Anxiety curve worksheet

Feared Stimulus: __________________________________________________________

Date: ____________________________________________________________________

Time: ____________________________________________________________________

Anxiety Level (0-10): ________________________________________________________

Date: ______________________________________________________________________

Time: _____________________________________________________________________

Anxiety Level (0-10): _________________________________________________________

Date: _____________________________________________________________________

Time: _____________________________________________________________________

Anxiety Level (0-10): _________________________________________________________

Date: ____________________________________________________________________

Time: ___________________________________________________________________

Anxiety Level (0-10): ________________________________________________________

Date: ____________________________________________________________________

Time: ____________________________________________________________________

Anxiety Level (0-10): _________________________________________________________

Observations:_________________________________________________________________________________________________________________________________________

Challenges to Avoidance Behaviors:___________________________________________________________________________________________________________________________________________

Reflections:_____________________________________________________________________________________________________________________________________________________________________________________________________________________

Reference

Holdaway, C., & Connolly, N. (2004). Getting Through it with CBT: A Young Person's Guide to Cognitive Behavioural Therapy (CBT). Blue Stallion Publications.

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