CBT Techniques — MRCPsych Paper B MCQ

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EasyPsychotherapyCBT TechniquesMRCPsych Paper B

During cognitive behavioural therapy for depression, a patient identifies the automatic thought, “I am a complete failure.” Which technique is most appropriate for helping the patient evaluate and modify this thought?

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Correct answer: D — Cognitive restructuring by examining the evidence

The correct answer is D. Cognitive restructuring addresses automatic negative thoughts by collaboratively examining the evidence supporting and contradicting them, identifying cognitive distortions and developing a more balanced appraisal. Socratic questioning and thought records are commonly used to guide this process rather than simply telling the patient that the thought is wrong. Free association, dream analysis and transference interpretation are principally psychodynamic techniques and do not directly test the accuracy of an automatic thought. Flooding is an exposure technique involving sustained confrontation with a feared stimulus, most relevant to fear and avoidance rather than a depressive cognition such as “I am a complete failure.”

Reference: NHS Every Mind Matters. Thought record CBT exercise. Current page checked 2026. https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/self-help-cbt-techniques/thought-record/