The CBT Triangle: What it is and How it Works

July 12, 2022

Our thoughts, feelings, and behaviors are connected. Therefore, changing one of these factors can change the others.

You’ve probably heard about the cognitive behavioral therapy triangle or CBT triangle, which is used by therapists and other mental health professionals to help people with anxiety, depression, post-traumatic stress disorder (PTSD), and those who are under a lot of stress.

Read on to learn more about the CBT triangle, how each part is connected, how to use it, and tips on explaining it to a child.

At the end of this article, you’ll find a list of worksheets that will support you or someone you know who may benefit from CBT.

What is the CBT Triangle?

The CBT triangle, also called the cognitive triangle, is a tool that illustrates the relationship between how we think, feel, and behave. It’s one of the essential components of cognitive behavioral therapy.

The tip of the triangle represents our thoughts, while the bottom right and left points represent our feelings and behaviors, accordingly.

Cognitive Triangle

By using this triangle as part of therapy, we can better appreciate the fact that by changing one part of the triangle, our situation improves.

Here’s an example: To overcome anxiety, a person can engage in anxiety-reducing behaviors such as exercising and using positive affirmations. These actions allow the person to feel happier and more relaxed and may distract them from the things they’re anxious about.

What are the 3 Parts of the Cognitive Triangle?

Below is an explanation of each side of the cognitive triangle:

Thoughts — the tip of the triangle

According to a 2020 study, the average person has more than 6,000 thoughts each day[*]. These include positive thoughts and negatively biased habitual thoughts or “cognitive distortions,” such as[*]:

All-or-nothing thinking. This is also known as black-or-white thinking, in which a person views something as either good or bad and not something in between. For example, they may view a small mistake as a total failure and as a result, they’re afraid to try again.
Catastrophizing. This distorted type of thinking is when a person assumes the worst possible scenario. People who catastrophize may have experienced a traumatic event that causes them to be fearful.
Mind reading. This is when you assume what someone else is thinking. For example, assuming that your spouse is angry with you because they stayed silent during dinner.
Emotional reasoning. This refers to the use of one’s emotions (instead of rational evidence) to form conclusions about a situation. For example, you’re scared to play the piano on stage because you might make a mistake. During the big event, you felt nervous and started sweating. Then you tell yourself, “I’m going to fail.”
Labeling. When a person uses labeling, they judge themselves or others based on one characteristic. For example, calling yourself “dumb” because you got a bad grade in school.
Personalization. This is when you take things personally, blame yourself, or someone else for situations that are uncontrollable. Individuals with depression, anxiety, or a history of trauma are at risk of having this cognitive distortion.

Feelings — the bottom right point of the triangle

Feelings are your emotional experiences and they enable you to communicate with others, respond to events, and make important decisions. For example, you wake up one morning feeling happy and energized, which made you want to cook breakfast for the whole family.

Sometimes, feelings can cause trouble in our lives when we don’t deal with them properly. Unhealthy ways of coping include suppressing anger, dwelling on resentment, and engaging in risky behaviors like bullying and substance abuse[*].

It’s important to become aware of your feelings so that you can express them healthily and move past negative feelings.

Behaviors — the bottom left point of the triangle

Behaviors refer to the way you react to stimuli. Your behavior can be influenced by different things, including your thoughts and feelings. In other words, a person’s behavior can serve as a clue on how they’re feeling, especially when they don’t communicate it.

Consider this example: A happy person is more likely to socialize with others, display a “can do” attitude, and engage in health-promoting behaviors such as exercising and eating nutritious foods.

How the CBT Triangle Connects Thoughts, Feelings, and Behaviors

The CBT triangle shows that thoughts create feelings and feelings lead us to act a certain way. If you find yourself stuck in a negative cycle in your life, it may be helpful to explore the role that your thoughts, feelings, and actions play so that you can break out of that cycle.

Let’s take this simple example:

Thought: “I am not qualified for this job.”
Feeling: Sad, defeated, embarrassed
Behavior: Quitting the job

With the help of the cognitive triangle, a person will be able to challenge this negative thought and replace it with a positive one:

Alternative thought: “I can learn and improve with practice.”
New feeling: Empowered, interested, hopeful
New behavior: Doing your best

Using the CBT Triangle

The CBT triangle can be used to help kids, adolescents, and adults who are dealing with trauma and a variety of mental disorders, such as anxiety and depression.

In addition to showing the triangle to your student or patient, let them fill out a worksheet where they can identify:

A situation that’s negatively affecting them
The thought that arose from that negative situation
How that thought made them feel
How they acted in response to that feeling

To target irrational thoughts, you may ask them to identify positive self-talk statements and positive coping skills that they can use to counteract negative thoughts and feelings.

In the “CBT Worksheets” section below, you’ll find a list of downloadable tools to help patients gain self-awareness and support them through life’s challenges.

How Do You Explain the Cognitive Triangle to a Child?

If you’re looking to use cognitive behavioral therapy to help your child, show them an image of the cognitive triangle. This would introduce them to the concept of CBT.

Make sure to provide concrete examples or scenarios for each point of the triangle. Visual aids, such as the “feelings and emotions” poster and thermometer help with the learning process. Asking questions also gets them to think. Last but not least, use age-appropriate terms to increase their understanding.

CBT Worksheets

Download these resources, which include interpersonal effectiveness skills, coping statements, strategies for anger management, and more. Use any of these as part of your therapy toolkit or in any setting to help a child or teenager:

Summary

The cognitive behavioral triangle focuses on the impact of thoughts on feelings and behaviors, and how changing them can improve situations. Therapists and other mental health professionals may use this tool to help anyone with a wide range of problems.

CBT worksheets are great tools that will allow your patients (or yourself) to spot unhelpful thinking patterns and explore new behaviors to interrupt any negative cycle.

References:

Tseng J et al. Brain meta-state transitions demarcate thoughts across task contexts exposing the mental noise of trait neuroticism. 2020 July 13
Rnic K et al. Cognitive Distortions, Humor Styles, and Depression. 2016 August 19
Algorani E et al. Coping Mechanisms. 2022 April 28