MedStart Psychiatry · Patient Tools
Anxiety Thought Record
Based on Cognitive Behavioral Therapy (CBT) principles
How to use this worksheet: When you notice anxiety, worry, or a strong negative emotion, work through each step below as soon as possible — ideally within a few hours of the experience. You can complete one worksheet per situation. Bring completed worksheets to your appointment.
1
The Situation
What was happening? Where were you, who was there, what were you doing?
Be factual — just the observable facts, not your interpretation of them.
2
Emotions & Physical Sensations
What emotions did you feel? Circle any that apply, or write your own.
AnxiousAfraid
OverwhelmedPanicked
EmbarrassedAshamed
AngrySad
HopelessIrritable
LonelyGuilty
________________
Rate the intensity of each emotion (0–100%):
Physical sensations (tight chest, racing heart, etc.):
3
The Automatic Thought
What went through your mind? What were you telling yourself about the situation?
Try to capture the exact words — "I'm going to fail," "They think I'm stupid," "Something bad is going to happen."
How much did you believe this thought in that moment? (circle)
0%
10
20
30
40
50
60
70
80
90
100%
4
Examine the Evidence
Evidence that supports this thought:
Evidence that does NOT support this thought:
What would you say to a close friend who had this thought in this situation?
5
A More Balanced Thought
Based on the evidence, what is a more realistic, balanced way to think about this situation?
This isn't about being positive — it's about being accurate. A balanced thought acknowledges both the difficulty and the fuller reality.
How much do you believe this balanced thought? (circle)
0%
10
20
30
40
50
60
70
80
90
100%
6
Outcome
After completing this record, how do you feel now? Re-rate your emotions (0–100%):
What, if anything, will you do differently next time?
Notes for my next appointment