Cognitive Behavioral Therapy Worksheet

Patient Information

Name: Shawnmarie Carpenter
Age: 55-64
Condition Summary: Stable, experiencing difficulty with sleep patterns contributing to daily fatigue
Main Condition: Anxiety
Current Medication: None
Therapy Experience: None

Introduction to Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a structured, time-limited psychotherapeutic approach that aims to change patterns of thinking or behavior behind people's difficulties, thereby improving the way they feel. This worksheet is designed to help you address your sleep issues and manage anxiety, contributing to better overall well-being.

Identifying Sleep Patterns

1. Sleep Diary

Keep a daily log of your sleep patterns for the next week. This will help us identify any recurring themes or issues.

Date	Time Went to Bed	Time Fell Asleep	Time Woke Up	Time Got Up	Notes (Mood, Anxiety Levels, etc)
[Date]
[Date]
[Date]
[Date]
[Date]
[Date]

2. Reflect on Your Sleep Quality

On a scale from 1-10, how would you rate your sleep quality over the last week?
What factors do you believe contribute to any challenges you experience while trying to sleep?

Identifying Thoughts and Feelings

3. Thought Record

Each time you experience anxiety or difficulty sleeping, record what you're thinking and feeling. This can help identify negative thought patterns.

Date	Situation	Feelings/Emotions	Automatic Thoughts	Alternative Thoughts
[Date]	Difficulty falling asleep
[Date]	Waking up too early
[Date]	Feeling tired during the day
[Date]	General anxiety

Behavioral Changes and Coping Strategies

4. Sleep Hygiene Practices

Implement the following tips to improve your sleep quality:

Create a Bedtime Routine: Aim to go to bed and wake up at the same time every day.
Limit Screen Time: Avoid screens for at least an hour before bedtime.
Create a Comfortable Sleep Environment: Keep your bedroom dark, quiet, and cool.
Avoid Caffeine and Heavy Meals: Try to limit caffeine intake and large meals close to bedtime.

5. Relaxation Techniques

Practice these techniques during the day and before bed:

Deep Breathing Exercises: Inhale deeply through your nose, hold for a few seconds, and exhale slowly through your mouth.
Progressive Muscle Relaxation: Tense and then relax each muscle group in your body, starting from your toes and working up to your head.
Guided Imagery: Imagine a peaceful scene or a place where you feel relaxed and safe.

Setting Goals

6. Goal Setting

Identify one or two specific goals to work towards improving your sleep and reducing anxiety.

Short-Term Goal: For example, “I will practice a bedtime routine five nights this week.”
Long-Term Goal: For example, "In three months, I want to sleep at least 6 hours a night consistently."

Conclusion

By using this worksheet, you are taking proactive steps to manage your anxiety and sleep challenges. Regularly reviewing and updating this information can help track your progress and adjust strategies as necessary. Your commitment to these practices is essential for achieving your goals.

Reminders

Acknowledge and celebrate small successes.
Reach out if you need support or if anxiety feels overwhelming.
Consider scheduling regular follow-up sessions to discuss your progress.

End of Worksheet
Therapist’s Signature: __
Date: __

Feel free to fill out the sections based on your experiences and progress. This will be a valuable tool for you and any mental health professional you may work with in the future.