CBT Tools to Use and Download

Four practical tools from the CBT section, to read here, print, or download and fill in.

Each tool is shown in full on this page, so it works with a screen reader, zoom or your own browser settings. Each also comes as an editable Word file. They are free to use and adapt. They are not a substitute for therapy or medical advice.

Access Request Template
Flare Plan for Therapy
Therapy Review Questions
Activity and Energy Record

Access Request Template

For asking for an adjustment at work, in a service, or anywhere else. Change any wording so it sounds like you.

Download Access Request Template (Word, editable)

A written request

I’m writing to ask for [the adjustment] so that I can [take part / do my job / attend]. This would help because [a brief reason]. Could you let me know by [date] whether this is possible, or what alternative you can offer?

A shorter version, for a message

Hi [name]. To take part on [date], I need [the adjustment]. Can you confirm this is possible, or let me know what you can offer?

Planning the request

What exactly would help?
Who can actually say yes?
How will I ask: in writing, in person, using AAC, with a supporter, or through an advocate?
What might they say, and what would I do next?

If the answer is no

Ask for the reason, ideally in writing.
Ask what would make it possible, or what alternative they can offer.
Say you will consider your options, rather than deciding on the spot.
Seek advice from an advocate, union or advice service.
Decide whether to escalate, adapt, or let it go for now. Each is a legitimate choice.

In Ireland, employers have a duty to provide reasonable accommodation. In the UK, employers and service providers have a duty to make reasonable adjustments. This is general information, not legal advice.

More on this: Assertiveness and Access Requests

Flare Plan for Therapy

Agree this with your therapist when you are well enough to think it through, so that a flare doesn’t also become a crisis about therapy. It is about therapy only, not a medical plan.

Download Flare Plan for Therapy (Word, editable)

Questions to answer together

What are my early signs of a flare?
What would I like to happen to sessions: shorter, online or by phone, a check-in by message, postponed without charge if possible, or paused for a while?
What does between-session work look like during a flare? “Nothing, rest is the plan” is a valid answer.
How will I let my therapist know, and how much notice can I usually give?
What do I not want during a flare?
How will we talk about it afterwards?

A flare is not a sign that therapy has failed. New, worsening or concerning symptoms need medical advice: contact your GP or the professional who manages your condition. In an emergency call 112 or 999. Samaritans (Ireland and the UK): 116 123.

More on this: Pain, Fatigue and Fluctuating Capacity

Therapy Review Questions

Use these on your own, or bring them to a session. Your view of the work counts most.

Download Therapy Review Questions (Word, editable)

Reviewing therapy overall

What has helped so far?
What has cost too much, in energy, time or feeling?
What remains unresolved?
What would I like next: continue, adapt the format, pace or focus, pause, or try a different approach or therapist?

Reviewing one experiment or activity

What happened?
What did it cost, on the day and afterwards?
What did I learn?
What is still uncertain?
Repeat it, change it, or stop?

Questions I might ask my therapist

How will we know whether this is helping?
How do you tell a distorted thought from an accurate one?
Can we change the format, length or pace of sessions?
What would you suggest if this approach is not the right fit for me?

More on this: When to Adapt, and When to Change Direction

Activity and Energy Record

A standard CBT activity record with energy cost added, on the day and the next day. Ratings are optional: words such as “a little”, “some” or “a lot” work as well as numbers.

Download Activity and Energy Record (Word, editable)

For each day, note

What I did.
Enjoyment.
Meaning or achievement.
Energy cost on the day.
Energy cost the next day.
Would I do it again the same way?

Looking back at the week

What was worth its cost?
What cost more than it gave?
What would I change next week, if anything?

This record is for noticing patterns, not for pushing yourself to do more. If activity is making a condition such as ME/CFS worse, plan any increases with someone who understands energy management.