Self-monitoring is a fundamental tool in cognitive behavioral therapy (CBT). Self-monitoring can be used to:
- Identify negative automatic thoughts (NATs)
- Help clients understand the links between thoughts, emotions, body sensations, and responses
This Anxiety Self-Monitoring Record is designed to help clients to better understand their anxious thoughts and responses.
- Clients should be instructed to record specific instances in which anxious thoughts, feelings, or responses were prompted.
- In the first column (Situation) clients should be instructed to record what they were doing when they started to notice a significant change in how they were feeling. Training clients to record specific details (such as who they were with, where they were, and what had just happened) is often helpful when later elaborating a memory for an event, or simply in understanding the reasons for subsequent thoughts and responses
- In the second column (Emotions and body sensations) clients should be instructed to record the emotional reactions that caught their attention in that moment (which can typically be described using single words, e.g. anxious, scared, terrified) and associated body sensations (e.g. tightness in my stomach). Clients should be encouraged to rate the intensity of these sensations on 0–100% scale.
- In the third column (Anxious thoughts) clients should be directed to record any automatic cognitions. They should be reminded that cognitions can take the form of verbal thoughts, but can also take the form of images, or memories. Anxious thoughts often take the form of (negative) predictions about the (near) future. If a recorded cognition is an image (e.g. “I had a picture in my mind of my daughter falling over the edge”) clients should be directed to question what that image means to them (e.g “It means I’m careless and not capable of looking after her”) and to record that idiosyncratic meaning.
- In the fourth column (Coping responses) clients should be instructed to record what they did in response to the anxious thought and feeling. Did they make efforts to express or suppress it? Did they respond overtly (e.g. safety behavior) or covertly (e.g. self-reassurance)?
- Barlow, D. H. (2004). Anxiety and its disorders: The nature and treatment of anxiety and panic. Guilford press.
- Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.