Cost–Benefit Analysis in Cognitive Behaviour Therapy

The Cost–Benefit Analysis is a practical decision-making tool used in Cognitive Behaviour Therapy (CBT).

• Provide the format: Give the client the table or template and ask them to list their thoughts for each option in clear, numbered points.
• Ensure clarity: Make sure each point is distinct. If similar ideas appear more than once within a box, group them together as a single point.
• Avoid repetition: Check that there’s no overlap between the positives of one option and the negatives of the other. If such overlap exists, keep the point in the most relevant box and remove it from the other.
• Assign scores: Ask the client to rate each point from 1 to 10 based on how positive or negative it feels.
• Calculate the scores:
  1. Option 1 Score = Positives of Option 1 + Negatives of Option 2
  2. Option 2 Score = Positives of Option 2 + Negatives of Option 1
• Compare the results: The option with the higher total score is usually the better choice.
• If the score difference is small (less than 10): Encourage the client to think of additional points or revisit the exercise later when more information is available.
• Discuss coping strategies:
  1. Explore ways to handle the negatives of the chosen option.
  2. Discuss how to manage missing out on the positives of the other option.
• If scores are equal: Even after updating all the information, if both options score the same and a decision is urgent, the client may use a simple method like flipping a coin to make the choice.
• Comparing more than two options: This method compares only two options at once. If there are three choices, first compare any two and find the higher score. Then, compare that option with the third one to reach the final decision.