Cognitive Behavioral Therapy Worksheet for Malachi

Patient Name: Malachi
Age: Child
Date: __
Therapist Name: __

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Section 1: Understanding My Feelings

1.1 Identifying Emotions

• List three situations that make you feel anxious or nervous.

  1. ---

  2. ---

  3. ---

• Next to each situation, write down how you feel.

  • Situation 1: _____

  • Feeling(s): __

  • Physical Sensations: ____

  • Situation 2: _____

  • Feeling(s): __

  • Physical Sensations: ____

  • Situation 3: _____

  • Feeling(s): __

  • Physical Sensations: ____

1.2 Exploring Thoughts

• What thoughts run through your mind during each of these situations?
  • Situation 1 Thoughts: __
  • Situation 2 Thoughts: __
  • Situation 3 Thoughts: __

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Section 2: Challenging My Thoughts

2.1 Identifying Cognitive Distortions

• Review the thoughts you wrote above. Do any of these thoughts fall into common cognitive distortions? (e.g. all-or-nothing thinking, catastrophizing, overgeneralizing) Circle or highlight any that apply.

2.2 Reframing Thoughts

• Rewrite the distorted thoughts into more balanced and realistic ones for each situation.

  • Situation 1:

    • Original Thought: __
    • Reframed Thought: ____

  • Situation 2:

    • Original Thought: __
    • Reframed Thought: ____

  • Situation 3:

    • Original Thought: __
    • Reframed Thought: ____

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Section 3: Action Plan for Behavioral Changes

3.1 Setting Goals

• Write down three small, realistic goals you want to work on to help reduce your anxiety.

  1. ---

  2. ---

  3. ---

3.2 Steps to Achieve My Goals

• For each goal, list the steps you can take to achieve it.

  • Goal 1: [Your Goal]

    • Step 1: ___
    • Step 2: ___
    • Step 3: ___

  • Goal 2: [Your Goal]

    • Step 1: ___
    • Step 2: ___
    • Step 3: ___

  • Goal 3: [Your Goal]

    • Step 1: ___
    • Step 2: ___
    • Step 3: ___

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Section 4: Coping Strategies

4.1 Techniques for Managing Anxiety

• List three coping strategies you can use when you feel anxious.

  1. ---

  2. ---

  3. ---

4.2 Practice Mindfulness

• Practice a mindfulness exercise, such as deep breathing or focusing on the present moment, and describe how it made you feel.
  • Exercise: ____
  • How it made me feel: ____

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Section 5: Reflection

5.1 Learning About Myself

• What have you learned about your feelings and thoughts through this exercise?

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5.2 Commitment to Change

• Write a commitment statement to yourself about working towards changes in your feelings and behaviors.

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Therapeutic Insights:

• Remember that change takes time. Be patient with yourself and celebrate small achievements along the way.
• You are capable of making positive changes to overcome anxiety and improve your confidence.

Next Session Date: __
Therapist Signature: __

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End of Worksheet