Trigger/Situation:

When? Where? What? With whom?

What did you feel anxious about?

Tight Chest, Shortness of

Physical
Sensations Breath, Nausea, Shaking

Emotions
(What did you
The
Automatic
feel while Anxiety Thoughts Challenging Negative
anxious)
Cycle Thoughts/Thought Traps

Negative Thinking/
Thinking Traps:

Behaviors i.e. Catastrophizing

(Automatic (Expecting the worst)
***Temporary Relief response: Rumination
from Avoidance/ What did you All-or-Nothing
Reassurance do to
handle/cope
Seeking. with anxiety)

Stopping Reassurance-
seeking / Avoidance

Source: Anxiety Toolbox Student Workbook

Identifying and Challenging Negative Thoughts

1. Event/Situation: What happened? What triggered off this episode of anxiety? Describe the situation as it happened, without interpretation/s.

2. Thoughts: What was going through my mind regarding the situation? What is upsetting about this thought? What am I worrying about? What am I
predicting or jumping into conclusion? What does this thought say about me?

Underline the most bothersome thought and rate how much you believe it (0-10)

3. Emotions: When I think this way, what emotions do I feel? Rate the intensity (0-10)
How does my body react? What physical sensation do I experience?

4. Behavior/Response: What do I do as a result of my thoughts, feelings, and physical sensations? Was my response beneficial to me? Did it help in the
situation?

5. Challenging my Thoughts
What factual evidence/s support my thought? Am I 100% certain that What evidence does not support my thought? Am I worrying about worry?
my thoughts were to come true?

6. What could I do if my thoughts were indeed true and has factual basis? How can I cope with it?

7. Are there any other possible explanations for my symptoms, or for my doctor’s response?
Any medical condition that may explain the symptoms that you are experiencing? Change in diet or routine? Increased activity and stress level

What is the most likely explanation then for my symptoms?

8. Adopting a Realistic and more positive thought

Based on the evidences (in support of and against my thought) what Rate how much you believe now your original thought.
would be a more realistic and positive way of looking at my symptom/s?
Re-rate the intensity of emotion that you originally were feeling.
With a more realistic and positive thought, what can I do differently
when I have symptoms in the future?
Source: Anxiety Toolbox Student Workbook