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Anxiety

Fear and its associated reactions (freeze, flight, fight) can be useful responses to a dangerous or threatening situation. However, clients suffering from anxiety disorders experience these reactions too strongly, too often, or in inappropriate situations - and they can be distressing and exhausting. Psychology Tools can help you with CBT for anxiety - our anxiety worksheets are designed to help clients with generalized anxiety disorder (GAD), health anxiety (hypochondriasis), panic disorder, phobias, and social anxiety. Read more
Anxiety
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Living With Worry And Anxiety Amidst Global Uncertainty

This free guide was published in March 2020 in response to the coronavirus pandemic and is designed for anyone experiencing anxiety or worry. In times ... https://www.psychologytools.com/resource/living-with-worry-and-anxiety-amidst-global-uncertainty

Guides

Magnification And Minimization

The Magnification And Minimization information handout forms part of the cognitive distortions series, designed to help clients and therapists to work ... https://www.psychologytools.com/resource/magnification-and-minimization

Information handouts

Making Sense Of Your Panic (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter brings tog ... https://www.psychologytools.com/resource/making-sense-of-your-panic-psychology-tools-for-overcoming-panic

Books & Chapters

Managing Social Anxiety: Therapist Guide

Managing Social Anxiety – A Cognitive-Behavioral Therapy Approach comes in two volumes. This page is for the Therapist Guide. Click on the following ... https://www.psychologytools.com/resource/managing-social-anxiety-therapist-guide

Treatments That Work®

Managing Social Anxiety: Workbook

Managing Social Anxiety – A Cognitive-Behavioral Therapy Approach comes in two volumes. This page is for the Workbook. Click on the following link t ... https://www.psychologytools.com/resource/managing-social-anxiety-workbook

Treatments That Work®

Mastery Of Your Anxiety And Panic: Therapist Guide

Mastery Of Your Anxiety And Panic comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying C ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-panic-therapist-guide

Treatments That Work®

Mastery Of Your Anxiety And Panic: Workbook

Mastery Of Your Anxiety And Panic comes in two volumes. This page is for the Workbook. Click on the following link to access the accompanying Therapis ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-panic-workbook

Treatments That Work®

Mastery Of Your Anxiety And Worry: Therapist Guide

Mastery Of Your Anxiety And Worry comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying W ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-worry-therapist-guide

Treatments That Work®

Mastery Of Your Anxiety And Worry: Workbook

Mastery Of Your Anxiety And Worry comes in two volumes. This page is for the Workbook. Click on the following link to access the accompanying Therapis ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-worry-workbook

Treatments That Work®

Maximizing The Effectiveness Of Exposure Therapy

Despite its position as the leading treatment technique for anxiety disorders, not all clients respond to exposure therapy and some individuals relaps ... https://www.psychologytools.com/resource/maximizing-the-effectiveness-of-exposure-therapy

Information handouts

Mental Filter

The Mental Filter information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/mental-filter

Information handouts

Mind Reading

The Mind Reading information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/mind-reading

Information handouts

Mindful Attention (Audio)

Mindful Attention is a technique for becoming aware of one’s thoughts and experiences, and being able to observe these as transient mental events. ... https://www.psychologytools.com/resource/mindful-attention-audio

Audio

Mindfulness In Everyday Life (Audio)

Mindfulness In Everyday Life is a short mindfulness exercise which guides clients how to bring present-moment awareness into everyday life. This audio ... https://www.psychologytools.com/resource/mindfulness-in-everyday-life-audio

Audio

Mindfulness Of Breath (Long Version) (Audio)

Mindfulness Of Breath (Long version) is a mindfulness exercise encouraging present-moment awareness, using the breath as an anchor for the attention. ... https://www.psychologytools.com/resource/mindfulness-of-breath-long-version-audio

Audio

Mindfulness Of Breath (Short Version) (Audio)

Mindfulness Of Breath (Short version) is a mindfulness exercise encouraging present-moment awareness, using the breath as an anchor for the attention. ... https://www.psychologytools.com/resource/mindfulness-of-breath-short-version-audio

Audio

Mindfulness Of Sounds And Thoughts (Audio)

Mindfulness Of Sounds And Thoughts is a mindfulness practice exercise that encourages relating to thoughts as ‘just thoughts’ that come and go in ... https://www.psychologytools.com/resource/mindfulness-of-sounds-and-thoughts-audio

Audio

Monitoring Your Panic (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter introduces tec ... https://www.psychologytools.com/resource/monitoring-your-panic-psychology-tools-for-overcoming-panic

Books & Chapters

Negative Thoughts - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/negative-thoughts-self-monitoring-record

Worksheets

Overgeneralization

The Overgeneralization information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effect ... https://www.psychologytools.com/resource/overgeneralization

Information handouts

Panic - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/panic-self-monitoring-record

Worksheets

Panic Attack Progress Record

Recovery often has a fluctuating course and it is important to monitor progress in cognitive behavioral therapy. Clients can use the Panic Attack Prog ... https://www.psychologytools.com/resource/panic-attack-progress-record

Worksheets

Panic Attack Record

Self-monitoring of thoughts, feelings and symptoms is an essential skill for clients engaged in cognitive behavioral therapy (CBT). The Panic Attack R ... https://www.psychologytools.com/resource/panic-attack-record

Worksheets

Panic Diary

The Panic Diary is a cognitive behavioral therapy (CBT) diary for panic symptoms. Clients can record panic attack frequency along with information abo ... https://www.psychologytools.com/resource/panic-diary

Worksheets

Panic Formulation

The aim of a formulation is to help the client and therapist to come to a shared understanding of what a client is experiencing. The Panic Formulation ... https://www.psychologytools.com/resource/panic-formulation

Worksheets

Panic Symptom Tracker

Self-monitoring of thoughts, feelings, and symptoms is an essential skill in cognitive behavioral therapy (CBT). This symptom tracker helps clients to ... https://www.psychologytools.com/resource/panic-symptom-tracker

Worksheets

Peaceful Place (Audio)

The Peaceful Place exercise guides the listener through a short imagery exercise designed to facilitate the visualization of soothing imagery and noti ... https://www.psychologytools.com/resource/peaceful-place-audio

Audio

Performance And The Yerkes-Dodson Law

The Yerkes-Dodson Law suggests that performance increases with mental arousal (stress) but only up to a point: when an individuals’ level of stress ... https://www.psychologytools.com/resource/performance-and-the-yerkes-dodson-law

Information handouts

Personalizing

The Personalizing information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/personalizing

Information handouts

Perspective-Taking

Cognitive restructuring techniques in CBT teach clients ways of analyzing situations in ways that might initially be unfamiliar. A simple way of intro ... https://www.psychologytools.com/resource/perspective-taking

Worksheets

Progressive Muscle Relaxation

Progressive relaxation training originated in the 1930’s as a treatment for tension and anxiety. Edmund Jacobsen developed a systematic and lengthy ... https://www.psychologytools.com/resource/progressive-muscle-relaxation

Exercises

Progressive Muscle Relaxation (Archived)

NOTE: An improved version of this resource is available here: Progressive Muscle Relaxation. Older versions of a resource may be archived in the event ... https://www.psychologytools.com/resource/progressive-muscle-relaxation-edition-1

Archived

Progressive Muscle Relaxation (Audio)

The Progressive Muscle Relaxation exercise guides the listener through a sequence in which muscle groups are tensed and relaxed. ... https://www.psychologytools.com/resource/progressive-muscle-relaxation-audio

Audio

Psychology Tools For Living Well

Cognitive behavioral therapy can help your clients to live happier and more fulfilling lives. Psychology Tools for Living Well is a self-help course ... https://www.psychologytools.com/resource/psychology-tools-for-living-well

Books & Chapters

Psychology Tools For Overcoming Panic

This helpful workbook will teach you everything you need to know about panic. Drawing upon the evidence base, Psychology Tools for Overcoming Panic  ... https://www.psychologytools.com/resource/psychology-tools-for-overcoming-panic

Books & Chapters

Raisin Exercise (Audio)

The Raisin Exercise is a short mindfulness exercise encouraging present-moment awareness of the senses, connecting with taste, touch and smell while y ... https://www.psychologytools.com/resource/raisin-exercise-audio

Audio

Recognizing Agoraphobia

Agoraphobia is characterized by a marked fear of situations such as open spaces or public places. Recognizing Agoraphobia compares the DSM-5 and ICD- ... https://www.psychologytools.com/resource/recognizing-agoraphobia

Information handouts

Recognizing Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) is characterized by an extended period of excessive worry. The DSM also emphasizes the importance of the client’s ... https://www.psychologytools.com/resource/recognizing-generalized-anxiety-disorder-gad

Information handouts

Recognizing Panic Attacks And Panic Disorder

Panic attacks are characterized by sudden surges of intense fear or discomfort, and panic disorder is characterized by recurrent panic attacks. Recogn ... https://www.psychologytools.com/resource/recognizing-panic-attacks-and-panic-disorder

Information handouts

Recognizing Social Anxiety Disorder

Social Anxiety Disorder is characterized by fear regarding social situations and individuals with social anxiety are concerned about negative evaluati ... https://www.psychologytools.com/resource/recognizing-social-anxiety-disorder

Information handouts

Recognizing Specific Phobia

Specific phobia is characterized by marked fear or anxiety regarding a particular object or situation. Recognizing Specific Phobia compares the DSM-5 ... https://www.psychologytools.com/resource/recognizing-specific-phobia

Information handouts

Relaxed Breathing

Practising Relaxed Breathing serves to reduce physiological arousal and can be an excellent grounding technique. This client information handout descr ... https://www.psychologytools.com/resource/relaxed-breathing

Exercises

Relaxed Breathing Exercise 1 (Audio)

Breathing Exercise 1 guides the listener through simple instructions to make their breathing slower, deeper, and more regular. ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-1-audio

Audio

Relaxed Breathing Exercise 2 (Audio)

Breathing Exercise 2 uses the imagery of inflating a balloon to help the listener make their breathing slower, deeper, and more regular. ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-2-audio

Audio

Relaxed Breathing Exercise 3 (Audio)

Breathing Exercise 3 uses the imagery of breathing air of different colours to help the listener make their breathing slower, deeper, and more regular ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-3-audio

Audio

Relaxed Breathing Exercise 4 (Audio)

Breathing Exercise 4 guides the listener through simple instructions to breathe in a more relaxed fashion. ... https://www.psychologytools.com/resource/relaxed-breathing-exercise-4-audio

Audio

Relaxed Breathing Record Form

Practicing relaxed breathing serves to reduce physiological arousal and can be an excellent grounding technique. This record form helps clients to mon ... https://www.psychologytools.com/resource/relaxed-breathing-record-form

Worksheets

Responses To Threat: Freeze, Appease, Flight, Fight

Human beings are programmed to respond automatically in a variety of ways to a threat including freezing, escaping, and dissociation. Traumatized indi ... https://www.psychologytools.com/resource/responses-to-threat-freeze-appease-flight-fight

Information handouts

Rumination - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/rumination-self-monitoring-record

Worksheets

Rumination Diary (Archived)

NOTE: An improved version of this resource is available here: Rumination – Self-Monitoring Record. Older versions of a resource may be archived ... https://www.psychologytools.com/resource/rumination-diary-archived

Archived

Rumination Self-Monitoring Record (Archived)

NOTE: An improved version of this resource is available here: Rumination Self-Monitoring Record. Older versions of a resource may be archived in the e ... https://www.psychologytools.com/resource/rumination-self-monitoring-record-archived

Archived

Safety Behaviors

Safety behaviors are actions carried out with the intention of preventing a feared catastrophe. In the short-term they often give a sense of relief, b ... https://www.psychologytools.com/resource/safety-behaviors

Information handouts

Safety Behaviors Example

Safety behaviors are actions carried out with the intention of preventing a feared catastrophe. In the short-term they often give a sense of relief, b ... https://www.psychologytools.com/resource/safety-behaviors-example

Information handouts

Selective Attention

Selective attention can be conceptualized as a maintaning process (mechanism) within CBT. Biases in perception can lead to biases in information proce ... https://www.psychologytools.com/resource/selective-attention

Information handouts

Self-Blame

The Self-Blame information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively wi ... https://www.psychologytools.com/resource/self-blame

Information handouts

Self-Monitoring Record (Universal)

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/self-monitoring-record-universal

Worksheets

Sensory Grounding Using Smells (Audio)

The Sensory Grounding Using Smells exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to teach ... https://www.psychologytools.com/resource/sensory-grounding-using-smells-audio

Audio

Sensory Grounding Using Your Five Senses (Audio)

The Sensory Grounding Using Your Five Senses exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed ... https://www.psychologytools.com/resource/sensory-grounding-using-your-five-senses-audio

Audio

Social Anxiety Formulation

People suffering from social anxiety disorder (previously known as social phobia) experience persistent fear or anxiety concerning social or performan ... https://www.psychologytools.com/resource/social-anxiety-formulation

Worksheets

Stages Of Social Anxiety

The Stages Of Social Anxiety worksheet is a tool to record unhelpful socially anxious responses to social situations, and to map alternative ways of t ... https://www.psychologytools.com/resource/stages-of-social-anxiety

Worksheets

Taking Panic Out Of The Body

A critical driver of panic reactions is catastrophic misinterpretation of body sensations. This worksheet helps therapists to teach clients about the ... https://www.psychologytools.com/resource/taking-panic-out-of-the-body

Exercises

Testing Anxious And Panicky Predictions (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter introduces beh ... https://www.psychologytools.com/resource/testing-anxious-and-panicky-predictions-psychology-tools-for-overcoming-panic

Books & Chapters

The Experience Of Panic (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter describes the ... https://www.psychologytools.com/resource/the-experience-of-panic-psychology-tools-for-overcoming-panic

Books & Chapters

The Parts Of Your Panic (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter helps a client ... https://www.psychologytools.com/resource/the-parts-of-your-panic-psychology-tools-for-overcoming-panic

Books & Chapters

Theory A / Theory B

Human beings actively try to understand their world and what happens to them. However, these understanding can be inaccurate or unhelpful. Worse, unhe ... https://www.psychologytools.com/resource/theorya-theoryb

Worksheets

Theory A / Theory B (Archived)

NOTE: An improved version of this resource is available here: Theory A / Theory B . Older versions of a resource may be archived in the event that the ... https://www.psychologytools.com/resource/theorya-theoryb-edition-1

Archived

Therapy Blueprint (Universal)

A therapy blueprint is CBT tool which summarizes the work a therapist and patient have completed together. It represents the past (the problems, what ... https://www.psychologytools.com/resource/therapy-blueprint-universal

Worksheets

Therapy Blueprint For Panic

A therapy blueprint represents the past (the problems, what maintained them), the present (the therapy itself, new knowledge learned and skills develo ... https://www.psychologytools.com/resource/therapy-blueprint-for-panic

Worksheets

Therapy Blueprint For Social Anxiety

A therapy blueprint represents the past (the problems, what maintained them), the present (the therapy itself, new knowledge learned and skills develo ... https://www.psychologytools.com/resource/therapy-blueprint-for-social-anxiety

Worksheets

Thinking Versus Sensing (Audio)

Thinking Versus Sensing is a short mindfulness exercise to demonstrate the difference between thinking about our experience and sensing it directly. E ... https://www.psychologytools.com/resource/thinking-versus-sensing-audio

Audio

Thought Record – Courtroom Trial

Thought records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. The Thought Record – Co ... https://www.psychologytools.com/resource/thought-record-courtroom-trial

Worksheets

Thought Record (Evidence For And Against)

CBT Thought Records exist in multiple variants, depending on the needs and abilities of the client. This Thought Record (Evidence For And Against) is ... https://www.psychologytools.com/resource/thought-record-evidence-for-and-against

Worksheets

Thoughts In Panic (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter discusses the ... https://www.psychologytools.com/resource/thoughts-in-panic-psychology-tools-for-overcoming-panic

Books & Chapters

Transdiagnostic Processes

A ‘transdiagnostic process’ is the label given to a mechanism which is present across disorders and which is either a risk or maintaining factor f ... https://www.psychologytools.com/resource/transdiagnostic-processes

Information handouts

TRAP TRAC

TRAP & TRAC worksheets can be usefully used as part of a behavioral activation programme as a way of overcoming responses which result in avoidanc ... https://www.psychologytools.com/resource/trap-trac

Exercises

Trauma, Dissociation, And Grounding (Archived)

NOTE: An improved version of this resource is available here: Trauma And Dissociation. Older versions of a resource may be archived in the event that ... https://www.psychologytools.com/resource/trauma-dissociation-and-grounding

Archived

Types Of Dissociation

The Types Of Dissociation information handout is designed for clients who have experienced trauma and describes dissociation using accessible terminol ... https://www.psychologytools.com/resource/types-of-dissociation

Information handouts

Uncertainty Beliefs – Experiment Record

Situations which are uncertain, novel, or ambiguous trigger a state of uncertainty. Evidence indicates that individuals who are dispositionally high i ... https://www.psychologytools.com/resource/uncertainty-beliefs-experiment-record

Worksheets

Understanding Death Anxiety

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-death-anxiety

Guides

Understanding Depersonalization And Derealization

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-depersonalization-and-derealization

Guides

Understanding Fears And Phobias

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-fears-and-phobias

Guides

Understanding Generalized Anxiety And Worry

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-generalized-anxiety-and-worry

Guides

Understanding Health Anxiety

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-health-anxiety

Guides

Understanding My Panic

The Cognitive Behavioral Model Of Panic identifies catastrophic misinterpretation of body sensations as a criticial maintenance factor which serves to ... https://www.psychologytools.com/resource/understanding-my-panic

Information handouts

Understanding Panic

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-panic

Guides

Understanding Social Anxiety

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-social-anxiety

Guides

Unhelpful Thinking Styles

Human thinking is subject to a number of characteristic biases. In the 1960s, Aaron Beck identified several of these biases which were common in his d ... https://www.psychologytools.com/resource/unhelpful-thinking-styles

Information handouts

VAS Scale

Visual analogue scales (VAS's) can be used for subjective ratings of emotion or other sensations such as pain. This is a handy VAS scale in the style ... https://www.psychologytools.com/resource/vas-scale

Exercises

What Causes Panic? (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter introduces the ... https://www.psychologytools.com/resource/what-causes-panic-psychology-tools-for-overcoming-panic

Books & Chapters

What Does Exercise Do For the Mind And Body?

Exercise is an evidence-based treatment for depression and anxiety and research suggests that in the treatment of depression, exercise interventions l ... https://www.psychologytools.com/resource/what-does-exercise-do-for-the-mind-and-body

Information handouts

What Does The Brain Do? (Lobes and Regions)

The human brain is the center of the body’s nervous system and the seat of cognition. It is responsible for everything that we do, feel and perceive ... https://www.psychologytools.com/resource/what-does-the-brain-do-lobes-and-regions

Information handouts

What Does The Brain Do? (Lobes)

The human brain is the centre of the body’s nervous system and the seat of cognition. It is responsible for everything that we do, feel, and perceiv ... https://www.psychologytools.com/resource/what-does-the-brain-do-lobes

Information handouts

What If

"What if...?" questions are a powerful way in which anxious individuals generate or maintain anxious states, particularly in generalized anxiety disor ... https://www.psychologytools.com/resource/what-if

Exercises

What Is A Panic Attack?

Panic attacks are single episodes of intense fear or discomfort that begin suddenly and reach a peak within minutes. The cognitive behavioral model of ... https://www.psychologytools.com/resource/what-is-a-panic-attack

Information handouts

What Is A Panic Attack? (Psychology Tools For Overcoming Panic)

Psychology Tools for Overcoming Panic takes a cognitive behavioral therapy (CBT) approach to this common anxiety problem. This chapter describes the ... https://www.psychologytools.com/resource/what-is-a-panic-attack-psychology-tools-for-overcoming-panic

Books & Chapters

What Is Exposure Therapy?

Exposure is an effective evidence-based treatment for fear. This information handout describes the key principles of Exposure Therapy. Clients who are ... https://www.psychologytools.com/resource/what-is-exposure-therapy

Information handouts

What Is Generalized Anxiety Disorder (GAD)?

Our ‘What Is … ?’ series is a collection of one-page information handouts for common mental health conditions. Friendly and explanatory, handout ... https://www.psychologytools.com/resource/what-is-generalized-anxiety-disorder-gad

Information handouts

What Is Social Anxiety Disorder?

Our ‘What Is … ?’ series is a collection of one-page information handouts for common mental health conditions. Friendly and explanatory, handout ... https://www.psychologytools.com/resource/what-is-social-anxiety-disorder

Information handouts

What Keeps Death Anxiety Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-death-anxiety-going

Information handouts

What Keeps Depersonalization And Derealization Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-depersonalization-and-derealization-going

Information handouts

Assessment

  • Brief Fear Of Negative Evaluation Scale | Leary | 1983
  • Fear Questionnaire (FQ) (Phobia) | Marks, Matthews | 1979
    • Scale download archived copy
    • Marks, I. M., & Mathews, A. M. (1979). Brief standard self-rating for phobic patients. Behaviour Research and Therapy17(3), 263-267.
  • Generalized Anxiety Disorder 7-item (GAD-7) | Spitzer, Kroenke, Williams, Lowe | 2006
    • Scale  download
    • Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder. Arch Inern Med. 2006;166:1092-1097.
  • Hamilton Rating Scale For Anxiety (HAM-A) | Hamilton | 1959
    • Scale download archived copy
    • Hamilton, M. (1959).The assessment of anxiety states by rating. British Journal of Medical Psychology 32, 50-55.
  • Health Anxiety Inventory (HAI) | Salkovskis, Rimes, Warwick, Clark | 2002
    • Scale download
    • Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(05), 843-853.
  • Liebowitz Social Anxiety Scale (LSAS-SR) | Liebowitz | 1987
  • Mobility Inventory For Agoraphobia (MIA) | Chambless, Caputo, Jasin, Gracely, Williams | 1985
    • Scale download  archived copy
    • Chambless, D. L., Caputo, G. C., Jasin, S. E., Gracely, E. J., & Williams, C. (1985). The mobility inventory for agoraphobia. Behaviour research and therapy23(1), 35-44.
  • Panic Disorder Severity Scale (PDSS) | Shear, Brown, Barlow, Money, Sholomskas, Woods, Gorman, Papp | 1997
    • Scale download archived copy
    • Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., … & Papp, L. A. (1997). Multicenter collaborative panic disorder severity scale. American Journal of Psychiatry154(11), 1571-1575.
  • Penn State Worry Questionnaire | Meyer, Miller, Metzger, Borkovec | 1990
    • Scale download archive.org
    • Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the penn state worry questionnaire. Behaviour Research and Therapy28(6), 487-495.
  • Spence Children’s Anxiety Scale | Spence | 1998
  • Severity Measure For Agoraphobia | Craske, Wittchen, Bogels, Stein, Andrews, Lebu | 2013
  • Severity Measure For Generalized Anxiety Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Severity Measure For Panic Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Severity Measure For Social Anxiety Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Severity Measure For Specific Phobia | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Social Phobia Inventory (SPIN) | Connor, Davidson, Churchill, Sherwood, Weisler, Foa | 2000
  • Social Phobia Scale | Mattick, Clarke | 1995

Intervention

Treatment guidelines

  • NICE guidelines for GAD and panic | 2011  download
  • NICE guidelines for social anxiety disorder | 2013  download

Treatment manuals

  • Comprehensive cognitive behavior therapy for social phobia: a treatment manual | Ledley, Foa, Huppert, Clark | 2006  download
  • Treatment manual for panic disorder (IAPT treatment manual for high intensity CBT therapists) | Clark, Salkovskis | 2009 download archived copy
  • A brief cognitive-behavioural treatment for social anxiety disorder | Morris, Mensink, Stewart  download  archived copy

Useful resources

  • Assertive defense of the self | Padesky | 1985 download archived copy
  • Interoceptive exposure definition | White, Basden, Barlow download archived copy
  • Task concentration training definition | Bögels download archived copy
  • Task concentration training and fear of blushing | Bögels, Mulkens, De Jong | 1997 download archived copy

Information Handouts

Generalized anxiety and mindfulness

Health anxiety

Panic

Panic

  • Panic self-help booklet by | Charles Young, Alison Hunte, Jessica Newell, Pat Valian | 2011 download archived copy
  • Panic self-help booklet from Glasgow STEPS including information about panic and self-help interventions download archived copy

Phobia

  • Phobia self-help booklet from Glasgow STEPS including information about phobia and self-help interventions download archived copy

Social anxiety

Social anxiety

  • ‘Shyness and social anxiety – a self help guide’ download archived copy

Worksheets

Generalized anxiety and mindfulness

Panic

Social anxiety

Self-Help Programmes

Self-help programme for anxiety

Self-help programme for generalized anxiety and mindfulness

Self-help programme for health anxiety

  • Understanding health anxiety download
  • How health anxiety develops download
  • What keeps health anxiety going? download
  • Reducing your focus on health anxiety symptoms and worries download
  • Re-evaluating unhelpful health-related thinking download
  • Reducing checking and reassurance seeking download
  • Challenging avoidance and safety behaviors download
  • Adjusting health rules and assumptions download
  • Healthy living and self-management planning download

Self-help programme for panic

Self-help programme for social anxiety

 

Presentations

  • New developments in exposure therapy for anxiety and related disorders: the inhibitory learning approach | Blakey, Abramowitz | 2018  download archived copy
  • Desirable difficulties: optimizing exposure therapy for anxiety through inhibitory learning | Abramowitz, Jacoby, Blakey | 2018 download archived copy
  • GAD – a cognitive model and treatment download  archived copy
  • Bringing Specificity to Generalized Anxiety Disorder: Conceptualization and Treatment of GAD using Intolerance of Uncertainty as the Theme of Threat | Robichaud | 2013 download archived copy

Recommended Reading

General

  • Clark, D. M. (1999). Anxiety disorders: why they persist and how to treat them. Behaviour Research and Therapy, 37, S5-S27 download archived copy

Generalized Anxiety Disorder

  • Behar, E., DiMarco, I. D., Hekler, E. B., Mohlman, J., Staples, A. M. (2009). Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders, 23, 1011-1023 download archived copy
  • Bottesi, G., Ghisi, M., Carraro, E., Barclay, N., Payne, R., & Freeston, M. H. (2016). Revising the Intolerance of Uncertainty Model of Generalized Anxiety Disorder: Evidence from UK and Italian Undergraduate Samples. Frontiers in psychology7, 1723 download  archived copy
  • Hirsch, C. R., Beale, S., Grey, N., & Liness, S. (2019). Approaching cognitive behavior therapy for generalized anxiety disorder from a cognitive process perspective. Frontiers in psychiatry, 10, 796. download archived copy
  • Milne, S., Lomax, C., & Freeston, M. H. (2019). A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety. the Cognitive Behaviour Therapist, 12. download

A number of treatment packages have demonstrated efficacy in the treatment of GAD:

Laval model

  • Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour research and therapy36(2), 215-226.

Avoidance model of worry and GAD

  • Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. Generalized anxiety disorder: Advances in research and practice2004.
  • Hjemdal, O., Hagen, R., Nordahl, H. M., & Wells, A. (2013). Metacognitive therapy for generalized anxiety disorder: Nature, evidence and an individual case illustration. Cognitive and Behavioral Practice20(3), 301-313 download  archived copy

Metacognitive model

  • Hjemdal, O., Hagen, R., Nordahl, H. M., & Wells, A. (2013). Metacognitive therapy for generalized anxiety disorder: Nature, evidence and an individual case illustration. Cognitive and Behavioral Practice20(3), 301-313.
  • Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and cognitive psychotherapy23(3), 301-320 download  archived copy

Emotional dysregulation model

  • Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Ritter, M. (2013). Emotion regulation therapy for generalized anxiety disorder. Cognitive and Behavioral Practice20(3), 282-300 nih.gov
  • Mennin, D. S., Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2002). Applying an emotion regulation framework to integrative approaches to generalized anxiety disorder. Clinical Psychology: Science and Practice9(1), 85-90 download  archived copy

Acceptance-based model of GAD

  • Roemer, L., & Orsillo, S. M. (2002). Expanding our conceptualization of and treatment for generalized anxiety disorder: Integrating mindfulness/acceptance‐based approaches with existing cognitive‐behavioral models. Clinical Psychology: Science and Practice9(1), 54-68 download  archived copy
  • Roemer, L., Salters, K., Raffa, S. D., & Orsillo, S. M. (2005). Fear and avoidance of internal experiences in GAD: Preliminary tests of a conceptual model. Cognitive Therapy and Research29(1), 71-88.

Health Anxiety

  • Asmundson, G. J. G., Abramowitz, J. S., Richter, A. A., Whedon, M. (2010). Health anxiety: current perspectives and future directions. Current Psychiatry Reports, 12, 306-312 download
  • Furer, P., Walker, J. R. (2008). Death anxiety: A cognitive behavioural approach. Journal of Cognitive Psychotherapy, 22(2), 167-182 download
  • Salkovskis, P. M., Warwick, H. M. C., Deale, A. C. (2003). Cognitive-Behavioral Treatment for Severe and Persistent Health Anxiety (Hypochondriasis). Brief Treatment and Crisis Intervention, 3, 353-367 btci.edina.clockss.org archived copy
  • Walker, J. R., Furer, P. (2008). Interoceptive exposure in the treatment of health anxiety and hypochondirasis. Journal of Cognitive Psychotherapy, 22(4), 366-378 download

Panic disorder

  • Clark, D. A. (1999). Anxiety disorders: Why they persist and how to treat them. Behaviour Research and Therapy, 37, S5-S27 download archived copy
  • Huppert, J. D., & Baker-Morissette, S. L. (2003). Beyond the manual: The insider’s guide to panic control treatment. Cognitive and Behavioral Practice10(1), 2-13.
  • Schmidt, N. B., Woolaway-Bickel, K., Trakowski, J. et al. (2000). Dismantling cognitive-behavioural treatment for panic disorder: Questioning the utility of breathing retraining. Journal of Consulting and Clinical Psychology, 68(3), 417-424 download archived copy
  • Wells, A. (1997). Cognitive Therapy of Anxiety Disorders. Chichester: Wiley.

Social Anxiety Disorder

  • Clark, D. M. (2001). A cognitive perspective on social phobia download archived copy
  • Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualized case conceptualization and treatment. Cognitive and Behavioural Practice, 16. 123-134 download archived copy
  • Wild, Hackmann, Clark (2008). Rescripting early memories linked to negative images in social phobia: a pilot study. Behaviour Therapy, 39(1), 47-56. download
  • Veale, D. (2003). Treatment of social phobia. Advances in Psychiatric Treatment, 9, 258-264 download archived copy
  • Warnock-Parkes, E., Wild, J., Stott, R., Grey, N., Ehlers, A., & Clark, D. M. (2017). Seeing is believing: Using video feedback in cognitive therapy for social anxiety disorder. Cognitive and behavioral practice, 24(2), 245-255. view archived copy
  • Warnock-Parkes, E., Wild, J., Thew, G., Kerr, A., Grey, N., & Clark, D. (2022). ‘I’m unlikeable, boring, weird, foolish, inferior, inadequate’: How to address the persistent negative self-evaluations that are central to social anxiety disorder with cognitive therapy. The Cognitive Behaviour Therapist, 15, E56. doi:10.1017/S1754470X22000496 view archived copy

What Is Anxiety?

Signs and Symptoms of Anxiety Disorders

Different anxiety disorders are characterized by various foci of concern.

In addition to disorder-specific cognitive content, individuals experiencing anxiety disorders are likely to experience physical symptoms of anxiety including:

  • palpitations or accelerated heart rate
  • sweating
  • trembling or shaking
  • dry mouth
  • difficulty breathing
  • a feeling of choking
  • nausea or abdominal discomfort
  • dizziness
  • derealization or depersonalization
  • fear of losing control or passing out
  • fear of dying
  • hot flushes or cold chills
  • numbness or tingling
  • blushing
  • fear of vomiting
  • urgency or fear of urination or defecation

Psychological Models and Theories of Anxiety

One broad conceptualization of anxiety can be summarized by an ‘anxiety equation’ (Beck, Emery, & Greenberg, 1985; Salkovskis, Forrester, & Richards, 1998):

Anxiety = (perceived probability of therapy × perceived cost or awfulness of danger)

÷ (perceived ability to cope + perceived ‘rescue factors’)

Disorder-specific ‘CBT for anxiety’ cognitive models have been developed for all of the anxiety disorders. These are helpful in that they direct the therapist’s attention toward key interpretations and behaviors that act to perpetuate the anxiety disorders. For example, the critical mechanism that Clark identified in the cognitive model of panic (1986) is that body sensations are misinterpreted catastrophically as signs of danger, with concomitant effects upon emotions, behavior, and secondary cognitions.

Evidence-Based Psychological Approaches for Working with Anxiety

Cognitive behavior therapy has a strong evidence base for treating all of the anxiety disorders. Key components of CBT for anxiety interventions include exposure to the feared situations or stimulus, and an experimental approach to test the accuracy of beliefs.

Resources for Working with Anxiety

Psychology Tools resources available for working therapeutically with anxiety may include:

References

  • Beck, A. T., Emery, G., & Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.
  • Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461–470.
  • Salkovskis, P. M., Forrester, E., & Richards, C. (1998). Cognitive–behavioral approach to understanding obsessional thinking. The British Journal of Psychiatry, 173(S35), 53–63.