The Low Self-Esteem Formulation worksheet is designed for mental health professionals to help clients explore and challenge persistent negative beliefs about themselves.
Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.
Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.
An editable Microsoft PowerPoint version of the resource.
Low self-esteem centers around entrenched negative beliefs that persist, often despite contradictory evidence. This formulation worksheet highlights how perceptual and interpretational biases sustain these beliefs. It helps clients identify situations that activate negative schemas, prompting biased predictions and subsequent anxiety-driven behaviors.
The Low Self-Esteem Formulation worksheet provides a structured approach for therapists to identify and address aspects of negative self-belief.
Persistently negative beliefs about oneself.
Persistent fear of negative evaluation.
Enduring beliefs about self-worth and failure.
Unyielding standards leading to self-criticism.
Help the client identify situations where personal rules or standards are threatened.
Use the worksheet to explore negative beliefs and rules governing behavior.
Examine client predictions and expectations about outcomes.
Identify emotional reactions and safety behaviors prompted by these predictions.
Discuss actual outcomes versus expectations, and how beliefs may have shaped interpretations.
Encourage clients to reinterpret biased conclusions with an open mind.
Develop strategies to test the accuracy of client beliefs and rules.
Low self-esteem is underpinned by enduring negative beliefs about the self — such as “I’m not good enough,” “I’m unlovable,” or “I always fail.” These beliefs often originate from early life experiences and become internalized as core schemas. Once formed, they shape how individuals interpret their world, often in ways that maintain the negative self-view.
Fennell’s cognitive model of low self-esteem highlights a self-reinforcing cycle: when a triggering situation occurs, negative self-beliefs are activated, leading to biased predictions (e.g., “They’ll think I’m useless”), heightened emotional distress, and the use of safety behaviors (e.g., avoidance, over-preparation, or people-pleasing). These behaviors often prevent disconfirmation of the underlying belief and can inadvertently reinforce it.
An important aspect of treatment involves socialising clients to the components which act to maintain low self-esteem, and to explore the effects of their beliefs and rules. The Low Self-Esteem Formulation worksheet provides a clear, structured method for helping clients map out a maintenance cycle of low self-esteem. By breaking down real-life situations into identifiable components — triggering events, negative beliefs, biased predictions, emotional responses, and safety behaviors — clients begin to understand how their beliefs operate in practice.
