CBT Worksheets for Anxiety (downloadable PDF): A simple CBT workbook

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A simple CBT worksheets workbook to record progress when using CBT for anxiety.



cbt worksheets for anxiety

CBT Worksheets for Anxiety will be an ideal book for therapists to gift those who decide to undertake CBT for anxiety. Full of useful exercises and blank CBT sheets, readers can keep all their CBT records in one place and look back on them whenever they need to. All the worksheets in this book can be photocopied so this book may also be useful for therapists working with their clients. Each page has been written in a simple, straight-forward manner to help people make the most of their CBT.

The photocopyable CBT Worksheets in this book fit very nicely with the ‘The Anxiety and Worry Workbook’ by David A. Clark & Aaron T. Beck and are an ideal accompaniment to ‘The Anxiety & Phobia Workbook’ by Edmund Bourne.


ISBN: 978-1533297983
Pages: 148
File size: 12 MB
Page size: 21 cm x 29.7 cm


“The writing is beautiful and the work is filled with exercises that allow readers to make the transforming journey through their anxiety, diagrams that are as symbolic as they are helpful, examples that readers will easily relate to, powerful illustrations, and questions that bring clarity and help readers work better on themselves” ***** Readers’ Favorites

“CBT Worksheets for Anxiety” by Drs. James Manning and Nicola Ridgeway is an incredible resource for anyone who has difficulty dealing with life stressors, psychological concerns, or anxiety in their daily lives.” Readers Views

An extract from CBT Worksheets for Anxiety (Chapter 9) is shown below

There are several ways to change physiological processes associated with anxiety and we will describe several strategies in this chapter. It is important to note that these strategies are not supposed to encourage avoidance of symptoms of anxiety. (Avoidance is likely to result in your anxiety symptoms remaining for a longer period of time.)

Temporarily reduce your stress levels (extracted from CBT Worksheets for Anxiety)

Individuals with stressful lives can experience high baseline anxiety/stress levels due to a number of factors. Based on this suggestion it could be helpful for you to look at specific areas where you may be able to temporarily reduce your stress levels, thereby reducing your overall threat response activation. Solutions for stress reduction could be a) working less hours, or b) lessening commitments in various areas. Reducing stress levels will not necessarily remove anxiety symptoms but they can become less severe.

Abdominal breathing (extracted from CBT Worksheets for Anxiety)

One strategy to utilise if you are experiencing panic symptoms is abdominal breathing. Deliberately breathe deeply and slowly, inhaling air to the bottom of your lungs while concentrating on your breath. This will help to prevent hyper-ventilation, one of the main reasons for an experience of dizziness or light-headedness. If you are experiencing panic symptoms, breathing more slowly will reduce the amount of carbon dioxide that is leaving your body, and thereby produce a calming effect.

Focused distraction (extracted from CBT Worksheets for Anxiety)

A temporary short-term strategy for anxiety is focused distraction. Distraction can be used to prevent negative self-talk and catastrophic thinking. There are a number of different ways of carrying out distraction. One method is to look at the details of everything around you, focusing your attention externally. In this respect you will be looking at the colours, textures, smells, patterns in your surroundings. This is deliberate behaviour designed to intentionally divert your focus away from frightening thoughts and feelings, and towards an awareness of your environment. When you do this ask yourself, ‘What do I see, hear, or notice outside of myself?’

Guided imagery (extracted from CBT Worksheets for Anxiety)

Guided imagery can reduce anxiety symptoms for many people. As a result of being offered imaginary information through the senses, the primitive part of the mind can be deceived into believing that he or she is in an imaginary place, thereby creating a calming effect. When primitive areas of the brain become calmer, this then allows the regulator (prefrontal cortex) and thinking mind (neocortex) to become more dominant. At times, guided imagery is sufficient to break many individuals out of an anxious state, which in turn, helps people to gain access to more balanced thoughts. Guided imagery exercises can be downloaded from the internet or purchased as digital downloads/CDs. The best imagery exercises focus on all of the senses, particularly what is seen, heard, and felt. We have placed a typical imagery exercise at the end of this chapter, called the Safe Place Exercise, (see Tables 6a and 6b).

Systematic relaxation (extracted from CBT Worksheets for Anxiety)

One strategy to utilise if you are experiencing panic symptoms is systematic relaxation. This can be achieved by focusing on one area of the body at a time, and by either clenching muscles or stretching different body parts. Most systematic relaxation exercises start with the toes and gradually work through the body until finally reaching the head. As with guided imagery these exercises can easily be downloaded from the internet or purchased as digital downloads or as CD’s. Yoga helps many people with anxiety and it incorporates many of these exercises.

Some studies have found that regular exercise produces the same benefits on mood as medication, while other studies have found that people who carry out regular exercise have better mental health than those who do not. Many experts suggest that exercise improves mood by reducing stress levels: several scientific studies have found that although levels of cortisol increase during exercise, cortisol levels after exercise become lower and remain at more balanced levels.

Massage (extracted from CBT Worksheets for Anxiety)

Several studies have found that massage (involving skin to skin touch) reduces anxiety and stress levels. The type of massage does not seem to matter. Interestingly, massages where massage therapists wore gloves were found to be not as effective at relieving anxiety.


Medication is still the most commonly used treatment for anxiety, and evidence indicates that a combination of CBT and medication is more beneficial than using either approach alone. There are logical reasons that explain why medication enhances a CBT approach. If, at an organic level, the mind does not have the capacity to think straight there is very little likelihood that people will have the concentration or energy to complete CBT exercises effectively, or to make any of the changes we have covered in this book. Medication may give people the extra energy or boost required to make these changes. Equally, if you take medication without making any changes to your behaviour you will not be making the best use of your medication.

Mindfulness (extracted from CBT Worksheets for Anxiety)

Growing evidence indicates that mindfulness can be very helpful for people who experience anxiety. Mindfulness encourages the processing and observation of feelings; helps people to stay in the present moment and detach themselves from rumination and worry and; exercises the prefrontal cortex which then becomes more effective at 1) reducing background noise in the mind, and 2) regulating emotions.

As with the use of CBT exercises, you will need to keep using mindfulness-based approaches in order to maintain your positive mood state. Being mindful will also help you become much more aware of the types of environment and people that impact on your mood state. With awareness comes choice. You can choose to move away from negative environments and negative people if you wish. Equally, you can choose to think negatively about others or you can choose to think compassionately.

A mindfulness practice can be incorporated into many daily activities to make good use of your time. You can practise mindfulness in the shower, while eating, running, driving, and doing housework. The list is endless really. Practising mindfulness does not necessarily need additional time once you have taken the time to learn how to complete the exercises.

Eye Movement Desensitisation and Reprocessing (EMDR) (extracted from CBT Worksheets for Anxiety)

EMDR is best known for its use with individuals suffering from Post-Traumatic Stress Disorder. Rapid eye movement is used in conjunction with accessing traumas, which allows people to process partially processed or unprocessed memories. As unprocessed memories are stored in subcortical regions of the brain, there is a tendency for many individuals to become emotionally distressed in environments that have cues connected to their previous memories. When this occurs, people can feel emotionally distressed, but will often not understand why.
EMDR reduces the impact of traumatic memories on anxiety and many people find that after they have had a course of EMDR their anxiety has been turned down a notch or two.

Walking in the woods (extracted from CBT Worksheets for Anxiety)

Although walking in the woods could also be classed as exercise, many scientists suggest that additional benefits beyond exercise can be obtained by breathing in phytoncides emitted by plants. Plants emit phytoncides to protect themselves from rotting and being eaten by insects. Breathing in phytoncides is thought to enhance immune system functioning in humans.

Cold showers (extracted from CBT Worksheets for Anxiety)

This is perhaps the quickest but also most uncomfortable way to change physiological state amongst the ideas we have included in this chapter. Cold showers trigger a process known as vaso constriction. This results in blood being pushed away from the extremities and moved towards the core. Research has found that cold showers reduce levels of cortisol (a hormone often associated with stress) in the body. If you are considering having cold showers it is best to introduce your body to the shower gradually, for example putting one part of your body in cold water first, before immersing the whole body.

Cut back on caffeine (extracted from CBT Worksheets for Anxiety)

A huge number of scientific studies have found that consuming caffeinated products, such as cola, tea, and coffee increase anxiety levels. For some, high levels of caffeine consumption can lead to panic attacks.

Reduce alcohol consumption (extracted from CBT Worksheets for Anxiety)

Although many people find that drinking alcohol helps them to relax, relaxation only occurs in the initial phase. As the body works to metabolise or burn off alcohol, anxiety actually increases. As a result, many people with anxiety notice they wake up feeling more anxious when they have consumed alcohol the night before.


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