Cognitive Restructuring: A CBT Technique for Reframing Negative Thoughts and Managing Emotions

Written By Z. Hamilton Avery

Cognitive Restructuring, sometimes called reframing, is a Cognitive Behavioral Therapy (CBT) skill that helps you examine the thoughts, assumptions, and meanings that show up during stressful moments. The goal is not to “think positive,” dismiss your feelings, or pretend a painful situation is fine. The goal is to pause long enough to ask: Is this thought accurate? Is it complete? Is it fair to me? Is there another honest way to understand what is happening?

Stressful thoughts often feel true because they arrive with strong emotion, painful memories, or urgency. Cognitive restructuring helps you separate the feeling of certainty from the quality of the evidence. A thought may contain part of the truth and still be exaggerated, incomplete, harsh, fear-driven, or missing important context. Peer-reviewed research on cognitive restructuring, cognitive reappraisal, and CBT components suggests that changing how people work with thoughts and appraisals can support therapy outcomes, emotion regulation, and cognitive flexibility (Buhle et al., 2014; Ciharova et al., 2021; Ezawa & Hollon, 2023; Norbury et al., 2024; Webb et al., 2012).

A helpful reframe does not deny reality, excuse harm, erase grief, or pressure you to feel differently before you are ready. It keeps the facts in view while loosening the grip of a thought that may be making the situation feel even more painful or impossible. The purpose is not perfect thinking, but finding a more workable perspective that supports clarity, self-respect, boundaries, problem-solving, coping, or the next wise step.

Guided Practice
(optional)

Start by naming a situation in one simple sentence. Then write down the thought that feels most intense or believable. Ask yourself:

  • What went through my mind?

  • What emotion came with this thought?

  • What evidence supports this thought?

  • What evidence does not fully fit?

  • What might I be leaving out?

  • What would I say to someone I care about in this situation?

  • What is a more balanced thought that is still honest?

Example

Original thought: “I messed everything up.” Balanced reframe: “I made a mistake, and I can take responsibility without turning this into a statement about my whole self.”

Complementary/Alternative Practices

Affect Labeling

Behavioral Experiments

Cognitive Defusion

Cognitive Triangle

Continuum Thinking

Coping Statements

Decatastrophizing

Double-Standard

Downward Arrow

Fact Checking

Positive Data Log

Reality Testing

Responsibility Pie

Self-Compassion

Socratic Questioning

Thought Records

References

Buhle, J. T., Silvers, J. A., Wager, T. D., Lopez, R., Onyemekwu, C., Kober, H., Weber, J., & Ochsner, K. N. (2014). Cognitive reappraisal of emotion: A meta-analysis of human neuroimaging studies. Cerebral Cortex, 24(11), 2981-2990. https://doi.org/10.1093/cercor/bht154

Ciharova, M., Furukawa, T. A., Efthimiou, O., Karyotaki, E., Miguel, C., Noma, H., Cipriani, A., Riper, H., & Cuijpers, P. (2021). Cognitive restructuring, behavioral activation and cognitive-behavioral therapy in the treatment of adult depression: A network meta-analysis. Journal of Consulting and Clinical Psychology, 89(6), 563-574. https://doi.org/10.1037/ccp0000654

Ezawa, I. D., & Hollon, S. D. (2023). Cognitive restructuring and psychotherapy outcome: A meta-analytic review. Psychotherapy, 60(3), 396-406. https://doi.org/10.1037/pst0000474

Norbury, A., Hauser, T. U., Fleming, S. M., Dolan, R. J., & Huys, Q. J. M. (2024). Different components of cognitive-behavioral therapy affect specific cognitive mechanisms. Science Advances, 10(13). https://doi.org/10.1126/sciadv.adk3222

Webb, T. L., Miles, E., & Sheeran, P. (2012). Dealing with feeling: A meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychological Bulletin, 138(4), 775-808. https://doi.org/10.1037/a0027600

Z. Hamilton Avery

Z. Hamilton Avery, LCSW, BC-TMH, CMT, CYT-1,000, TIYT (he/they) is a queer and non-binary therapist, health educator, wellness coach, body and energy worker, yoga and meditation teacher, and abstract artist in Tulsa, Oklahoma. In addition to having obtained over a dozen certifications in various modalities of complementary and alternative medicine (CAM), Z holds an associate’s degree in pre-nursing studies, a bachelor’s degree in psychology, and a master’s degree in social work. When supporting clients and students, Z takes a humanistic, person-centered, strengths-based, trauma-informed approach. Their practice is grounded in compassion, harm reduction, inclusivity, social justice, and evidence-based interventions. Ultimately, Z’s mission is to provide a safe and non-judgmental space for adolescents (13+) and adults who are navigating challenges such as anxiety, depression, trauma, addiction, pain, and chronic illness; he does this by offering sessions, classes, groups, workshops, retreats, and trainings.

Understanding that mental health is interconnected with many other facets of life, Z takes a holistic approach to therapy. Knowing that there is no one-size-fits-all treatment, he strives to honor the uniqueness of each client by custom-tailoring his approach to best meet the needs, preferences, and goals of each individual. For this reason, Z believes that it is imperative to be cross-trained in many different treatment approaches. As a therapist, they utilize a variety of evidence-based practices, including motivational interviewing (MI), cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), and written exposure therapy (WET). As a body and energy worker, Z is certified to practice massage therapy, Thai yoga massage, myofascial release, craniosacral therapy, and reiki. They are also certified in both Chinese and Japanese styles of acupuncture. After completing more than 1,000 hours of accredited yoga teacher training (primarily in India), Z is certified to teach various styles of yoga, including Hatha, Kundalini, yin, and restorative. He also researches and writes about topics including stress, trauma, self-care, mindfulness, self-compassion, holistic health and well-being, CAM, HIV/AIDS, and issues related to the Two-Spirit, lesbian, gay, bisexual, transgender, queer, intersex, agender, plus (2SLGBTQIA+) community.

https://www.therapywithz.com
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