Climate Change‐Related Thoughts and Cognitive Styles in Psychotherapy—A Qualitative Analysis of Therapists' Reports

ABSTRACT Background Although several studies have examined climate change‐related concerns affecting mental health, it remains unclear what specific cognitions are present in clinical samples. The present study examines (1) the thought content of patients with climate change‐related concerns and (2) their cognitive styles, as reported by therapists. Methods This study is a secondary analysis of a nationwide survey of German therapists on climate change‐related concerns in their patients. We qualitatively analysed reports from a subgroup of N = 214 therapists regarding patients' thought content and cognitive styles with structural content analysis. Results Therapists' reports revealed diverse themes of thought content as outlined in the literature, with the most prevalent categories reported by approximately half of therapists being the deadly threat posed by climate change (54.2%) and helplessness in face of collective inaction and individual inability (52.8%) as well as the paralysis and disengagement from life goals (48.1%) and the immediacy, celerity, and irreversibility of climate change (46.7%). The most commonly identified cognitive styles in the therapists' reports were rumination (50.0%), catastrophising (44.9%), and self‐ and other‐blame (32.2%). Conclusions The findings indicate that recurring climate change‐related cognitions in therapy correspond with established cognitive patterns and overarching themes such as loss and danger, commonly linked to depression and generalised anxiety. Preliminary associations with disorders like panic and adjustment disorder require further empirical validation. Clinically, assessing these cognitions may guide intervention adaptation and inform targeted psychotherapist training using relevant cognitive content.