Challenges to unhelpful thinking patterns

The aim of the remaining session time is to help the client better manage those unhelpful patterns of thinking that are associated with their cravings/ use of speed. You will then help the client to learn ways to challenge these unhelpful thoughts and replace them with more helpful ones. In this way the client will learn how to manage their thoughts about stressors and also cope with any cravings they might experience.

Exercise 2: Recognising unhelpful patterns of thinking

It is important for the client to challenge any unhelpful thinking patterns by asking themselves the following four questions (Jarvis, Tebbutt & Mattick, 1995):

  1. "What is the evidence to support this thought? Is this 100% true?"

    It is common for people to mistake their feelings for evidence/fact, when in reality feelings are not facts. Often the evidence is contradictory to the client's thought.

  2. "What are the advantages/disadvantages of thinking in this way?"

    Unhelpful thoughts will have some advantages for the client, particularly when they help him/her avoid a difficult situation. In considering the disadvantages, such as anxiety or increase in speed use, it may be that the disadvantages outweigh the advantages and possibly pave the way for the person to develop new ways of thinking.

  3. "Is there a thinking error?"

    Is the client able to identify whether they are falling into the habit of an unhelpful pattern of thinking described above? For example, are they personalising, catastrophising, jumping to negative conclusions, or using black/white thoughts or should/ought statements? If so, this is a sign that the client is putting himself or herself at risk of using speed.

  4. "What alternative ways of thinking about the situation are there?"

    There will always be more than one way to interpret any trigger situation. Often these alternatives will be more helpful than the interpretations and consequences encouraged by unhelpful patterns of thinking. Brainstorm with the person some alternative ways of thinking/reacting to the stressful/trigger situations.

Practise these steps with the client using the trigger situations listed on their urge diary from last week. Top of page

Exercise 3: Monitoring thoughts about triggers

  • Give a copy of the self-monitoring record below to the client.

  • Ask the client to take home the self-monitoring sheet and fill it in over the week. Explain how to use the sheet, e.g. "over the next week, every time you have a craving to use speed, say to yourself stop, slow down, and then fill in the sheet. Make sure you complete all columns on the form, identify the unhelpful thinking pattern you are using in this situation, and ask yourself the four questions listed here on the sheet to challenge these thoughts."

  • Ask the client to either do this for every craving they experience, or to complete the form at the end of each day, and bring it in next session.

Self-monitoring record sheet

Use this form to record any time this week when you experience a craving to use. Try to fill it in at least once a day to help you remember clearly what was happening.
  • Time and date:

  • What was happening? (A)

  • What were you thinking? (B)

  • What were the consequences? (cravings?) (C)

  • What is the evidence to support your thoughts about this situation?

  • What are the positives and negatives of thinking in this way?

  • Are you falling into an unhelpful pattern of thinking? If so, what?

  • Is there another way of looking at this situation?