Rumination Self-Monitoring Record (Archived)

A structured worksheet based on rumination-focused cognitive behavioral therapy (RF-CBT), designed to help clients track and understand episodes of rumination.

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Full resource pack (PDF)

Everything you could need: a PDF of the resource, therapist instructions, and description with theoretical context and references. Where appropriate, case examples and annotations are also included.

Worksheet only (PDF)

A copy of the worksheet in PDF format.

Fillable version (PDF)

A fillable version of the resource. This can be edited and saved in Adobe Acrobat, or other PDF editing software.

Editable version (PPT)

An editable Microsoft PowerPoint version of the resource.

Editable version (DOC)

An editable Microsoft Word version of the resource.

Overview

Rumination-focused CBT (RF-CBT) takes a functional-analytic approach to rumination and aims to help depressed clients to identify the contexts in which rumination occurs, the consequences of rumination, and to develop alternative options to rumination. The Rumination Self-Monitoring Record follows the RFCBT approach, helping clients to understand the context and consequences of their rumination.

Why Use This Resource?

Self-monitoring is a cornerstone of cognitive behavioral therapy (CBT), supporting both assessment and intervention. This resource assists clients in observing and recording important information that can:

Enhance awareness and insight into experiences of rumination.
Inform case conceptualizations, treatment planning, and intervention.
Provide a measure of change during treatment.
Support and encourage client-therapist collaboration.

Key Benefits

Structured

Provides a clear, organized format for capturing clients' experiences.

Insightful

Promotes awareness of the factors contributing to rumination.

Engaging

Encourages active participation in therapy.

Flexible

Can be used to support assessment, intervention, and symptom monitoring.

Who is this for?

Depression

Repetitive negative thoughts that contribute to low mood.

Generalized Anxiety Disorder (GAD)

Persistent negative thoughts about past events.

Post-Traumatic Stress Disorder (PTSD)

Dwelling on the causes and consequences of trauma.

Other Difficulties

Other difficulties where rumination is a feature, such as social anxiety and low self-esteem.

Integrating it into your practice

Introduce

Explain the benefits and rationale for self-monitoring.

Identify

Agree targets for self-monitoring.

Practice

Provide instructions for completing the record and rehearse with the client.

Review

Review the client's completed self-monitoring record.

Adjust

Modify self-monitoring based on progress, shifting focus as needed.

Theoretical Background & Therapist Guidance

Depressive rumination is defined as “behaviour and thoughts that focus one’s attention on one’s depressive symptoms and on the implications of these systems” (Nolen-Hoeksema, 1991). It typically involves repeated thinking about the self, past events, and ongoing concerns. Ruminative thinking often analyses the causes and consequences of negative events, problems & moods. “Why …?” Questions feature prominently, and thoughts often chain together leading to spiralling feelings. Rumination is a transdiagnostic mechanism which is implicated in the maintenance of depression and generalised anxiety disorder (GAD).

Some authors have argued that traditional CBT thought challenging can be unhelpful in depressive rumination since stopping one thought does not necessarily stop the flow of ruminative thoughts, one exception may be when thought challenging catches the start of a chain of rumination (Watkins, 2010).

Rumination-focused CBT (RFCBT) conceptualizes rumination as an escape and avoidance behaviour that has been negatively reinforced or has positive associations (Watkins, 2010). RFCBT takes a functional-analytic approach to rumination and aims to help depressed clients to identify the contexts in which rumination occurs, the consequences of rumination, and to develop alternative options to rumination. The Rumination Self-Monitoring Record follows the RFCBT approach, helping clients to understand the context and consequences of their rumination.

What's inside

An introduction to rumination and rumination-focused CBT (RF-CBT).
Guidance for using the resource with clients.
References and further reading for learning more about self-monitoring and rumination.

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FAQs

Self-monitoring involves systematically observing and recording specific targets that are related to the client's difficulties.

It supports client engagement, informs case conceptualization and treatment planning, and provides an ongoing measure of client's difficulties.

Begin with a simple focus and encourage the client to record key data immediately after relevant experiences to ensure it is as accurate as possible.

How This Resource Improves Clinical Outcomes

Integrating self-monitoring records into therapy supports:

Enhanced understanding and management of rumination.
Data-driven insights for more effective treatment planning and intervention.
Increased client engagement and insight into their difficulties.

References And Further Reading

Nolen-Hoeksema, S. (1991). Responses to Depression and Their Effects on the Duration of Depressive Episodes. Journal of Abnormal Psychology, 100, 569-582.

Watkins, E. (2010). Cognitive-behaviour therapy for depressive rumination. Unpublished manuscript, University of Exeter, Exeter.

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