Weekly Anxiety Therapy Exercise

Name*
Email*
Situation*
Emotion(s) / How it makes you feel*
Unhelpful thought(s)*
Challenges to unhelpful thought(s)
Use the questions listed below to help
Is there any evidence that contradicts this thought?*
Can you identify any of the patterns of unhelpful thoughts described above?*
What would you say to a friend who had this thought in a similar situation?*
How will you feel about this in 6 months time?*
What are the costs and benefits of thinking this way?*
Benefits Cost
Is there another way of looking at this situation?*
Who would you allow yourself to be and do if you didn't have these limiting thoughts?*
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Drop Us A Line Or Request An Appointment

Your Name* *

Your Email *

Your Personal Mobile Phone Number* *

Location of Sessions *

Session Type Needed: *

Are You Hoping To Use Your Insurance? *

Your Complete Date of Birth: *

What Is Your Current Top Concern? *

What Is The Current Trend Of Your Top Concern? *

How Long Have You Been Dealing With Your Top Concern? *

Are You Currently Experiencing Any Suicidal/Self-Harm Thoughts? *

How Would You Describe Your Usual Conversational Style? *

Who Referred You To Us? *

Comment or Message *

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Phone: +1 (310) 500 8442
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Phone: +1 (310) 500 8442
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