Pros and Cons is a basic skill that’s taught early on in CBT and is part of DBT’s distress tolerance module. The tool has a broad application; it can be used to examine decision making across a variety of issues (lack of motivation for treatment, high risk behaviors in addiction, parenting, distress tolerance, etc..). It’s also a nice bridge to other tools in CBT as it gets a person accustomed to what the work is going to look like moving forward.
Although most folks feel like they already know how to apply Pros and Cons, much of what the skill has to offer isn’t fully utilized.
The purpose of this post is to demonstrate the benefits of using the Pros and Cons skill in a manner consistent with CBT.
Pros and Cons allows us to examine a situation, potential action or decision away from emotional intensity and logical rigidity and yes, it is important that you write it out. Writing it out gives you a kind of perspective that may not be possible when doing the math in your head simply because of what else may going on up there.
The other benefit to the tool is that it can act to increase motivation around adaptive behaviors and call your attention to the consequences of maladaptive behaviors.
The example below may relate to a person whose symptoms of depression or anxiety affects their ability to maintain an orderly household. The first thing you may notice about the tool is that it breaks the decision down between two potential actions and four possible sets of outcomes.
The tool pushes your thinking around outcomes related to action and inaction and this distinction matters. The benefits of looking at it both ways allows you to determine consistent themes in the decision making and increases the likelihood that you’ll consider other factors that may not have come up for you if you went with a traditional approach.
The other benefit to the Pros and Cons tool that I tend to emphasize is that, although the action considered may not be effective if implemented, you may be able to tease out needs that could be met by simply using a different strategy. In this example, Tom considers whether he should tell Joe (a coworker) off for taking his donut.
So creating a spectacle over a donut appears to be a no-go but, by examining what was written closely Tom may able to tease out some goals in developing a new strategy in his communication with Joe. Using Tom’s sheet and what he highlighted as an example, a different strategy could center around the following priorities:
-Letting Joe know that Tom is aware of the issue.
-Communicating the issue in a way that seeks to effectively influence change in Joe’s donut stealing ways.
-Communicating in a way that does not endanger Tom’s employment.
-Communicating in a way that avoids embarrassing Joe and is consistent with Tom’s moral understanding of how people ought to be treated.
I was debating whether to post the tool because really….you should be able to draw a bunch of rectangles that vary in size on your own. However, being the generous and compassionate soul that I am, I decided to post it anyway.
I’m also humble.