Cognitive Therapy of Anxiety Disorders

163

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 5.2

Situational Analysis Form

Name:

Date:

Directions:

Please write down any situations that triggered an anxiety respon

se. v

ery briefly describe the situation in column two and in the

third column rate the intensity of anxiety (0–100) and its duration (numb

er of minutes). In the fourth column note the most prominent anxious

symptoms you experienced and in the fifth column record any imm

ediate thoughts in the situation. In the final column please comment on your

immediate response to the anxiety.Date/Time

Situation

anxiety Intensity

(0–100) and Duration

(min)

Primary a

nxious

Symptoms

Immediate a

nxious

Thoughts

Immediate Response to

Feeling a

nxious