Decision making can be difficult when we’re struggling with a strong emotion and can be problematic when we’re coping with depression and anxiety. Pros and Cons is a flexible, easy to use and effective CBT skill that can improve our decision-making skills and increase confidence when making decisions.

Pros and Cons can be helpful in the following areas:

1. Distress Tolerance: Comparing the Maladaptive coping mechanism to the Adaptive Coping Mechanism

2. Life Skills (exercise, medication compliance, eating well): Comparing, for example, Working Out v. Netflix.

3. Social Anxiety: Comparing Avoiding a Social Event v. Attending

4. Depression: Getting out of bed at your scheduled time v. Staying in Bed

5. Anxiety: Opening the Mail v. Not opening the Mail.

6. Interpersonal Effectiveness: Asking for too much v. Asking for too little

7. Everyday Life Decisions: Buying the Honda v. Buying the Toyota

This list is certainly not all-inclusive and as you can see, Pros and Cons are helpful in almost every zone of distress from very high to low. So let’s get started.

The first thing we would need to do is identify the choices with specificity. In this example, we’ll pull from the list and use the choice between Working Out v. Watching Netflix.

Notice that there are two options, each with an area set aside for benefits and costs.  Now we will fill in the benefits and costs of each choice.

The next step is to place a value on each cost and benefit, we are going to rate how meaningful each cost and benefit is on a scale of 1 to 100.  This serves the purpose of giving appropriate weight to each item so we can determine the overall benefit/cost of each choice.  The key here is to be 100% honest, don’t value an item on what it SHOULD be but rather how you really feel about it.

Now we will add up the total for each Benefit and Cost quadrant.

Next, we’ll subtract the cost value from the benefit value for each choice.

In this example and based on my values, Working Out holds a far greater value than Netflix.  When I’m feeling unmotivated I can pull this out in the future to remind me what watching Netflix instead of working out would cost me.  That’s another cool thing about this skill, use it at the moment and it can help not only with the decision in front of you but that same decision in the future if it’s something you consistently struggle with, but we’re not done yet.  Now we want to cultivate strategies for each of the costs associated with working out so we’re more likely to do it.

To learn a little more about Imaginal Rehearsal you can check out my last article.

If your choices both generate negative numbers (the costs outweigh the benefits) you would consider the greater of the two. Also, you can apply Pros and Cons to more than two choices, just add more rows.