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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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"Should" Statements

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

A Guide To Emotions (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/a-guide-to-emotions-psychology-tools-for-living-well

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

Am I Experiencing Death Anxiety?

Am I Experiencing Death Anxiety? is an indicative screening tool, designed to help clients self-assess whether their experiences might warrant further ... https://www.psychologytools.com/resource/am-i-experiencing-death-anxiety

Am I Experiencing Generalized Anxiety Disorder (GAD)?

Generalized anxiety disorder (GAD) is a condition characterized by problematic worry. Am I Experiencing Generalized Anxiety Disorder? is an indicative ... https://www.psychologytools.com/resource/am-i-experiencing-generalized-anxiety-disorder-gad

Am I Experiencing Health Anxiety?

Health anxiety (also referred to as illness anxiety disorder and hypochondriasis) is a condition characterized by a preoccupation with, or fear about, ... https://www.psychologytools.com/resource/am-i-experiencing-health-anxiety

Am I Experiencing Social Anxiety?

Social anxiety disorder is characterized by persistent fear or anxiety concerning social or performance situations that is out of proportion to the ac ... https://www.psychologytools.com/resource/am-i-experiencing-social-anxiety

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

Anxiety Self-Monitoring Record (Archived)

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

Approach Instead Of Avoiding (Psychology Tools For Overcoming Panic)

When we start to avoid things it can shrink the number of places that it feels ‘safe’ to go. It can cut us off from rewarding experiences, and avo ... https://www.psychologytools.com/resource/approach-instead-of-avoiding-psychology-tools-for-overcoming-panic

Arbitrary Inference

Arbitrary inference is one of the earliest and broadest cognitive disotortions described in CBT. Beck defines it as "the process of forming an interpr ... https://www.psychologytools.com/resource/arbitrary-inference

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

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

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

Attention Training Practice Record

When people struggle to control the focus of their attention, they find it much harder to interrupt cycles of worry, rumination, and other forms of se ... https://www.psychologytools.com/resource/attention-training-practice-record

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

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

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

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

Avoidance Hierarchy (Archived)

NOTE: An improved version of this resource is available here: Fear Ladder. Older versions of a resource may be archived in the event that they are ava ... https://www.psychologytools.com/resource/avoidance-hierarchy

Balance

Our sense of balance is the result of a complex system which receives visual, vestibular, and proprioceptive inputs. This Balance client information h ... https://www.psychologytools.com/resource/balance

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

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

Behaviors 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 beha ... https://www.psychologytools.com/resource/behaviors-in-panic-psychology-tools-for-overcoming-panic

Being With Difficulty (Audio)

Being With Difficulty is a mindfulness exercise which gently brings present-moment awareness to bear upon thoughts and feelings that are more difficul ... https://www.psychologytools.com/resource/being-with-difficulty-audio

Body Scan (Audio)

The Body Scan is a mindfulness exercise encouraging present-moment awareness, with the sensations of the body being used as an anchor for mindful atte ... https://www.psychologytools.com/resource/body-scan-audio

Body Sensations 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 body ... https://www.psychologytools.com/resource/body-sensations-in-panic-psychology-tools-for-overcoming-panic

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

Breathing To Calm The Body Sensations 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 discusses the ... https://www.psychologytools.com/resource/breathing-to-calm-the-body-sensations-of-panic-psychology-tools-for-overcoming-panic

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

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

Challenging Your Negative Thinking (Archived)

NOTE: An improved version of this resource is available here: Evaluating Unhelpful Automatic Thoughts. Older versions of a resource may be archived in ... https://www.psychologytools.com/resource/challenging-your-negative-thinking

Classical Conditioning

Classical conditioning is a process by which stimuli become associated with responses. This information handout describes key principles of Classical ... https://www.psychologytools.com/resource/classical-conditioning

Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)

Depersonalization is an experience where an individual feels a sense of detachment from themselves, or estrangement from their perceptions, actions, a ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-depersonalization-hunter-phillips-chalder-sierra-david-2003

Cognitive Behavioral Model Of Fear Of Body Sensations

Fear of bodily sensations is present in a number of conditions, most notably panic disorder. The Cognitive Behavioral Model Of Fear Of Bodily Sensatio ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-fear-of-body-sensations

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

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

Cognitive Behavioral Model Of Panic (Clark, 1986)

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/cognitive-behavioral-model-of-panic-clark-1986

Cognitive Behavioral Model Of Persistent Postural-Perceptual Dizziness (PPPD: Whalley, Cane, 2017)

Persistent postural-perceptual dizziness (PPPD) is a form of dizziness which is thought to be maintained by psychological factors. This is a Cognitive ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-persistent-postural-perceptual-dizziness-pppd-whalley-cane-2017

Cognitive Behavioral Model Of Social Phobia (Clark, Wells, 1995)

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/cognitive-behavioral-model-of-social-phobia-clark-wells-1995

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

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

Combined Relaxation Exercise (Audio)

The Combined Relaxation Exercise is an audio track from the Psychology Tools For Relaxation Audio Collection. It is designed to help anyone experienci ... https://www.psychologytools.com/resource/combined-relaxation-exercise-audio

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

Coping With Body Sensations (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 inte ... https://www.psychologytools.com/resource/coping-with-body-sensations-psychology-tools-for-overcoming-panic

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

Court Trial Thought Challenging Record (Archived)

NOTE: An improved version of this resource is available here: Thought Record - Courtroom Trial. Older versions of a resource may be archived in the ev ... https://www.psychologytools.com/resource/court-trial-thought-challenging-record

Critical Care And PTSD

The Critical Care And PTSD information handout is designed to help clients to learn about the properties of critical care that can increase the likeli ... https://www.psychologytools.com/resource/critical-care-and-ptsd

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

Developing Psychological Flexibility

Acceptance and Commitment Therapy (ACT) proposes that suffering is associated with psychological inflexibility. ACT suggests that to increase psycholo ... https://www.psychologytools.com/resource/developing-psychological-flexibility

Disqualifying The Positive

This Disqualifying the Positive information handout forms part of the cognitive distortions series, designed to help clients and therapists work more ... https://www.psychologytools.com/resource/disqualifying-the-positive

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

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

Emotions 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/emotions-in-panic-psychology-tools-for-overcoming-panic

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

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

Exercise For Mental Health

Exercise is an evidence-based treatment for depression and anxiety and research suggests that, in the treatment of depression, exercise interventions ... https://www.psychologytools.com/resource/exercise-for-mental-health

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

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

Exposures For Fear Of Appearing Anxious

Concerns about appearing anxious in front of others plays a central role in social anxiety. Exposure is an effective treatment for tackling these fear ... https://www.psychologytools.com/resource/exposures-for-fear-of-appearing-anxious

Exposures For Fear Of Body Sensations

Fearful responses to physical sensations are common in several disorders. Interoceptive exposure (or ‘symptom induction’) is an effective treatmen ... https://www.psychologytools.com/resource/exposures-for-fear-of-body-sensations

Exposures For Fear Of Breathlessness

Fearful responses to benign physical sensations such as breathlessness are common in several disorders, most notably panic disorder (with and without ... https://www.psychologytools.com/resource/exposures-for-fear-of-breathlessness

Exposures For Fear Of Death

Fear of death is common, and is associated with a variety of psychological disorders including generalized anxiety disorder, depression, panic disorde ... https://www.psychologytools.com/resource/exposures-for-fear-of-death

Exposures For Fear Of Flying

Fear of flying is a very common fear, affecting up to 18% of individuals, and is characterized by intense and persistent fear during, or in anticipati ... https://www.psychologytools.com/resource/exposures-for-fear-of-flying

Exposures For Fear Of Heights

Fear of heights is a very common fear, characterized by an avoidance of high places including staircases, tall buildings, and bridges. Exposure is an ... https://www.psychologytools.com/resource/exposures-for-fear-of-heights

Exposures For Fear Of Illness

Fear of illness is a common and persistent fear that can result in significant functional impairment. Exposure is an effective treatment for health-re ... https://www.psychologytools.com/resource/exposures-for-fear-of-illness

Exposures For Fear Of Losing Control Of Your Mind

Fearful responses to benign physical sensations are common in several disorders, and interoceptive exposure (or ‘symptom induction’) is an effecti ... https://www.psychologytools.com/resource/exposures-for-fear-of-losing-control-of-your-mind

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

Exposures For Fear Of Vomiting

Fear of vomiting is a chronic and distressing difficulty that is associated with significant impairment. Exposure is an effective treatment for addres ... https://www.psychologytools.com/resource/exposures-for-fear-of-vomiting

Externalizing

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

Facing Your Fears (CYP)

Graded or graduated exposure is a traditional way of overcoming fears and phobias. The therapist helps the client to draw up a list of feared situatio ... https://www.psychologytools.com/resource/facing-your-fears-cyp

Facing Your Fears And Phobias

The Facing Your Fears And Phobias guide is written for clients who struggle with fears or phobias. It provides comprehensive information about what fe ... https://www.psychologytools.com/resource/facing-your-fears-and-phobias

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

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

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

Grounding Statements (Audio)

The Grounding Statements exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. This audio track is designed for p ... https://www.psychologytools.com/resource/grounding-statements-audio

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

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

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

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

Health Anxiety Formulation

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/health-anxiety-formulation

Health Anxiety Self-Monitoring Record (Archived)

NOTE: An improved version of this resource is available here: Health Anxiety Self-Monitoring Record. Older versions of a resource may be archived in t ... https://www.psychologytools.com/resource/health-anxiety-self-monitoring-record-edition-1

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

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

How Does This All Add Up To 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 discusses the ... https://www.psychologytools.com/resource/how-does-this-all-add-up-to-a-panic-attack-psychology-tools-for-overcoming-panic

How Is Panic Disorder Different From 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 disambiguates ... https://www.psychologytools.com/resource/how-is-panic-disorder-different-from-a-panic-attack-psychology-tools-for-overcoming-panic

How Much Do You Know About 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 includes a qui ... https://www.psychologytools.com/resource/how-much-do-you-know-about-panic-psychology-tools-for-overcoming-panic

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

Identifying The Meaning Of Body Sensations

Some anxiety disorders (including panic and health anxiety), are concerned with body sensations and symptoms. The Identifying The Meaning Of Body Sens ... https://www.psychologytools.com/resource/identifying-the-meaning-of-body-sensations

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

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

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

Introduction To CBT (Psychology Tools For Overcoming Panic)

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

Intrusive Memory Record

Intrusive (unwanted, involuntary) memories are a common feature of PTSD, but also depression and other conditions. This Intrusive Memory Record is des ... https://www.psychologytools.com/resource/intrusive-memory-record

Jumping To Conclusions

The Jumping to Conclusions information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more ef ... https://www.psychologytools.com/resource/jumping-to-conclusions

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

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

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

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

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) | 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

  • 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
  • Anxiety And Substance Use | NDARC: Mills, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Triningham | 2011
  • 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

  • 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

  • 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
  • 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
  • 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

  • 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

Social Anxiety Disorder

  • 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

  • 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

Health anxiety

  • 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.