Cognitive Behavioral Therapy Worksheet for Braylin Jordan

Patient Information

Name: Braylin Jordan
Age: Child
Main Condition: Generalized Anxiety Disorder
Additional Condition: ADHD
Current Medication: None
Therapy Experience: Unknown

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Goals of Therapy

1. Alleviate symptoms of social anxiety.
2. Improve academic performance and focus.
3. Enhance social skills and relationships.
4. Develop a consistent daily routine aimed at reducing anxiety.

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Reflection Questions

1. Understanding the Issues

• Academic Challenges:
  What specific academic tasks cause you the most anxiety?
  How do you feel when you work on homework or participate in class?

• Social Situations:
  Describe a recent situation where you felt anxious interacting with peers. What triggered that anxiety?

• Home Chores:
  How do you feel about completing your chores? What thoughts go through your mind when you avoid them?

2. Identifying Negative Thoughts

List any negative thoughts associated with your situations:

• Academics:

  • “I’ll fail if I speak up in class.”
  • “I’m not as smart as my classmates.”

• Socializing:

  • “They won’t like me.”
  • “I don’t know what to say.”

• Chores:

  • “I can’t do this; I’ll mess up.”
  • “It’s too boring.”

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Behavioral Interventions

1. Challenge Negative Thoughts

• For each negative thought listed above, write a more balanced or positive thought:

  • Academics:
    “Everyone makes mistakes, and that's how I learn.”
    “I have strengths in areas; sharing them can help me and others.”

  • Socializing:
    “I have friends who care about me.”
    “I can ask questions; it’ll keep the conversation going.”

  • Chores:
    “Completing chores helps my family, and I can do it right.”
    “I can listen to music and make it enjoyable.”

2. Behavioral Experiments

• Academics:
  Set a small goal: Answer one question in class this week. How did that make you feel?

• Socializing:
  Try introducing yourself to one new classmate. What did you observe about your anxiety levels before and after?

• Chores:
  Choose one chore to complete while listening to a favorite song. Did this help you complete it more easily?

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Routine Development Plan

To help establish a consistent routine, fill in the following schedule for one week:

Day	Morning Routine	School Activities	Afternoon Activities	Evening Routine
Monday	Breakfast, Brush Teeth	Class, Lunch	Homework, Free Play	Dinner, Read a book
Tuesday	Breakfast, Brush Teeth	Class, Lunch	Chores, Outdoor Play	Dinner, Prepare for bed
Wednesday	Breakfast, Brush Teeth	Class, Lunch	Homework, Craft Time	Dinner, Family Games
Thursday	Breakfast, Brush Teeth	Class, Lunch	Chores, Free Play	Dinner, Read a book
Friday	Breakfast, Brush Teeth	Class, Lunch	Movie Night	Prepare for bed
Saturday	Sleep In, Family Time	Chores, Outdoor Activity	Hobbies	Movie Night
Sunday	Family Breakfast	Prepare for Week Ahead	Free Play	Family Check-In

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Progress Tracking

Use the following points to check your progress weekly:

• How many times did you challenge negative thoughts?
• Did you complete the small behavioral experiments?
• Were you able to follow your daily routine? Where did you struggle?
• Reflect on your feelings and anxiety levels each day.

Reflective Questions

• What strategies did you find most helpful?
• How do you see yourself progressing over the next week?

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Conclusion

Establishing a routine and challenging negative thoughts is essential for managing anxiety symptoms, particularly with social situations and academics. Maintain open communication about your feelings and progress with your therapist to ensure continued support and success.