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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

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100 of 221 resources

Grounding Techniques Menu

Dissociation can be described as a shift of a person’s attention away from the present moment. When working with traumatized clients, this shift oft ... https://www.psychologytools.com/resource/grounding-techniques-menu/

Cognitive Distortions – Unhelpful Thinking Styles (Extended)

Cognitive distortions (or ‘unhelpful thinking styles’) are ways that our thoughts become biased. Different cognitive biases are associated with di ... https://www.psychologytools.com/resource/cognitive-distortions-unhelpful-thinking-styles-extended/

Fight Or Flight Response

The fight or flight response is an automatic physiological reaction to an event that is perceived as stressful or frightening. The perception of threa ... https://www.psychologytools.com/resource/fight-or-flight-response/

Cognitive Distortions – Unhelpful Thinking Styles (Common)

Cognitive distortions (or ‘unhelpful thinking styles’) are ways that our thoughts become biased. Different cognitive biases are associated with di ... https://www.psychologytools.com/resource/cognitive-distortions-unhelpful-thinking-styles-common/

Self-Sacrifice

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/self-sacrifice/

Assertive Communication

Communicating and acting assertively is an interpersonal skill that helps people to maintain healthy relationships, resolve interpersonal conflict, an ... https://www.psychologytools.com/resource/assertive-communication/

Window Of Tolerance

The window of tolerance concept was coined by Dan Siegel in his 1999 book The Developing Mind. Siegel proposes that everyone has a range of intensitie ... https://www.psychologytools.com/resource/window-of-tolerance/

Audio Collection: Psychology Tools For Developing Self-Compassion

Psychology Tools For Developing Self-Compassion is an audio collection which guides clients through an empirically-supported programme of compassionat ... https://www.psychologytools.com/resource/psychology-tools-for-developing-self-compassion-audio-collection/

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/

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/

Embracing Uncertainty

Intolerance of uncertainty (IU) was first described in individuals suffering from Generalized Anxiety Disorder (GAD). Many behaviors associated with G ... https://www.psychologytools.com/resource/embracing-uncertainty/

Grounding Techniques

Individuals who have experienced trama often find it difficult to stay within the 'window of tolerance'. Grounding techniques (which can be sensory/pe ... https://www.psychologytools.com/resource/grounding-techniques/

Unhelpful Thinking Styles (Archived)

NOTE: Two improved versions of this resource are available here: Cognitive Distortions – Unhelpful Thinking Styles (Common) and Cognitive Disto ... https://www.psychologytools.com/resource/unhelpful-thinking-styles-archived/

Intolerance Of Uncertainty

Uncertainty is a normal part of life – we can never be 100% sure about what will happen next. Many people feel good about uncertainty and live lives ... https://www.psychologytools.com/resource/intolerance-of-uncertainty/

Assertive Responses

Being able to communicate assertively is an essential skill for developing and maintaining healthy relationships and positive self-esteem. Individuals ... https://www.psychologytools.com/resource/assertive-responses/

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/

Theory A / Theory B

People naturally seek to understand their world and develop explanations based on their experiences. When these beliefs are inaccurate or only partial ... https://www.psychologytools.com/resource/theorya-theoryb/

Emotions Motivate Actions

Many clients find it helpful to recognize the range of actions that are motivated by different emotional states. This worksheet encourages clients to ... https://www.psychologytools.com/resource/emotions-motivate-actions/

Worry Flowchart

Worry is a cognitive process that involves thinking about problems that might happen in a way that causes anxiety. Not all worry is problematic – we ... https://www.psychologytools.com/resource/worry-flowchart/

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/

Audio Collection: Psychology Tools For Relaxation

The Psychology Tools For Relaxation Audio Collection is designed to help anyone experiencing stress or heightened physiological arousal. The audio col ... https://www.psychologytools.com/resource/psychology-tools-for-relaxation-audio-collection/

Anxiety - 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/anxiety-self-monitoring-record/

Mastery Of Your Anxiety And Worry (Second Edition): 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/

Behavioral Experiment

Behavioral experiments are planned experiential activities to test the validity of a belief. They are one of the most powerful techniques available to ... https://www.psychologytools.com/resource/behavioral-experiment/

Abandonment

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/abandonment/

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/

Valued Domains

Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, such as ... https://www.psychologytools.com/resource/valued-domains/

Behavioral Experiment (Portrait Format)

Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ... https://www.psychologytools.com/resource/behavioral-experiment-portrait-format/

Worry Postponement

Worry postponement ("worry time") is often prescribed as an exploratory or standalone intervention relatively early in the treatment of GAD, but  ... https://www.psychologytools.com/resource/worry-postponement/

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/

What Keeps Generalized Anxiety And Worry 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-generalized-anxiety-and-worry-going/

What Keeps Obsessive Compulsive Disorder (OCD) Going?

The "What Keeps It Going?" series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, t ... https://www.psychologytools.com/resource/what-keeps-obsessive-compulsive-disorder-ocd-going/

Decatastrophizing

Catastrophic thinking (magnification) is characteristic of many anxiety problems. This CBT worksheet for decatastrophizing is a tool for cognitive res ... https://www.psychologytools.com/resource/decatastrophizing/

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/

Compassionate Thought Challenging Record

Thought challenging records are commonly used in CBT to help people to evaluate their negative automatic thoughts for accuracy and bias. This Compassi ... https://www.psychologytools.com/resource/compassionate-thought-challenging-record/

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/

Fear Ladder

The Fear Ladder is a tool for exploring and ranking the contexts or situations in which a client experiences fear. It is designed to help the client a ... https://www.psychologytools.com/resource/fear-ladder/

Evaluating Unhelpful Automatic Thoughts

The Evaluating Unhelpful Automatic Thoughts guide is written for clients who struggle with negative automatic thoughts. It provides a comprehensive in ... https://www.psychologytools.com/resource/evaluating-unhelpful-automatic-thoughts/

Values: Connecting To What Matters

Values: Connecting To What Matters is a practical self-help guide which introduces the reader to a cornerstone of acceptance and commitment therapy (A ... https://www.psychologytools.com/resource/values-connecting-to-what-matters-full-guide/

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Therapist Guide

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition) comes in two volumes. This page is for the Therapist Guide. ... https://www.psychologytools.com/resource/unified-protocol-for-transdiagnostic-treatment-of-emotional-disorders-second-edition-therapist-guide/

How Breathing Affects Feelings

Normal, anxious, and exercise breathing have significant effects upon our physiology and our emotions. This information handout explains the physiolog ... https://www.psychologytools.com/resource/how-breathing-affects-feelings/

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Client Workbook

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition) comes in two volumes. This page is for the Client Workbook. ... https://www.psychologytools.com/resource/unified-protocol-for-transdiagnostic-treatment-of-emotional-disorders-second-edition-client-workbook/

Panic Formulation

The cognitive approach to panic suggests that anxiety escalates rapidly when physical sensations of panic are misinterpreted as signs of danger, which ... https://www.psychologytools.com/resource/panic-formulation/

Choosing Your Values

Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, includin ... https://www.psychologytools.com/resource/choosing-your-values/

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/

Exploring Valued Domains

Values are the “principles for living” that capture what matters most to people. Elucidating values can serve many therapeutic functions, such as ... https://www.psychologytools.com/resource/exploring-valued-domains/

[Free Guide] An Introduction To Values

People’s lives feel unfulfilling or directionless if they’re not guided by values. An Introduction to Values is a practical self-help guide design ... https://www.psychologytools.com/resource/an-introduction-to-values/

Audio Collection: Psychology Tools For Mindfulness

The Psychology Tools For Mindfulness Audio Collection is the perfect way to introduce your clients to the practice of mindfulness. Developed by a clin ... https://www.psychologytools.com/resource/psychology-tools-for-mindfulness-audio-collection/

Core Belief Magnet Metaphor

Core beliefs (schemas) are self-sustaining. They act to 'attract' confirmatory evidence and 'repel' (or distort) disconfirmatory evidence. This inform ... https://www.psychologytools.com/resource/core-belief-magnet-metaphor/

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/

Habituation

The Habituation information sheets are designed to help clinicians to explain the concept of habituation and its role in exposure therapy. The handout ... https://www.psychologytools.com/resource/habituation/

Exposure Session Record

The Exposure Session Record is a tool for recording clients’ use of exposure. The worksheet guides clients to identify a specific fear they are will ... https://www.psychologytools.com/resource/exposure-session-record/

Managing Social Anxiety (Third Edition): 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/

Pie Chart - Responsibility

The Pie Chart - Responsibility exercise is designed to guide clients through the process of clarifying and re-evaluating their responsibility for nega ... https://www.psychologytools.com/resource/pie-chart-responsibility/

What Keeps Low Self-Esteem 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-low-self-esteem-going/

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/

Interoceptive Exposure

Misappraisals of body sensations trigger emotional and physiological reactions of fear and heightened arousal. These feelings motivate behavioral resp ... https://www.psychologytools.com/resource/interoceptive-exposure/

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/

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/

Worry – Self-Monitoring Record

The Worry – Self-Monitoring Record worksheet is designed to help clients capture information about situations where they engaged in worry. Consisten ... https://www.psychologytools.com/resource/worry-self-monitoring-record/

What Keeps Social 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 concise, t ... https://www.psychologytools.com/resource/what-keeps-social-anxiety-going/

Worry Thought Record

Anxiety stems from negative predictions about the future (and also from assumptions that one will not be able to cope with the magnitude of the threat ... https://www.psychologytools.com/resource/worry-thought-record/

What Keeps Health 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-health-anxiety-going/

Boundaries - 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/boundaries-self-monitoring-record/

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/

Autonomic Nervous System

The autonomic nervous system (ANS) automatically regulates the function of body systems outside of voluntary control. The Autonomic Nervous System han ... https://www.psychologytools.com/resource/autonomic-nervous-system/

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/

Interpersonal Beliefs And Styles

Interpersonal issues and relationship problems form an important part of what clients bring to therapy: they might present as clients’ current conce ... https://www.psychologytools.com/resource/interpersonal-beliefs-and-styles/

Mastery Of Your Anxiety And Panic (Fifth Edition): 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/

Progressive Muscle Relaxation (Audio)

Progressive Muscle Relaxation is an audio exercise from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to help anyone exper ... https://www.psychologytools.com/resource/progressive-muscle-relaxation-audio/

Exposures For Fear Of Uncertainty

Fear of uncertainty is commonly associated with many psychological difficulties, including generalized anxiety disorder (GAD), obsessive compulsive di ... https://www.psychologytools.com/resource/exposures-for-fear-of-uncertainty/

"Should" Statements

“Should” statements (sometimes referred to as ‘musturbation’, ‘necessitous thinking’, ‘self-commands’, and ‘injunctions’) are char ... https://www.psychologytools.com/resource/should-statements/

Exposure Practice Form

Exposure is an effective treatment for many forms of anxiety. The Exposure Practice Form is a CBT worksheet which guides therapists and clients throug ... https://www.psychologytools.com/resource/exposure-practice-form/

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/

Emotional Reasoning

The Emotional Reasoning information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effec ... https://www.psychologytools.com/resource/emotional-reasoning/

Attention Training Experiment

Self-focused attention can make people less likely to see their social performance in a positive light, and contributes to the maintenance of social a ... https://www.psychologytools.com/resource/attention-training-experiment/

Mastery Of Your Anxiety And Panic (Fifth Edition): 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/

CBT Appraisal Model

The CBT Appraisal Model worksheet is a transdiagnostic formulation tool. The centrality of appraisals underpins all of the disorder-specific cognitive ... https://www.psychologytools.com/resource/cbt-appraisal-model/

Learning To Relax (CYP)

Stress and tension are prevalent complaints amongst children and young people. Teaching relaxation exercises can engender a beneficial sense of contro ... https://www.psychologytools.com/resource/learning-to-relax-cyp/

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/

Cognitive Behavioral Model Of Generalized Anxiety Disorder (GAD: Dugas, Gagnon, Ladouceur, Freeston, 1998)

Individuals with generalized anxiety disorder (GAD) report significant worry which they find difficult to control and experience as distressing. Numer ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-generalized-anxiety-disorder-gad-dugas-gagnon-ladouceur-freeston-1998/

Your Stone Age Brain

Your Stone Age Brain is an information handout which describes the freeze-flight-fight response: a set of evolutionary adaptations that increase the c ... https://www.psychologytools.com/resource/your-stone-age-brain/

Mastery Of Your Anxiety And Worry (Second Edition): 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/

What Keeps Post-Traumatic Stress Disorder (PTSD) Going?

The "What Keeps It Going?" series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, t ... https://www.psychologytools.com/resource/what-keeps-post-traumatic-stress-disorder-ptsd-going/

How Your Body Responds To Stress

Many clients identify with the concept of ‘stress’ more readily than ‘threat’ and the The How Your Body Responds To Stress information handou ... https://www.psychologytools.com/resource/how-your-body-responds-to-stress/

Fight or Flight (CYP)

The Fight Or Flight (CYP) information handout has been specifically designed for younger children and includes carefully simplified language. The prof ... https://www.psychologytools.com/resource/fight-or-flight-cyp/

Health Anxiety - 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/health-anxiety-self-monitoring-record/

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/

Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with h ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-health-anxiety-salkovskis-warwick-deale-2003/

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/

What Keeps Panic Going?

The "What Keeps It Going?" series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concise, t ... https://www.psychologytools.com/resource/what-keeps-panic-going/

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/

ABC Model

ABC is an acronym for Antecedents, Behavior, Consequences. It is used as a tool for the assessment and formulation of problem behaviors and is useful ... https://www.psychologytools.com/resource/abc-model/

Selective Attention

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

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/

Catching Your Thoughts (CYP)

Before thoughts can be examined or challenged they must be ‘caught’ – they must be noticed and distinguished from events and feelings. The Catch ... https://www.psychologytools.com/resource/catching-your-thoughts-cyp/

Managing Social Anxiety (Third Edition): 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/

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/

Health Anxiety Thought Record

Individuals with health anxiety experience clinically significant distress associated with health concerns. This thought-challenging record enables cl ... https://www.psychologytools.com/resource/health-anxiety-thought-record/

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

  • Oxford - Agoraphobic Avoidance Scale (O-AS) | Lambe, S., Bird, J. C., Loe, B. S., Rosebrock, L., Kabir, T., Petit, A., ... & Freeman, D. | 2023
    • Scale
    • Reference Lambe, S., Bird, J. C., Loe, B. S., Rosebrock, L., Kabir, T., Petit, A., ... & Freeman, D. (2023). The Oxford agoraphobic avoidance scale. Psychological Medicine, 53(4), 1233-1243.
  • Brief Fear of Negative Evaluation Scale | Leary | 1983
  • Severity Measure For Agoraphobia | Craske, Wittchen, Bogels, Stein, Andrews, Lebu | 2013
  • Social Phobia Scale | Mattick, Clarke | 1995
  • Social Phobia Inventory (SPIN) | Connor, Davidson, Churchill, Sherwood, Weisler, Foa | 2000
  • Severity Measure For Specific Phobia | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Severity Measure For Social Anxiety Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Severity Measure For Panic Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Severity Measure For Generalized Anxiety Disorder | Craske, Wittchen, Bogels, Stein, Andrews, Lebeu | 2013
  • Spence Children’s Anxiety Scale | Spence | 1998
  • Penn State Worry Questionnaire | Meyer, Miller, Metzger, Borkovec | 1990
    • 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 Therapy, 28(6), 487-495.
    • Scale archive.org
  • Panic Disorder Severity Scale (PDSS) | Shear, Brown, Barlow, Money, Sholomskas, Woods, Gorman, Papp | 1997
    • 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 Psychiatry, 154(11), 1571-1575.
    • Scale
  • Mobility Inventory For Agoraphobia(MIA) | Chambless, Caputo, Jasin, Gracely, Williams | 1985
    • Chambless, D. L., Caputo, G. C., Jasin, S. E., Gracely, E. J., & Williams, C. (1985). The mobility inventory for agoraphobia. Behaviour research and therapy, 23(1), 35-44.
    • Scale
  • Liebowitz Social Anxiety Scale (LSAS-SR) | Liebowitz | 1987
  • Health Anxiety Inventory (HAI-18) | Salkovskis, Rimes, Warwick, Clark | 2002
    • Scale
    • Reference 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.
  • Hamilton Rating Scale For Anxiety (HAM-A) | Hamilton | 1959
    • Hamilton, M. (1959).The assessment of anxiety states by rating. British Journal of Medical Psychology 32, 50-55.
    • Scale
  • Generalized Anxiety Disorder 7-item (GAD-7) | Spitzer, Kroenke, Williams, Lowe | 2006
    • Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder. Arch Inern Med. 2006;166:1092-1097.
    • Scale
  • Fear Questionnaire (FQ) (Phobia) | Marks, Matthews | 1979
    • Marks, I. M., & Mathews, A. M. (1979). Brief standard self-rating for phobic patients. Behaviour Research and Therapy, 17(3), 263-267.
    • Scale
  • Brief Fear Of Negative Evaluation Scale | Leary | 1983

Guides and workbooks

  • Anxiety And Substance Use | NDARC: Mills, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Triningham | 2011
  • Specific phobia: patient treatment manual | Clinical Research Unit for Anxiety and Depression (CRUfAD)
  • Working To Overcome Anxiety (Workbook) | Lucock, Noble, Pallister, Horsefield, Padgett, Westley, Atha, Khan | 2015
  • Social Anxiety (An NHS Self-Help Guide) | Lesley Maunder, Lorna Cameron | 2020
  • Phobia Self-Help Booklet | Anne Joice, Jim White | 2006
  • Panic attacks: what they are and how to stop the next one | Glasgow STEPS
  • Coping with panic | Charles Young, Alison Hunte, Jessica Newell, Pat Valian | 2011
  • Health Anxiety – A Self-Help Guide | Maunder, Cameron, Young, Leyland | 2015

Information Handouts

Information (Professional)

Presentations

  • Cognitive-Behavioral Therapies for Social Anxiety Disorder: Integrating the 3 Waves of Evidence-Based Therapy | Larry Cohen | 2022
  • Why worry? Key cognitive processes that maintain worry and Generalised Anxiety Disorder | Colette Hirsch
  • New developments in exposure therapy for anxiety and related disorders: the inhibitory learning approach | Blakey, Abramowitz | 2018
  • Bringing Specificity to Generalized Anxiety Disorder: Conceptualization and Treatment of GAD using Intolerance of Uncertainty as the Theme of Threat | Robichaud | 2013
  • GAD – a cognitive model and treatment
  • Desirable difficulties: optimizing exposure therapy for anxiety through inhibitory learning | Abramowitz, Jacoby, Blakey | 2018

Self-Help Programmes

Treatment Guide

  • Comprehensive cognitive behavior therapy for social phobia: a treatment manual | Deborah Roth Ledley, Edna B. Foa, Jonathan D. Huppert (in consultation with David M. Clark) | 2005
  • Cognitive behavioral therapy for anxiety: an application of the F.E.A.R. model for adults | Stephen Lenz
  • The CARS cognitive behavioral treatment for anxiety manual | Center for Adolescent Research in Schools | 2014
  • Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders (2014) | Katzman et al | 2014
  • Panic disorder: Manual for Improving Access to Psychological Therapy (IAPT) High intensity CBT therapists. | David Clark, Paul Salkovskis | 2009
  • Comprehensive cognitive behavior therapy for social phobia: a treatment manual | Ledley, Foa, Huppert, Clark | 2006
  • NICE Guidelines For Social Anxiety Disorder | NICE | 2013
  • NICE Guidelines For GAD And Panic | NICE | 2011
  • A brief cognitive-behavioural treatment for social anxiety disorder | Eric P. Morris, David Mensink, and Sherry H. Stewart

Worksheets

Recommended Reading

Health anxiety

  • Walker, J. R., Furer, P. (2008). Interoceptive exposure in the treatment of health anxiety and hypochondirasis. Journal of Cognitive Psychotherapy, 22(4), 366-378

Social Anxiety Disorder

  • 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
  • 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
  • Veale, D. (2003). Treatment of social phobia. Advances in Psychiatric Treatment, 9, 258-264
  • Wild, Hackmann, Clark (2008). Rescripting early memories linked to negative images in social phobia: a pilot study. Behaviour Therapy, 39(1), 47-56.
  • 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
  • Clark, D. M. (2001). A cognitive perspective on social phobia

Panic disorder

  • Wells, A. (1997). Cognitive Therapy of Anxiety Disorders. Chichester: Wiley.
  • 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
  • Huppert, J. D., & Baker-Morissette, S. L. (2003). Beyond the manual: The insider’s guide to panic control treatment.Cognitive and Behavioral Practice,10(1), 2-13.
  • Clark, D. A. (1999). Anxiety disorders: Why they persist and how to treat them. Behaviour Research and Therapy, 37, S5-S27

Health anxiety

  • 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
  • Furer, P., Walker, J. R. (2008). Death anxiety: A cognitive behavioural approach. Journal of Cognitive Psychotherapy, 22(2), 167-182
  • 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

Generalized Anxiety Disorder

  • 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 Research,29(1), 71-88.
  • 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 Practice,9(1), 54-68
  • 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 Practice,9(1), 85-90
  • Fresco, D. M., Mennin, D. S., Heimberg, R. G., & Ritter, M. (2013). Emotion regulation therapy for generalized anxiety disorder.Cognitive and Behavioral Practice,20(3), 282-300 nih.gov
  • Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder.Behavioural and cognitive psychotherapy,23(3), 301-320
  • 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 Practice,20(3), 301-313.
  • 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 Practice,20(3), 301-313
  • Borkovec, T. D., Alcaine, O., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder.Generalized anxiety disorder: Advances in research and practice,2004.
  • Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model.Behaviour research and therapy,36(2), 215-226.
  • 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.
  • 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.
  • 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 psychology,7, 1723
  • 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

General

  • Clark, D. M. (1999). Anxiety disorders: why they persist and how to treat them. Behaviour Research and Therapy, 37, S5-S27
  • Task concentration training and fear of blushing | Bögels, Mulkens, De Jong | 1997

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.