From grimoire
Guides systematic identification and restructuring of distorted thinking patterns and avoidant behaviors using evidence-based CBT strategies.
How this skill is triggered — by the user, by Claude, or both
Slash command
/grimoire:apply-cognitive-behavioral-techniquesThe summary Claude sees in its skill listing — used to decide when to auto-load this skill
Guide systematic identification and modification of distorted thinking patterns and avoidant behaviors using CBT's evidence-based cognitive and behavioral strategies.
Guide systematic identification and modification of distorted thinking patterns and avoidant behaviors using CBT's evidence-based cognitive and behavioral strategies.
Adopted by: NICE (UK National Institute for Health and Care Excellence) as first-line treatment for depression, GAD, panic disorder, OCD, PTSD, and social anxiety; APA Division 12 list of empirically supported treatments; VA/DoD clinical practice guidelines for PTSD.
Impact: Butler et al. (2006) meta-analysis of 332 studies: CBT effect sizes 0.82–2.0 for anxiety disorders, 0.82 for depression; 75% of individuals with depression achieve response vs. 30% with placebo; CBT effects are more durable than medication at 1-year follow-up for depression (Hollon et al. 2005).
Why best: CBT directly targets the cognitive-behavioral maintenance cycles that perpetuate psychological distress; its structured, time-limited format (typically 12–20 sessions) makes it scalable; it teaches transferable skills that continue working after therapy ends.
Sources: Beck (1979) ch. 8–11; Butler et al. Psychol Bull 132:659–686 (2006); NICE CG90 Depression (2009); NICE CG113 GAD (2011).
Establish a collaborative therapeutic relationship — CBT is structured and directive but requires genuine rapport; establish shared goals, explain the cognitive model (thoughts → feelings → behaviors → situations), and validate the person's experience before introducing techniques.
Identify the presenting problem and target — define the specific problem in concrete terms: situation, emotion (type and intensity 0–10), automatic thought, behavior, and consequence. Use a thought record as the initial structure.
Identify automatic thoughts — ask "What was going through your mind just before you felt [emotion]?" Identify hot thoughts (thoughts most linked to emotional distress, rated highest subjectively). Common thought distortions: catastrophizing, mind reading, all-or-nothing, personalization, emotional reasoning, fortune telling.
Examine the evidence — for the hot thought, systematically evaluate: (a) What is the evidence FOR this thought? (b) What is the evidence AGAINST? (c) What would you tell a friend who had this thought? (d) What is a more balanced alternative? Rate belief in original thought and alternative (0–100%).
Cognitive restructuring — develop a balanced alternative thought that accounts for all evidence; it should not be forced positivity but an accurate reappraisal. Re-rate emotion intensity after restructuring; aim for 20–40% reduction, not elimination.
Apply behavioral activation for depression — schedule activities with high mastery or pleasure value; use activity monitoring to identify mood-behavior connections; break avoidance cycles by scheduling small, achievable activities first and building up.
Apply behavioral experiments for anxiety — design a specific test of an anxious prediction: "I predict X will happen (rate 0–100%); we will do Y; then evaluate what actually happened." Repeated disconfirmation of feared outcomes extinguishes anxiety via corrective learning.
Build a problem-solving structure — for practical life stressors: (a) define the problem specifically, (b) brainstorm all solutions without judgment, (c) evaluate pros/cons of top 3, (d) implement the chosen solution, (e) review outcome and adjust.
Identify and modify core beliefs — after surface automatic thoughts are addressed, examine underlying dysfunctional assumptions ("I must be perfect to be worthwhile") using downward arrow technique: "If that thought were true, what would that mean about you?"
Develop a relapse prevention plan — identify early warning signs of return of symptoms; document learned skills; create a specific action plan for applying CBT tools if symptoms re-emerge; schedule booster sessions if needed.
npx claudepluginhub jeffreytse/grimoire --plugin grimoireRestructures distorted automatic thoughts into balanced alternatives using CBT techniques. Useful for addressing catastrophic thinking, anxiety, or depression.
Provides DSM-5 diagnostic criteria, evidence-based therapy modalities (CBT, DBT, EMDR, ACT, etc.), treatment planning, and progress measurement for mental health documentation.
Applies cognitive reframing methodology to identify and correct distorted automatic thoughts causing disproportionate distress.