Cognitive Therapy of Anxiety Disorders

330

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 8.2

Symptom Reappraisal Form

Name:

Date:

Instructions:

Please use this form to write down any alternative explanations y

ou can think for why you are experiencing a variety of physical

sensations that make you feel anxious or panicky.State the Physical Sensation Experienced (e.g., racing heart, breathlessness, nausea)

List a Number of a

lternative Explanations for the

Sensations Other Than the Worst Outcome (i.e., the

feared catastrophe)

Rate Belief in

Each Explanation

When Not

anxious

(0 –100)*

Rate Belief in

Each Explanation When in a

nxious

State

(0 –100)*

Effectiveness of Explanation in Countering

anxiety

(0 –100)+

1. 
   
   
   
   2. 
      
      
      
      3. 
         
         
         
         4. 
            
            
            
            5. 
               
               
               
               • For belief ratings, 0 = absolutely no belief in the expla
               
               
               
               
            
            
            
            
         
         
         
         
      
      
      
      
   
   
   
   

nation, 100 = absolutely certain that this is the cause of the p

hysical sensations.

+ For effectiveness ratings, 0 = explanation has absolu

tely no positive effect on anxiety, 100 = explanation is compl

etely effective in eliminating anxious feelings.