Appendix II

Worksheets

All the worksheets for The CBT Anxiety Solution Workbook program are gathered here so they can be easily reproduced, and so that you can see the key elements of treatment in one place.

Comprehensive Coping Inventory

The items in this inventory are different ways of dealing with problems. As you complete this inventory, think about difficult or stressful events in your life. Do your best to rate each item in terms of how frequently you use it. There are no right or wrong answers, so choose the most accurate answer for you, not what you think is most acceptable, or what most people would say or do.

Rate each item on a scale of 1 to 5, where 1 means you don’t use that strategy at all, and 5 means you use it a great deal.

1.1 I try to stay away from things that make me anxious or uncomfortable rather than face them.

1.2 I worry about all the bad things that could happen in the future.

1.3 When I get upset by a situation, my negative thoughts often don’t turn out to be completely true.

1.4 I don’t believe I can cope with situations in which I feel anxious or fearful.

2.1 I tend to avoid situations, people, places, or things that make me feel anxious or upset.

2.2 I tend to focus on all the negative outcomes that might result from a decision.

2.3 I tend to assume things will be worse—more painful and scary—than they turn out to be.

2.4 I doubt my ability to face situations that trigger anxiety.

3.1 If I feel anxious and uncomfortable I avoid situations altogether—even though I wish I didn’t have to.

3.2 Whenever there’s a problem, I tend to dwell on the worst things that could happen.

3.3 When the situations are especially upsetting to me, I tend to have a string of thoughts about myself or others that feel true at the time, but often aren’t.

3.4 I don’t know how to cope with anxious feelings or situations in which I am fearful.

4.1 There are situations or things that make me anxious, and I try to avoid them.

4.2 I find that I tend to overthink bad scenarios that could happen.

4.3 I easily jump to conclusions when I’m upset by something—and my conclusions aren’t really accurate.

4.4 I feel distressed by fear or anxiety in a way that seems too big to cope with.

5.1 I try to avoid things I feel I must do to protect myself from feeling too anxious.

5.2 My problems trigger a lot of thinking about all the bad directions things could take.

5.3 In difficult situations I can have one negative thought after another that makes things seem worse than they really are.

5.4 I don’t feel strong enough to face fear-inducing situations.

You might feel overwhelmed by the number of items that were relevant for you. The good news is that you are bringing awareness to the coping behaviors that are reinforcing your anxiety. This is where the change starts to happen. Let’s look at what’s significant for you.

1.1, 2.1, 3.1, 4.1, and 5.1 are statements that apply to avoidance of the things that make you feel anxious. These can be people, places, situations, things, or internal sensations that you tend to avoid.

1.2, 2.2, 3.2, 4.2, and 5.2 are statements that apply to worry/rumination, extended worrying about future dangers or threats and making negative predictions about the future that get in the way of creating solutions to problems.

1.3, 2.3, 3.3, 4.3, and 5.3 are statements that apply to cognitive misappraisal, evaluating a situation, object, sensation, or person as dangerous when it isn’t.

1.4, 2.4, 3.4, 4.4, and 5.4 are statements that apply to distress intolerance, the belief that you can’t stand certain experiences and the emotions they trigger.

Exposure Inventory Worksheet

Feared situation SUDS

0–100

 Safety behaviors

Cost of Avoidance Worksheet

Domain Avoidance or other safety behaviors Negative impact on my life Rating

1–5

Friendships

Family

Parenting

Work/education

Self-care/health

Pleasure, recreation, social activities

Life goals

Service to others

Romantic relationships

Values Worksheet

Fear

(Things I avoid)

 Blocked valued activities Values rating

1–5

Exposure Inventory Worksheet

Fearedsituation Safetybehaviors Plan to stop safety behavior and to expose SUDS 1–100 Value 1–5 Predicted worst-case outcome Percent probability

Results Tracker

Exposure:

Predicted worst-case outcome:

1. Did the worst-case outcome happen? Yes No

2. What happened instead?

3. Percent probability: Before: After:

4. What did you learn from the exposure?

5. SUDS 1–100: Before: After:

Learning Coping from Exposure Worksheet

Exposure experience SUDS: Before How I coped SUDS: After

My Coping Thoughts for Facing Challenging Situations

My coping thoughts for facing challenging situations
My coping thoughts for facing fear itself

Coping Plan Worksheet

Worst-case scenario:

Behavioral coping:

Emotional coping:

Cognitive coping:

Interpersonal coping:

Thought Log

Thought Negative

prediction

 Negative

focus

 Problem magnification

Predictions Log

Predictions

(What terrible thing will happen and when)

 What actually occurred

Problem Continuum Worksheet

Problems Problem continuum
(Rank big to small) Your problems

A terminal diagnosis

Death of a loved one

Loss of your job

House foreclosure

Divorce/breakup

Mild criticism from your boss

Mild disagreement with a friend

Loss of your wallet

A big auto repair bill

Car breakdown—need to be towed

Refrigerator needs replacing

Late for work

Probability Worksheet

Event Automaticthoughts Probability 0–100% Anxiety 0–100% Evidence pro and con Coping alternatives Probability 0–100% Anxiety 0–100%

Stressor Alarm Bells

Who (particular people)

What (things, situations)

Where (places)

When (events)

Cognitive Alarm Bells

Thought suppression

Distraction through fantasies, mantras, prayer

Rigid thinking (obsessively repeating the same thoughts)

Prolonged worrying

Misappraisal of threat (overestimating danger)

Sensation Avoidance Alarm Bells

Feeling too hot or cold

Being very tired, exhausted

Getting out of breath, sweaty

Sexual arousal

Safety Behavior Alarm Bells

Excessive reassurance seeking

Distraction

Procrastination

Overpreparation

Checking and double-checking

Rituals

Perfectionism

Overreliance on a support person

Contract

When these alarm bells ring:

I will:

  1. Name it a relapse and claim responsibility for it.
  2. Confront, encounter, and expose myself to what I fear, cutting avoidance short.
  3. Handle my stressors with my auxiliary skills of cognitive flexibility, defusion, accurate threat assessment, and distress tolerance.

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