49 CBT Questions to Ask Clients in Therapy Sessions

Cognitive Behavioral Therapy is based on the belief that our thoughts influence our feelings and behaviors. Because of this, CBT focuses on identifying and changing unhelpful thinking patterns with the goal of improving emotional responses and, in turn, actions. These shifts often lead to a reduction in symptoms and day-to-day challenges. As one of the most widely used therapeutic approaches, CBT can be applied to a broad range of presenting concerns and populations. In my own work, I use a variety of structured questions to help clients explore their thoughts more effectively, and in this guide I’ll share 49 CBT questions I often draw from in sessions.

CBT is frequently used with clients experiencing anxiety, depression, PTSD, and other Axis I disorders. It is also an effective approach for children managing symptoms related to ADHD, behavioral difficulties, anxiety, depression, and eating disorders.

For more valuable resources, view our CBT Tools and Resources hub

Getting Ready for Your First CBT Therapy Session with a New Client

While CBT can be applied across a wide range of mental health concerns, many of us work within a specific niche or treatment setting. CBT can be effectively used in inpatient programs, partial hospitalization settings, and outpatient care. The environment you practice in will naturally influence how you prepare for an initial session, the structure of the session itself, and the types of CBT questions you choose to use. Understanding your setting helps ensure that your approach is practical, client-centered, and aligned with the goals of your program.

Your familiarity with the paperwork and administrative requirements for a first session is equally important. Knowing what assessments, intake forms, or documentation are expected allows you to plan the session efficiently while still focusing on clinical work. Over time, your clinical experience will help you develop a workflow and routine that feels both effective and sustainable, so you can devote your energy to helping your clients rather than worrying about logistics.

In my own practice, I like to review any available documentation before meeting a client for the first time. Even a brief review helps me walk into the session with a clearer plan, anticipate potential areas of focus, and think about which CBT questions or interventions may be most useful. Additionally, reviewing documentation beforehand helps me start thinking about a CBT treatment plan that aligns with the client’s goals and the interventions I intend to use throughout therapy. Preparing this way ensures that the first session sets a strong foundation for progress, collaboration, and meaningful outcomes.

Common Questions to Ask CBT Clients

CBT questions can be used at different stages of treatment and across a variety of interventions. These include rating questions, exploring the validity of thoughts, identifying cognitive distortions, Socratic questioning, and addressing automatic thoughts. In my sessions, I often draw from all of these approaches depending on the client’s needs.

Rating Questions

Rating Questions can be used to rate the intensity of the emotion that your client is experiencing. Rating questions can be helpful in revising personal beliefs and automatic thoughts to work towards healthy cognitions.

An example of rating questions include:

1. On a scale of 1 to 5, with one being a mild impact to 5 as severe, how would you rate your experience?

Determining the Validity of Cognitions

Exploring the validity of a clients cognitions is an example of a phase of counseling where CBT questions can be used. Working with our clients to see where their thoughts are not fully valid, can help them see where changes can be made to make clinical gains.

Examples of CBT questions that could be asked include:

2. Ask your client what they would encourage a loved one to do if they were in their shoes
3. Encourage your client to take their concern to an extreme, and explore their thoughts afterwards
4. Encourage your client to imagine the worst possible result and explore ways in which they could respond to, or cope with the worst-case scenario

Cognitive Distortions and Automatic Thoughts

Cognitive distortions and automatic thoughts that anyone can have. For some, these automatic thoughts can have a significant impact on feelings and behaviors. Before you can work to change your thoughts, it is important to understand which thoughts are troubling your client. CBT questions can be used to guide exploration into the presence of different cognitive distortions and explore their impact. 

Examples of CBT questions that could be asked include:

5. Are you confusing a thought with a fact?
6. Are you jumping to conclusions?
7. Are you assuming that your view of things is the only possible way?
8. What is the effect of thinking the way you do? Advantages? Disadvantages?
9. Are you asking questions that have no answers?
10. Are you using ultimatum words in your thinking?
11. Are you condemning yourself as a total person or just for 1 event that occurred?
12. Are you focusing on your weaknesses rather than your strengths?
13. Are you blaming yourself for something that is not your fault?
14. Are you taking something personally that has little or nothing do with you?
15. Are you expecting yourself to be perfect?
16. Are you using a double standard?
17. Are you paying attention only to the negative things?
18. Are you overestimating your chances of disaster?
19. Are you exaggerating the importance of an event(s)?
20. Are you predicting the future before it happens (instead of waiting to see how it unfolds)?
21. Are you assuming nothing can change your situation?
22. Are you worrying about the way you think things should be instead of facing things as they are?

Socratic Questions

The questions you ask will be impacted by the specific distortion that you are looking to explore. Using a list of Socratic Questions with CBT can be used to guide an exploration of a thought pattern that your client has been experiencing. Socratic Questions can be defined differently, so using a worksheet like the one provided by TherapyByPro can be helpful. It is important to keep in mind that CBT takes a non-confrontational approach, and counselors work to guide their clients as they develop new perceptions of their challenges and concerns.  

Here are some Socratic question examples you can ask:

Clarification Questions

23. What is a thought you’d like to question?
24. Why do you say that?
25. What do you mean by that?
26. What do you think is the main problem?
27. Could you discuss this point further?

Assumption Questions

28. Are you making any assumptions in your thought?
29. Why would you make this assumption?
30. What else could you assume instead?
31. Can you verify this assumption?
32. Can you disprove this assumption?

Probing Questions

33. Could you tell me about an example?
34. What do you think causes this to happen?
35. Could you be reading the evidence incorrectly?
36. Are you looking at all the evidence or just evidence that supports your thought?
37. Are you basing your thought on facts or your feelings?
38. Are you having this thought out of habit or do the facts support it?

Consequences Questions

39. What are the short-term consequences of this thought / assumption?
40. What are the long-term consequences of this thought / assumption?
41. How does this thought / assumption affect you negatively?
42. How does this thought / assumption affect you positively?

Perspective Questions

43. What is evidence that agrees with this thought?
44. What is evidence that goes against this thought?
45. How would someone else think in your situation?
46. Did someone pass this thought or belief to you?
47. What could have been a better question to ask or thought to have?

Questioning the Question Questions

48. Why do you think I asked you this question?
49. Why is this question important?

Final Thoughts On Asking the Right Questions in CBT Therapy

Asking the right CBT questions is essential for helping clients gain insight and make meaningful changes. When we use these questions thoughtfully, keeping the goals of CBT and the therapeutic relationship in mind, we can guide clients toward greater awareness, healthier thinking patterns, and more effective coping strategies. By the end of therapy, clients should be able to apply the skills and perspectives they’ve developed through these questions, enabling them to navigate future challenges with confidence and resilience.

View all of our CBT Therapy Worksheets

To learn more about how you can apply Cognitive Behavioral Therapy, we encourage you to look for continuing education courses and other training opportunities.