The Worry Flowchart is an useful tool for guiding clients through practical interventions to manage excessive worry effectively.
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.
The Worry Flowchart is designed to help clinicians conceptualize and communicate treatment strategies for excessive worry. It systematically leads clients through interventions such as distinguishing hypothetical worries from real-event worry, problem-solving, and postponing worries. This resource enhances clients' ability to manage and reduce their anxiety symptoms in a structured, meaningful way.
The Worry Flowchart effectively integrates evidence-based interventions into therapy for generalized anxiety disorder:
Management of pervasive, uncontrollable worry.
Addressing excessive concern over potential health issues.
Helping clients who experience anxiety-induced insomnia.
Any anxiety or mood disorder where excessive worry is a concern.
Start by helping clients recognize when they are worrying.
Encourage clients to succinctly describe their worries.
Help distinguish between real and hypothetical worries.
Guide clients through appropriate strategies based on worry type.
Formulate actionable steps or interventions for real worries.
Encourage clients to focus on what is important and meaningful to them.
Generalized Anxiety Disorder (GAD) is characterized by chronic, excessive worry that often feels uncontrollable and distressing. Several theoretical models have been developed to explain the mechanisms that maintain worry in GAD.
The cognitive avoidance model (Borkovec, Alcaine, & Behar, 2004; Borkovec et al., 1983) proposes that worry functions as a verbal-linguistic strategy that individuals use to avoid the full emotional impact of distressing thoughts, images, and feelings. Although worry may provide short-term relief, it prevents emotional processing and reinforces the cycle of anxiety.
The intolerance of uncertainty model (Dugas & Robichaud, 2007) suggests that individuals with GAD react negatively to uncertain situations, leading them to engage in worry in an attempt to gain a sense of certainty and control. This pattern, however, typically leads to more anxiety and avoidance rather than resolution.
The metacognitive model (Wells, 2004) distinguishes between Type 1 worry (worry about non-cognitive external events) and Type 2 worry (worry about worrying itself). This model emphasizes the role of metacognitive beliefs — particularly the belief that worry is uncontrollable and dangerous — which contributes to persistent worry and distress.
The Worry Flowchart integrates these theoretical perspectives into a structured, clinician-friendly tool. It supports clients in identifying when they are worrying and helps them differentiate between real-event worries (which require practical action) and hypothetical worries (which are better addressed through strategies such as worry postponement).
