Cognitive Therapy of Anxiety Disorders

329

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 8.1

Weekly Panic and Acute Anxiety Log

Name:

Date:

Instructions:

Please use this form to record any panic attacks, limited panic a

ttacks or acute anxiety episodes that you experienced in the past

week. Try to complete the form as close to the anxiety episode as possib

le in order to increase the accuracy of your remarks.

Date, Time, and Duration of Episode

Situational Triggers

(Label E or UE)*

Severity/Intensity of a

nxiety (0–100);

(Label FP

a, LP

a,

aa

E)*

Description of the anxious Physical or Mental Sensations

anxious

Interpretation of the Sensations

Evidence for an a

lternative

Interpretation of

Sensations

Outcome (Coping Responses and Sense of Safety)+

1. 
   
   
   
   2. 
      
      
      
      3. 
         
         
         
         4. 
            
            
            
            5. 
               
               
               
               • E = expected to have panic in this situation; UE = pa
               
               
               
               
            
            
            
            
         
         
         
         
      
      
      
      
   
   
   
   

nic occurred unexpectedly, completely out of the blue; FPA = f

ull-blown panic attack; LPA = limited symptom attack;

AAE = acute anxiety episode (sudden onset of anxiety b

ut not panic)

+ rate sense of safety after panic ceases from 0 = don

’t feel at all safe from panic to 100 = feel absolutely safe fro

m further panic