One of the most valuable modules is cognitive re- structuring. This module focuses on the cognitive aspect of the CBT model. Patients learn about the na- ture of automatic thoughts, including slowing down time and identifying them. In-session exercises are conducted. For example, a patient may be asked to engage in an activity that causes pain and immedi- ately generate thoughts about the experience. Next, patients learn that the automatic thoughts follow a general pattern and fit into categories of cognitive errors/distortions. Patients learn the nature of the most common cognitive distortions and identify which of those they are typically making. Some of the cognitive errors include: 1) overgeneralization: tak- ing one situation and specific even and generalizing it to a large range of events and situations (e.g., ‘‘This coping strategy is not working for me so noth- ing will’’); 2) catastrophizing: focusing exclusively on the worst possibility regardless of its likelihood of occurrence (e.g., ‘‘The pain in my arm means that my entire body is degenerating and falling apart’’);3) all or nothing thinking: considering only the worst or best interpretation, without seeing the range of al- ternatives (e.g., ‘‘My life was perfect before the onset of pain, now it ishorrible’’);4) selective attention: selec- tively attending to negative aspects of the situation while ignoring the positive things (e.g., ‘‘Moving my arm serves only to make me feel worse than I al- ready do’’); 5) jumping to conclusions: accepting an arbitrary interpretation without a rational evaluation of the situation (e.g., ‘‘The doctor referred me to CBT because he thinks I am hopeless’’).Within the last step of the cognitive restructuring module, patients learn to reframe the negative thoughts into more adaptive and positive thoughts, by means of a process called cognitive reframing.27 During this process, patients learn to ask themselves questions that challenge the negative thoughts, such as: ‘‘What is the evidence that this thought is true?’’; ‘‘What is the real probability that this will ac- tually happen?’’; ‘‘What would I tell a friend in this particular situation?’’; ‘‘Where does this type of thinking get you?