175
From
Cognitive Therapy of Anxiety Disorders: Scienc
e and Practice
by David A. Clark and Aaron T. Beck. Copy
right 2010 by The Guilford Press. Permission to photocopy
this appendix is granted to purchasers of this book fo
r personal use only (see copyright page for details).
aPPENDIX 5.10
Anxious Reappraisal Form
Name:
Date:
Instructions:
Please complete the form below to record your perspective whe
n feeling anxious and when not feeling anxious. When you are
anxious, describe the worst outcome that you fear most and rate its felt p
robability from 0 (not at all likely to happen) to 100 (absolutely
expect it to happen). Then indicate how well you think you could co
pe with the anxiety and rate your level of confidence in yourself from 0 (no
confidence) to 100 (absolute confidence). Next repeat the form when you are n
ot feeling anxious. As you look back on those anxious situations,
what is the expected outcome and what is your perceived ability to cope w
ith your anxiety?
When Feeling anxious
When Not Feeling a
nxious
Feared Outcome
Ability to Cope with Anxiety
Expected Outcome
Ability to Cope with Anxiety
[Describe worst outcome and rate
its probability 0–100]
[Describe coping ability and
confidence 0–100]
[Describe most likely outcome and
rate its probability 0–100]
[Describe coping ability and
confidence 0–100]