Download worksheets on CBT, anxiety, PTSD, self-care and more
Therapy worksheets can make all the difference. While it’s great to talk through new concepts, having a physical tool to share or send home can reinforce all the work done in sessions.
Fortunately, PDF worksheets can work just as well for telehealth as in-person therapy. You can print them out, or share them electronically on-screen or via e-mail.
Here’s a little about how these worksheets were developed, along with descriptions of each.
Article Highlights Background
Background
I developed each of the worksheets below based on my CBT and PTSD training, as well as my real-life experience in the field.
I find many of the mental health worksheets online cover key concepts, but they aren’t always user-friendly.
For example, a “cognitive distortion,” really just refers to an unhelpful thought. “Exposure,” means facing a fear that’s making your life difficult.
(And sometimes all those charts in traditional worksheets just make me dizzy.)
My worksheets and tools generally try to avoid this kind of psychological jargon, especially in the prompts and descriptions for clients. (I do sometimes keep these tech terms in the titles, mainly so that therapists recognize them at a glance.)
While we teachers and counselors like terms like “evidence-based,” many clients simply want to know what these skills mean for their lives, and how they can feel a little better.
They don't necessarily need to know any of the psychology terms to overcome specific symptoms or problems.
With that in mind, here are the worksheets I’ve developed based on concepts like anxiety management, mindfulness, grounding, PTSD treatment, exposure, and self-care.
To get started, my CBT triangle worksheet is available here for free. You can get the rest of these in a bundle at a nominal price. (Use coupon code 1110 for 10% off any of the worksheet kits and downloads.)
If you’re struggling with cost, send me a message and I’ll keep you updated when I run deals or promotions in the future.
Now, let’s get into some therapy worksheets!
CBT Triangle Worksheet
The cognitive behavioral triangle, or CBT triangle, is a quick and easy tool to teach the idea of changing our thoughts.
While feelings are natural, and many thoughts are automatic, we can change negative patterns over time.
For example, if someone tends to beat themselves up anytime they struggle at work, there may be a pattern in place.
They may believe their colleagues or boss don’t like them. This could lead to them feeling anxious or discouraged.
This discouragement could then make it harder to work, repeating the cycle.
With the CBT triangle, you can chart these patterns. The thought, “I’m bad at this job,” connects to the feeling, “discouragement, fear,” which leads to the behavior (taking more time on projects).
This then reinforces the original thought of, “I’m bad at this job,” and the triangle goes round and round.
The most basic step in CBT is to practice changing that original thought.
In a therapy session, we might try changing it to, “I’m still learning this job, but I get a little better each day.”
This would lead to the feeling of hopefulness, and the behavior of asking for help when needed, or getting a project done a bit faster.
This then leads to more positive thoughts, feelings, and behaviors.
This worksheet walks through this process, gives examples, and prompts for your students or clients to practice. (Or you can use it for yourself! I do that plenty.)
Download the CBT triangle worksheet here for free, and get news and freebies in the future.
Anxiety Plan Worksheet
I most often work with problems like anxiety, post-traumatic stress disorder (PTSD), phobias, and panic disorders. These bring nasty symptoms that can lead to staying at home, missing work, and distancing from relationships.
While some anxiety is normal, there’s typically an underlying cause if it’s gotten this bad. While we work on dealing with that main issue, my clients need some relief in the moment.
While there are a handful of skills that work for many people, each of us are unique. That’s why I suggest clients try multiple options to see what works best for them. Simply having one to three tools can help someone get through a very difficult situation.
This worksheet covers the basics of anxiety, and walks the reader through developing a plan to use when things get bad.
You can get the anxiety plan worksheet here, as part of this bundle.
Understanding PTSD Worksheet
There are three main types of PTSD therapy I’ve used with clients. These included prolonged exposure (PE), cognitive processing therapy (CPT), and trauma-focused CBT (TF-CBT). In each of these, the first step is psychoeducation, or learning about the condition.
This worksheet is straightforward and includes the four categories of PTSD symptoms. It then walks you and your client through identifying their symptoms so they can better understand what’s going on.
This is a good tool to use at the beginning of trauma treatment. You can access it as part of the worksheet bundle. Check it out here.
Strong Emotions Worksheet
Feelings are normal. We’re all human, and we all have them in one way or another. Some of us struggle either temporarily or permanently with super-strong emotions.
Many therapies, like DBT (dialectical behavioral therapy) or TF-CBT have elements relating to emotion regulation. We want a balance of facing difficult feelings, accepting them, and decreasing them when they cause us problems.
This worksheet covers those concepts, including elements of exposure and regulation. It also includes tips to use when emotions connect to suicidal ideation or self-harm. This is a great tool to have on hand for yourself or your clients during times of overwhelm.
Get the strong emotions worksheet here as part of this set.
Challenging Thoughts
This worksheet builds on the idea of the CBT triangle, but takes it a step further. While the triangle is a place to start for everyday struggles, the process can be a bit harder for deeper issues.
One way to tackle these more difficult thoughts is through the socratic questioning process. This is a technique where a therapist guides the client in thinking through a belief, rather than simply telling them what to believe.
For example, if something thinks, “I’m a failure at everything I try,” it’s easy to answer, “No you’re not, and here’s why ...”
While that could be helpful, it can sometimes backfire. Many people hear that type of response all the time, but still don’t accept it. They may even try to defend the reasons they’re a failure, reinforcing the idea.
With questions, we can guide our own brains to come to new conclusions. This worksheet walks through a common process of challenging this type of thought.
Rather than jumping to the end, you or your client ask questions like, “Why do I believe this thought?” and “What is the evidence against this?”
Not only does this get us thinking differently about a particular belief, it can reprogram the way our brain responds to these thoughts in general.
This worksheet can be a great tool all on its own, or can be a starting place for you and your clients or students to begin to think differently.
Download it here as part of the anxiety set.
Reframing Trauma Thoughts
The previous worksheets build up to this more challenging one, which is why I developed them as a set.
When someone has PTSD, it means they have particular thoughts about the trauma that are holding them back. In CPT, they call these “stuck points.”
These thoughts usually include ones of self-blame for the trauma, and beliefs by the client that they can no longer be safe in the world.
This feeling of being unsafe is what leads the body to respond with other symptoms, such as hypervigilance, and intrusive memories. It’s trying to keep the person on alert, so they’ll be prepared for the next dangerous situation.
However, in most cases the individual is not in constant danger once the traumatic event has passed. However, their stuck points continue to convince them they are.
This worksheet covers common PTSD-related beliefs, often called “cognitive distortions,” relating to the trauma. It includes examples, and how one might challenge these thoughts.
This type of worksheet is likely to be used over several sessions in therapy. It fits particularly well with the processes of TF-CBT and CPT. It could also be used as an adjunct to PE and EMDR (eye movement desensitization reprocessing) therapy.
You can download the worksheet right away, and part of the anxiety and PTSD set here.
Anxiety Hierarchy
It’s harder to get around this particular technical term. The anxiety hierarchy is sometimes called gradual exposure. I like to call it mindful exposure, because adding the mindfulness element makes it work even better.
An anxiety hierarchy can be used when someone has a phobia, or a particular fear related to their anxiety or PTSD.
When someone continues to avoid the fear, it gets worse over time. Even if they are facing it, they may be powering through, or “white knuckling” it. This can also make the fear stronger, because the body stays on alert for danger.
Mindfully exposing to the fear will help decrease it. Sometimes this takes a while, and other times it only takes once.
For example, if someone has a fear of all dogs, they may start by simply walking near dogs. Over time, this could advance to walking with a friendly dog, all the way up to cuddling up with one.
At some point, the person is likely to replace their unrealistic fear of all dogs with a more balanced one. Rather than believing, “all dogs are dangerous,” they might come to believe, “many dogs are friendly and safe.”
This worksheet walks the reader through that process, and includes a homework sheet they can take with to fill out each time they practice.
Trauma Narrative
If you’re a mental health professional, you may be familiar with the term “trauma narrative, or “written account of the trauma.”
This simply means writing what happened during and after the trauma.
This is often used in therapies like CPT and TF-CBT. In PE, it’s typically done verbally, rather than in written form.
While it can be one of the most difficult parts of recovery, nearly all of my clients who do it say it was the most helpful part of their therapy.
Originally, the trauma narrative was always used in CPT. Over time, the therapists found that some people got better without it, although many clients still choose to do it.
The narrative is a type of mindful exposure in and of itself. Sometimes people struggle with facing their negative beliefs about themselves and the trauma. It may seem too scary to face them head on.
The trauma narrative helps people overcome this roadblock, so they can begin to get better. It also gives some power back. Rather than being controlled by having to avoid memories and fears all of the time, someone can take the reins of their life back.
The trauma narrative worksheet explains this process, and provides the space and structure to complete the narrative. This is generally done with the guidance of a therapist.
This is so that the therapist can help the client work through this challenging step. They can also provide some structure that encourages the survivor to actually do this, rather than always putting it off.
To get the worksheet as part of the set, click here.
Making Meaning
So many people hate the phrase, “everything happens for a reason.” I definitely get that. I’d like to rephrase it to, “We can make meaning of everything that happens.”
This can be a helpful part of recovery, and it seems to help people make peace with bad things. The alternative is to believe that all of life stinks, and will continue to until the end. This is a pretty tough way to live.
This worksheet keeps that step in mind. It’s meant to be used towards the end of working through PTSD symptoms. It looks at the big picture, and looking forward in life. It’s a great tool for those finishing up this portion of their therapy.
To get this worksheet along with the set, visit here.
Grounding Stone Worksheet and Kit
I recently developed this kit in response to our popular grounding stones article. This is a fun and tangible activity that helps teach the concept of mindfulness.
This worksheet includes education about grounding itself, and teaches the steps behind the process.
The steps of using a grounding stone are included in the worksheet. The kit also includes bonuses of posters, an audio meditation of the grounding stone exercise, and editable files to update the documents.
Check it out here, to see what’s included.
Self-Care Guide
It’s great to tackle problems and develop coping skills. Often we also need to look at the big picture as well.
Once we overcome problems like anxiety and PTSD, where do we go from there?
This worksheet takes a broader look at overall wellness. It includes prompts about one’s own strengths, as well as a brainstorming page on how to improve self-care.
This can be a great supplement to any other type of therapy group, class, or event. Download it as an individual worksheet here.
Making Use of Tools
When our lives are focused on helping clients, students, family, and others, things can get hectic. Therapy tools can help take a bit of that pressure off, while still offering evidence-based practices for real issues.
If you’re looking to make progress with your group or clients, stay on track, and use well-supported techniques, I’ve got you covered.
Our most popular product is our anxiety and PTSD bundle of worksheets, which you can download right here, and start using today.
Sources
Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused Cognitive Behavior Therapy for Traumatized Children and Families. Child and adolescent psychiatric clinics of North America, 24(3), 557–570. https://doi.org/10.1016/j.chc.2015.02.005
Walter, K. H., Dickstein, B. D., Barnes, S. M., & Chard, K. M. (2014). Comparing effectiveness of CPT to CPT-C among U.S. Veterans in an interdisciplinary residential PTSD/TBI treatment program. Journal of traumatic stress, 27(4), 438–445.