Guided Discovery

Usually in the context of discussing a problem, you elicit patients’ cognitions (automatic
thoughts, images, and/or beliefs). You will often ascertain which cognition or cognitions are most
upsetting to patients, then ask them a series of questions to help them gain distance (i.e., see their
cognitions as ideas, not necessarily as truths), evaluate the validity and utility of their cognitions,
and/or decastastrophize their fears.

Questions such as the following are often helpful:

“What is the evidence that your thought is true?

What is the evidence on the other side?”

“What is an alternative way of viewing this situation?”

“What is the worst that could happen, and how could you cope if it did?

What’s the best that could happen?

What’s the most realistic outcome of this situation?”

“What is the effect of believing your automatic thought, and what could be the effect of changing
your thinking?”

“If your [friend or family member] were in this situation and had the same automatic thought,
what advice would you give him or her?”

“What should you do?”

If the client is hesitant, ask her to summarize what we had discussed and then we may have
jointly composed a coping card based on her summary.