularly avoided it if I felt I'd done enough already.
What was the effect on you of completing this?
It has made me think about how difficult the task could be for children/young people to engage with...
What do your responses mean for the treatment of children with this model?
If I struggled to gather the energy to record and challenge my thoughts, it really makes me wonder how difficult the treatment must be for a young person who is, for example, moderately depressed. Already, they will be struggling with motivation so surely they would find it fairly hard to engage with at their level of low mood.

# data[].attributes.body
1. I felt unsure with completing this task, as when I have tried it before I found it difficult to pinpoint specific thoughts.
2. As I am not experiencing depression or anxiety, so do not have a lot of negative thoughts, i found it difficult to complete this task. When i do have any negative thoughts i usually rationalise them fairly quickly automatically.
3. Time is the biggest barrier for me, i found it hard to complete as I am usually on the go and do not always have time to stop and consider each individual thought and feeling.
4. Being constantly aware that i should be thinking something in order to have a feeling also put pressure on me. I was often trying to search for negative thoughts that just were not there.
5. My response would be very different than a child who was currently experiencing depression or anxiety, as they would be more likely to have negative thoughts. Being self aware is not an easy task, and one i feel children may struggle with, as i found it hard to pin point my exact thoughts which led to my emotions. Time and privacy is also another consideration to bear in mind.

# data[].attributes.body
Hody Lo
1. How did you feel about doing this?

I felt quite happy to complete this task as I have been using this intervention with patients during placement.

2. How easy was it to complete this?

Having experiencing of carrying out the task last year, I felt that it was quite easy for me to complete this task, especially when I do not have much negative thought this week.

3. Were there any barriers to completing this?

One of the key barriers was to record all my thoughts and to challenge them using evidence on the worksheet. I found it easy to come up with more balanced thoughts in my head and so, did not feel the need to write them down.

4. What was the effect on you of completing this?

I noticed that I do not have much negative thought during this week and even if experienced these thoughts, it was unlike to affect my mood. This in turn suggests that I may not experience the effect of this intervention as the patients would.

5. What do your responses mean for the treatment of children with this model?

I was able to carry out this intervention mentally rather that relying on physically written thought records. I could imagine that for children carrying out CR to reach this stage, i.e. to come up with revised thoughts mentally, it requires a thorough understanding of this intervention and how CR could apply to the children’s life outside of the clinic room.

# data[].attributes.body
1. How did you feel about doing this? Although I have had practice of engaging with this intervention myself through the Applied Course, this was a while ago and I have not had the opportunity to use this recently with a patient on placement. As the interventions I have engaged in with patients on placement have been behavioural focused, I felt apprehensive about the cognitive aspects of this.
2. How easy was it to complete this? It turned out to be easier than I was worrying it would be. However, I found myself doing it automatically in my head, rather than writing everything down each time. Although this isn't necessarily a bad thing (as that is the aim for a patient - for this to become an automatic and natural process), it was bad in the sense that I didn't fully get to understand what it would be like to use the sheets every time, like a patient first would.
3. Were there any barriers to completing this? A key barrier was using the sheets, as I wouldn't want to take them out in public for fear of wondering what other people would ask about them/see. I think this also exaggerated the fact that I tended to do it more mentally than in physical form.
4. Was was the effect on you of completing this? This made me more aware of how 'small' thoughts were impacting my behaviours and mood. This insight meant that I could 'nip the thoughts in the bud' so that they didn't exaggerate into having a larger negative impact.
5. What do your responses mean for the treatment of children with this model? Although I was able to do this mentally, for those just beginning to engage in the intervention, they could struggle with this. It is therefore better to make adaptations to how the physical copies could differ - whether the individual could use the 'notes' section on their phone, or an approved app, or carry a small notebook with them that it easier to carry and more inconspicuous.

# data[].attributes.body
1: My initial thoughts were fairly neutral. I didn't expect much personal benefit from it outside of insight into the process of using CR.
2: I found it difficult to record all my thoughts. I like to think that I am aware of much of my own thinking (that is bothering me) and that I do most of what is instructed on the CR sheet on my own.
3: Time and effort in doing it is always a problem. I found that the more I pay attention to my thousands of thoughts per day, the more unrealistic and trivial the task becomes.
4: Very little. I felt simple thought awareness as sufficient for any benefits made available from the exercise. I certainly did not feel it was helpful to write any of it down or assign arbitrary quantities to my beliefs etc.As soon as I was aware of the nature of the thought, it was easy to observe it fading away.  I think there is evidence to support my anecdotes here.
5: I am agnostic as to whether it would be more helpful for children to write down and document this exercise. Perhaps they can be taught it without using materials. Perhaps this is something they can develop the ability to do it without the materials over time.

# data[].attributes.body
1. I  felt a bit uneasy being asked to do this task, I found it quite triggering when I have tried it before.
2. I found it a bit tricky to do at first because I kept forgetting to take the diary with me so would try and remember later on which was a very unreliable way of recording the thoughts.
3. In order to get around this barrier, I found an app that has a thought diary function in it, called MindTools. I found this really helped me to always have a place to record the thoughts as I take my phone most places and also because only I can see the thoughts I recorded.
4. Recording the thoughts that I have means for me that I am attending to them more than I normally would, which I don't find helpful and actually can make me feel bad about myself. However, I do find it helpful to be aware of the different thinking styles (from the Chris Williams model of CR) and when I noticed my thoughts were of a particular style, that awareness was enough for me to disregard those thoughts. I find that the more I think about my NAT's and the core beliefs behind them and where those came from, the more my mood worsens. I find it more helpful to do things to challenge those NAT's and core beliefs rather than think about them more.
5. From using CR a few times, I think I have a preference for more behavioural interventions.This means that for patients, it is important to be able to offer a choice of treatments as we all have our personal preference, or it might be that one treatment does not help initially, so to be able to offer another type of treatment for the same thing can be helpful.

# data[].attributes.body
1) I felt comfortable in doing the task, the only thing was that in the previous week, I did not have many negative thoughts, and this task was not very helpful.
2) Regardless to the lack of negative thoughts, it was easy to find alternative explanation for the original thought.
3) There was not really any barriers for me; however based on the experience on placement, people usually find it difficult to think of evidence against the original thoughts. It might be me being quite mentally healthy, and thus it did not bother me to challenge myself.
4) I did not feel negative before the start of the task, and I tried very hard to note 2 thoughts, but they were quite minor. Therefore, I was not affected much.
5) I think my response in this case might not be focusing on CR... I think if the child thinks that the intervention is not helping. I would need to funnel around the barriers, to see whether it is a right focus but having difficulties in carry it out, or it is actually a wrong intervention. CR would not work without a person being able to identify thoughts.

# data[].attributes.body
1. I was happy to be asked to complete this task. I am familiar with this table and I believe it to self-explanatory.
2. This table was relatively easy to complete.
3. The main barrier I had was having to engage my rational mind and apply evidence for and against. This is something I do with patients and I can appreciate how hard this can be. Moreover, I have always struggled to access my own thoughts. Retrospectively, I believe them to be masked by my emotions.
4.After completing this, I felt more in contact with my thoughts. I think that the more I practice this the easier it will be. Engaging the rational mind and applying 'for and against' is a technique I would like to be able to do in my own head when out and about in order to confront NATs.
4. I believe that children may also struggle to access their thoughts. Currently on placement, I am working with two patients in their late teens. In comparison to my older patients, they struggle to access their thoughts and tend to only be aware of the emotion.

# data[].attributes.headline
Libby nellany1)  i felt comfortable with doing this task as i feel like i know the treatment well.

# data[].attributes.subject
Libby nellany1)  i felt comfortable with doing this task as i feel like i know the treatment well.

# data[].attributes.body
2) I a very aware of my thoughts so i found keeping a thought diary easy.
3) barrier was that i was afraid somebody would read my sheets so i started using my phone
4)this made me realize a common theme in my thinking
5) every NAT i had lead to a core belief (confirmed a core belief), so i think challenging the NAT for me p[personally is not enough however i think this would work on people with weaker core beliefs

# data[].attributes.body
1. I was comfortable with being asked to complete this task as we have previously practiced something similar last year as part of a reflection for the clinical course and therefore felt as though I already had some understanding of what we were being asked to do. I was apprehensive however, as before I have found that trying to counterbalance thoughts can be quite difficult.
2. I was surprised at how easy I found this task when I was completing the worksheets, however finding the time to complete them was more of a challenge.
3. One of the barriers I found was that it was difficult to think about or complete when I didn't have the sheets on me, as I couldn't remember all the different sections and I didn't want to heighten my awareness to my NATs if I wasn't in the position to deal with them appropriately. I can see how this might be a barrier for patients as you are not always in situations or environments where it would be appropriate to start trying to complete the sheets in order to balance try and balance your thoughts, which meant that I had to do a lot of it in the evening when I was reflecting back on the day - I feel that this probably reduces the effectiveness of the task as I was unable to catch my thoughts as they were happening and therefore deal with the effects that they were having on my mood in the moment.
4. This reduced my desire to want to complete the task as I knew that it was difficult to catch all my NATs, however of those I did complete the task with, I found improved my mood and perspective on the thoughts that I had been having.
5. I feel as though whilst this treatment is useful, it is definitely challenging and people may be easily put off if they are unable to see any beneficial changes soon after starting the treatment. I am aware that thought processes take quite a long time to challenge and practice before it becomes more natural, but this may be quite difficult for children and adolescents to engage with.

# data[].attributes.body
Jess Lawrence

1.       I did not find this task particularly obtrusive, but I thought it was difficult to remember every day and found myself having to look back to the day before.

2.       I felt this task was relatively easy to complete on a normal day to day basis, but

because I was away for 4 days and didn’t take the sheets with me it was difficult to complete them after this.

3.       Sometimes an activity was a lot shorter than an hour but still felt important enough to be included, which made it a bit more difficult to put everything on the sheet. I also thought sometimes the importance column was difficult to complete because basic needs are important but might not feel important to me in the same way making time to see friends is.

4.       This week I have been very busy so I found it made me feel quite accomplished, but I can imagine that in a less hectic week it might have made me feel like I waste quite a lot of time even though I find doing ‘nothing’ important to relax and stress less about uni work.

5.       My responses have highlighted to me that children might find it a bit disheartening or loose motivation if their records aren’t particularly full of activities. That said, I think the relative ease of completion of the tasks is suitable for children and that they could help children really think about what is important to them. I do think, however, that the relatively long time without acting upon what is recorded might initially make children think the process is not particularly valuable – but if the process is fully explained to begin with this should be avoided.

# data[].attributes.body
1. I felt comfortable being asked to do this task and thought it would probably be helpful for me not only in understanding the use of thought records in therapy but also personally.
2. I find these tasks easy enough as I understand the process behind balancing the evidence which supports and contradicts a thought in order to change the way you feel about the thought and create a more realistic one.
3. My barriers in completing this thought record came from the fact that I am currently taking part in a similar type of therapy for my anxiety. I have been practicing worry periods and some other CBT techniques and this meant I felt odd using a similar technique as part of uni work rather than for personal reasons.
4. Completing this though helped me further to understand what patients must feel like when being asked to complete thought records. I understand that these techniques can click instantly for some people but take a lot of practice and work for others for them to see improvements in depression and anxiety symptoms. I felt like I understood the use of thought records from both the therapist and the patient point of view.
5. I think the use of thought records are reasonably simple and well explained to be used in treatment for children and young people with depression and anxiety. I understand how children could be disheartened when they don't feel instant progress or satisfaction from tasks but these CBT techniques take time to starts seeing improvements in mood. I can see how these tasks can be quite time consuming and often if you are lacking motivation or feel hopeless a child might not be keen to complete these exercises very often. I think for young children these could be adapted to become more child friendly looking - perhaps with a simplified version of thought challenging.

# data[].attributes.body
1. I felt quite comfortable when thinking about starting this practice as we did some self practice last year. However, at the same time I was worried I wouldn't have time to do the task and I was concerned about the personal nature of revealing my thoughts on the padlet. 2. I found this task relatively easy once I had caught a thought. The table seems mostly self explanatory and having helped friends challenge their thinking and practised this with patients I felt quite confident applying it to myself. I feel that having learnt how to do this previously, when I have negative thoughts I do automatically try to challenge them and think of the evidence for and against.
3. The main barrier for me was trying to be aware of my thoughts as they happened. It was difficult to capture them in order to write them down. It was particularly difficult because I often got pre-occupied with other things I was doing and so this practice wasn't my first priority all week long.
4. This actually made me feel a lot better. I was having a bad day when I chose to practice challenging my thoughts and I was glad that I did this because it meant I could move on and actually felt better in the moment. This has also boosted my confidence in thinking about delivering this as a treatment to patients on placement and the future possibility of helping children try this.
5. I think it seems like a positive treatment to use for adolescents but I worry that it would not be as effective with younger children. It may also be important to spend some time helping the young person to identify their own thoughts to begin with.

# data[].attributes.body
1.     I felt confident in completing this task, as this is something that we were required to do last year and this is something that I have been implementing with a patient on placement. Therefore, I also felt that it would be a useful task for me to complete, in order to best empathise with some of the difficulties that my patient has been experiencing with this treatment course.

2.     I found it quite easy to complete the thought tasks. I feel this was due how many times I have prepared for treatment sessions to do with this topic and have also practised balancing thoughts with my patient frequently.

3.     I didn’t notice as many barriers to completing this task as I did with BA last week. I found it quite easy to balance the thoughts, and was able to think about what a friend may say to me, or think about it in a future time (e.g. 3 years on) whenever I struggled to come up with balancing thoughts from my own perspective. I also feel that I didn’t notice many barriers to thought challenging work, as this is something that I think I implement into daily life. I think it comes quite naturally to me, and is something that I use subconsciously to balance my thoughts a lot of the time.

4.     Before completing this task, I had lost some confidence in my understanding and knowledge of implementing this treatment, as the patient I have been working with has been struggling with the treatment for a few weeks. The effect of me completing this has restored my confidence in my understanding of the treatment, having completed it by myself, and also resulted in me allocating additional time into understanding each of the components. I can see its usefulness in treating depression and other related common mental health problems.

5.     I feel that my responses are positive in light of the use of this treatment. However, I do have concerns about how easy it would be for a child to complete these tasks, as it can be time consuming and (personally) I feel that it could be viewed as a slightly more boring task for children to carry out as homework. I therefore feel as though implementing this treatment with expertise about how a child may benefit from elements such as pictures, visual aids, puppets, etc. may be useful when working with children.

# data[].attributes.body
1. How did you feel about being asked to do this?
2. How easy was it to complete this?
3. Were there any barriers to completing this?
4. Was was the effect on you of completing this?
5. What do your responses mean for the treatment of children with this model?

# data[].attributes.body
Self practice self-reflection (SP/SR) has many values for the clinician. Not least of which is an understanding of what it is like to be asked to complete the treatments that we conduct with our clients.

This week is all about your response to completing thought records with the sheets given. I would like you to reflect upon your experiences by answering the questions in Box 2. Post your responses anywhere on the padlet.

# data[].attributes.headline
3. For anyone interested in developing their sense of the evidence base have a look at chapter 2 (you can access it online)...

# data[].attributes.subject
3. For anyone interested in developing their sense of the evidence base have a look at chapter 2 (you can access it online)...

# data[].attributes.attachment_link.title
University of Exeter Library /All Exeter