Cognitive reframing is a tool used in cognitive behavioural therapy (CBT) as a way to help identify unhelpful cycles of thinking and replace them with more constructive ones. Once learned, it’s a process that nearly anyone can use to help improve their mental health and manage stress.

What Is Cognitive Reframing?

Cognitive reframing operates on the basis that everyone’s perceptions and feelings are unique. Your perceptions of an event, for instance, may be very different from those of a friend or co-worker.

“Our emotional responses to a situation are heavily influenced by the way we view the situation,” explains Calvin Fitch, PhD, a staff psychologist with Massachusetts General Hospital and Harvard Medical School in Boston, who also works in private practice. “The way we view a situation may not always be accurate or helpful, and may exacerbate distress.”

“Cognitive reframing is a way of changing the way we view situations.”

While cognitive reframing is a method commonly used in psychotherapy (aka “talk therapy”), it can be a helpful tool for anyone to use to ease stress and anxiety and to see certain experiences in a more constructive light, notes Dr. Fitch.

Once you’ve identified a distressing thought, three general steps take place when using cognitive reframing, according to Ryan Sultan, MD, a psychotherapist and teaching psychiatrist at Columbia University in New York City:

1. Identify the thought

Recognise what your mind is telling you, which may or may not be based in fact.

2. Question the thought and identify any cognitive distortions

Ask important questions about the validity or likelihood of the thoughts you have, such as, “What evidence do I have to support this thought?” You might discover that your thought reflects a cognitive distortion, which is an unhelpful error in the story your mind has told you.

3. Create balanced thoughts

Replace negative or unhelpful thoughts with more balanced, realistic thoughts. “For instance, shifting from ‘I’ll fail this exam and my life is ruined,’ to ‘I can prepare and do my best on the exam,’” says Dr. Sultan.

In addition, Sultan recommends practising mindfulness techniques to assist with cognitive reframing.

“Mindfulness techniques [which involve focusing on the present moment rather than worrying about the past or future] can help individuals stay present and reduce rumination on negative thoughts,” says Sultan.

The U.K. National Health Service also suggests the “catch it, check it, change it” method as a simple, self-guided way to use cognitive reframing. The idea is similar to the process described above – you “catch” distorted thoughts, “check” them by questioning their validity, and then “change” them by replacing those distorted thoughts with more constructive ones.

There are two different ways to “check” your thoughts, says Fitch.



Socratic Questioning

“In using Socratic questioning, imagine yourself as a lawyer in a trial questioning the truth in the thoughts you are having,” says Fitch.

For instance, think about a friend passing you on the street without acknowledging you. If you assume they ignored you because they were mad at you for something, the types of questions you might ask yourself include:

  • “What is the evidence for and against my friend being mad at me?”
  • “Are there other explanations for my friend’s behaviour?”

After doing this exercise, you may realise you don’t have evidence to support your initial assumption that your friend is mad at you, helping you view the event in a different, less troubling light.

Identifying and Addressing Common Biases

The other common cognitive reframing method has to do with addressing inner biases that can inaccurately colour your experiences. The role of cognitive reframing is to identify these biases, question their truth, and evaluate the situation in a different light, says Fitch. These biases can include:

1. Black-and-White Thinking

This means thinking in extremes. “[For example], someone may think they are either a wild success or a complete failure instead of thinking they excel at some things and have difficulties with other things.”

2. Catastrophising

This involves overestimating the probability of a worst-case scenario taking place. “Someone may assume that receiving a critique from their boss means they will be fired,” Fitch says.

3. Emotional Reasoning

This means assuming feelings are facts. For instance, someone might feel unworthy says Fitch – if they feel it, they may assume they are factually unworthy.

4. Overgeneralisation

This involves applying experiences from one situation to most or all situations in general. For example, someone who had a traumatic experience with a man may think that because that one man was dangerous, all men are dangerous, Fitch says.

5. Magnification and Minimisation

This refers to a tendency to exaggerate bad things and minimise good things. “We may magnify how much we hate something we are wearing, but if someone compliments our outfit, we may minimise it by saying, ‘Oh, this is old. I hate this,’” explains Fitch, or by assuming the other person is just being nice.

What Conditions Can Cognitive Reframing Be Used to Treat?

Cognitive reframing can be a helpful technique for most people. “It is a transdiagnostic strategy, meaning that it can be used across many different mental health diagnoses,” says Fitch.

In CBT settings, cognitive reframing is often used as a standalone therapy or as part of a broader treatment regimen to help treat the following conditions or issues says Sultan:

  • Stress
  • Anger
  • Anxiety or anxiety disorders
  • Depression
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Substance use disorders

What Does Research Say About Cognitive Reframing?

Research on cognitive reframing is widely positive and suggests these techniques are effective for multiple mental health conditions and issues including:

Depression and Anxiety

A prior review of scientific evidence has found that cognitive reframing is particularly helpful for symptoms of anxiety and depression, and its benefits for these conditions may be long-lasting. Another study found that cognitive reframing techniques were effective for coping with learned fears (meaning fears that develop as a result of a specific event).


A study published in January 2018 in The British Journal of Psychiatry found cognitive reframing helped decrease PTSD symptoms and improve functioning among individuals with PTSD and severe mental illness such as major depression, bipolar disorder, and schizophrenia.

Substance Use Disorders

Research shows cognitive reframing can be beneficial for substance use disorders too. Specifically, a randomised controlled trial published in September 2018 in The American Journal of Psychiatry showed that cognitive reframing in the context of CBT was safe and effective compared with usual treatment for people with substance use disorders.

Practitioner or Caregiver Burnout

Some research also indicates cognitive reframing can be used among practitioners working with people with substance abuse issues to help avoid burnout, as well as caregivers of people with dementia to reduce feelings of depression, anxiety, and stress.

Making Lifestyle Changes

Research published in 2018 and a systematic review published in 2019 found that cognitive reframing could help those who have trouble sticking to exercise or dietary changes improve their odds of successfully making these positive behaviour changes.


Prior research has shown that helping people reframe their perceptions about stress from being a largely negative state to something that can be functional and adaptive helped improve their physiological and cognitive functioning during stressful tasks compared with control interventions.

How to Get Started With Cognitive Reframing

Here’s what you should know before starting cognitive reframing.

What Is a Cognitive Reframing Session Like?

“Cognitive reframing requires awareness of thoughts that, many times, happen so fast we’re not always aware of them,” says Fitch.

While most cognitive reframing is done during talk therapy sessions, your therapist may also ask you to fill out thought records, meaning you write down your thoughts and emotional reactions to different situations in detail outside of therapy.

During a session, your therapist may discuss those thought records with you, or they may simply ask you questions about specific situations in your life and your reactions or responses to them, Fitch explains. These conversations can help you see how you tend to frame different thoughts and situations and determine whether there’s a different or more helpful way to view these experiences.

How to Find a Cognitive Reframing Therapy Provider

Therapists trained in CBT are likely qualified to perform cognitive reframing techniques, though Fitch emphasises it’s important to verify with the clinician the exact types of therapy that they provide. Check with your primary care provider or your insurance provider for in-network recommendations.

How to Prepare for a Cognitive Reframing Therapy Session

Much of the prep for your first session involves readying yourself to discuss your thoughts, assumptions, and feelings in an in-depth manner with your therapist, says Fitch. Also, know this type of evaluation can be challenging, and may force you to face biases you’ve leaned on heavily throughout your life.

If there are specific things you’d like to discuss, it could help to write them down so you don’t forget them. You may also be asked to fill out journal pages or workbooks in advance of a session. “I prefer when clients prepare in advance by journaling,” says Leslie Dobson, PsyD, a clinical and forensic psychologist in private practice in Long Beach, California. “It’s helpful, as negative thoughts that need reframing may not be present when I’m with the client.”

Who Shouldn’t Try Cognitive Reframing Therapy?

Individuals with severe intellectual challenges may not be able to fully derive the benefits of cognitive reframing, says Fitch. Likewise, individuals with severe mood disorders or psychotic disorders may not be best suited to cognitive reframing if their condition isn’t well-managed.

SOURCE: Everyday Health