Cognitive Therapy of Anxiety Disorders

445

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 10.4

Risk and Uncertainty Record Form

Name:

Date:

from

to:

Instructions

: This form should be completed during episodes of daily worry. T

ry to complete the form as close to the worry episode as possible in

order to increase the accuracy of your remarks.Date and Duration of Worry

Primary Worry Concern

[briefly

describe your worries including

the worst outcome you are

thinking about.]

Sequence of “What If” Questions

[List the “what if” questions that are generated during the worry episode.]

Level of

Uncertainty

[Rate 0–100]

*

Responses to Uncertainty

[What

makes the uncertainty of this worry concern intolerable? How have you

tried to reduce the uncertainty?]

*Note:

Rate how much this worry makes you feel uncom

fortable and uncertain about the future outcome of this worry c

oncern from 0 (“no feeling of uncertainty”) to 100 (“I am

feeling extremely tentative, uncertain about the outome”)