Cognitive Therapy of Anxiety Disorders

173

From Cognitive Therapy of Anxiety Disorders: Science and Practice by David A. Clark and Aaron T. Beck. Copyright
2010 by The Guilford Press. Permission to photocopy this appendix is granted to purchasers of this book for personal
use only (see copyright page for details).

aPPENDIX 5.8

Worry Self-Monitoring Form A

Name: Date:

Instructions: Using the form below, please record whether or not you have any worries associated
with your anxiety. In the first column write down some occasions when you are feeling anxious,
then rate the intensity of the anxiety on the 0–100 scale, and then try to capture your first
apprehensive (anxious) thought in the situation. You can go back to the Apprehensive Thoughts Self-
Monitoring Form if you need help identifying the apprehensive thought. In the final column write
down anything that worried you about that situation as well as how long the worry lasted (number
of minutes or hours).

anxious Situation

[Describe briefly and include

date and time]

Intensity

of anxiety

[0–100

scale]

First apprehensive

(anxious) Thought

Worry Content

[Is there anything that worries you

about the situation or the effects

of anxiety? Is there any negative

consequence that worries you?

How long did you worry?

1.

2.

3.

4.

5.