Using CBT to help you cope with not passing the assessment

Not passing the exam can feel devastating. This page offers information and techniques to help you challenge negative thinking and turn thoughts into more positive and empowering beliefs.

This page is to help you better manage the emotional impact of not receiving the results you had hoped for in the assessment.

It includes information and techniques to help you challenge negative thinking and turn thoughts into more positive and empowering beliefs. For practical information on your options, including information on appeals and preparing for your next attempt, please see our page on what to do when you receive your results.

Seeing the positives in not passing

For many trainees, not passing the assessment can be emotionally tough. However, in many stressful situations we have the power to take control of how we emotionally respond. As the famous Greek philosopher Epictetus once said: “People are not disturbed by things, but by the view they take of them”.

For many trainees, reframing thoughts around their assessment results can make a big difference.

Using cognitive behaviour therapy (CBT) techniques can be very useful in helping to change irrational, negative, or faulty thoughts and thinking patterns.


Thoughts Feelings Behaviour diagram

CBT is based on the idea that the way we think about situations can affect the way we feel and behave. For example, if you interpret a situation negatively, you might experience negative emotions as a result. Those feelings then lead you to behave in a certain way.​ The diagram above shows how this behaviour cycle works. Thoughts create feelings, which lead to behaviours, which then reinforce your thoughts.

In theory, you can change any part of the cycle and it can have a positive impact on the other parts. However, it is often easiest to change your thoughts or beliefs to more positive or rational ones. This can positively change your feelings and behaviour, which then reinforces your positive thoughts. You could think of it as changing a vicious circle into a virtuous circle!

Re-learn your ABCs!

There is a CBT model which can help you challenge thoughts or beliefs that are having a negative impact on your feelings and behaviours. This is called the ABC model.

The history of CBT can be traced back to the ideas of the Greek philosophers in the Stoic tradition of philosophy, such as Epictetus. The work of the American psychiatrist, Aaron T. Beck and the American psychologist, Albert Ellis is key to the development of modern CBT. It was Ellis who developed the CBT ABC model in the 1950s.


The ABC Process

This model helps us to establish thought from fact. It shows that an event is just an event and has no meaning until we react or respond to it.

ABC stands for:

Activating Event



The ABC model can help us to challenge default negative reactions to events. The diagram shows how the model works. You can use this model for any events in your life. However, it may be especially helpful for trainees who have not passed an attempt at the assessment.

Quick wellbeing tip on positive language!

Replacing negative language and self-talk with more positive words can have a positive impact on how you view events, and on your overall wellbeing. You can start to change a negative reaction to not passing the assessment by changing your language in relation to this event. Constantly saying and thinking you “failed the assessment” may leave you feeling low, demotivated, and anxious about the future. Saying you “didn’t pass the assessment” is much less negative and may help you feel more optimistic about your future.

Let’s look at two examples below of how you can change your negative beliefs about your assessment results.


The ABC Process - negative belief

The ABC Process - positive belief

The ABC Process - negative belief 2

The ABC Process - positive belief 2

The above are just two examples. We understand you may have your own thoughts about the assessment. If the above examples don’t quite describe how you’re feeling, why not try and complete your own CBT ABC example.

If you like how the CBT ABC technique works, try using it in other areas of your life. As with all wellbeing techniques, practice makes perfect. The more we get into the habit of challenging default and unconscious negative thoughts and beliefs, the closer we get to changing them to unconscious positive thoughts and beliefs. These small steps over time really have the power to boost your self-esteem and improve your life!

This page was last reviewed and updated in February 2024. 

Further support if you haven't passed the assessment

Further support if you haven't passed the assessment

Listening Friends service

Listening Friends is our peer support service. This peer support service offers you the choice of speaking in confidence and anonymously to one of our trained volunteer pharmacists.

Further support if you haven't passed the assessment

“Re-sitting the registration assessment for a third time was the most challenging experience of my career.”

In this blog Independent Prescriber, Adam Ali, shares his experience of sitting the registration assessment three times and advice for other trainees.

Further support if you haven't passed the assessment

Registration assessment: What to do when you receive your results

On this page, you will find everything you need to do when you receive your registration assessment results and details about support available from us and other organisations.