1. Anxiety Symptoms Worksheet Anxiety symptoms can be often be grouped into 3 categories. Some symptoms are of the somatic or physiological type which are those that are related to physical sensations for example: shortness of breath tightness in the chest lightheadedness etc. Some symptoms are of the cognitive type (thought responses) and affective type (emotions) such as: fear of having a heart attack going crazy feeling frightened etc. The third category of symptoms is to do with how you act and behave for example: not going out avoiding people or objects going out only with people you are close to etc.
2. Somatic/Physiological Cognitive/Affective Behavioural Centre for linicalC Interventions • Psychotherapy • Research • Training This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. See website www.cci.health.wa.gov.au for more handouts and resources.
3. Daily Record of Your Breathing Rate Instructions • Monitor your breathing rate at the times shown below. • If you have just done some form of activity (e.g. walking upstairs etc.) that increases your breathing rate take your breathing rate about 20 minutes after you have finished the activity. • Try to be sitting or standing quietly when you count your breathing. Don’t try to alter your breathing rate as you are counting. • Breathing Exercise: a) put your writing hand on your stomach and the other hand on your chest b) breathe in through your nose and out through your mouth. Remember…jaw relaxed breathe low and slow c) Do this for approximately 5 minutes three times per day. • Remember to: 1) monitor your breathing rate 2) practise the breathing exercise and 3) monitor your breathing rate again.
4. 1..2..3..4.. Date CALMING TECHNIQUE 1. Ensure that you are sitting on a comfortable chair or laying on a bed 2. Take a breath in for 4 seconds (through your nose if possible) 3. Pause for 2 seconds 4. Release the breath taking 6 seconds (through your mouth). 10:00 a.m. Before After 2:00 p.m. Before After 7:00 p.m. Before After Centre for linicalC Interventions • Psychotherapy • Research • Training Breathing Rate: Number of breaths (in and out) in one minute. This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. See website www.cci.health.wa.gov.au for more handouts and resources.
5. Monitoring Your Relaxation Level It is important to practice relaxation to achieve the best results as this is a new skill that you are learning. You can monitor you own progress by keeping a relaxation diary that records the when where and how of your practice. This will help you to identify particular situations and / or times of the day when you are most tense. Use the scale to indicate your level of relaxation before and after you complete your relaxation. The most relaxed and 0 10 1 2 3 4 5 6 7 8 9 The most tense or anxious Date & Time Comments / Reactions Relaxation level before Relaxation level after Comments / Reactions: • What parts of your body relaxed easily? • What sensations were you aware of in your body? • Was your mind relaxed? • What sorts of images were most relaxing for you? Centre for linicalC Interventions • Psychotherapy • Research • Training This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. See website www.cci.health.wa.gov.au for more handouts and resources.
6. Weekly Activity Schedule Week Beginning: Monday 8 to 9 am 9 to 10 10 to 11 11 to 12 pm 12 to 1 1 to 2 2 to 3 3 to 4 4 to 5 5 to 6 6 to 7 7 to 8 8 to 10 10 to 12 am Centre for linicalC Interventions Tuesday Wednesday Thursday Friday Saturday Sunday This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. See website www.cci.health.wa.gov.au for more handouts and resources. •Psychotherapy•Research•Training
7. Weekly Activity Schedule 6 to 8 am Monday Tuesday Wednesday Thursday Friday Week Beginning: Saturday Sunday 8 to 10 10 to 12 pm 12 to 2 2 to 4 4 to 6 6 to 8 8 to 10 10 to 12 am Centre for linicalC Interventions This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. See website www.cci.health.wa.gov.au for more handouts and resources. •Psychotherapy•Research•Training
8. Weekly Activity Schedule Monday Tuesday Wednesday Thursday Friday Week Beginning: Saturday Sunday Centre for linicalC Interventions This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. See website www.cci.health.wa.gov.au for more handouts and resources. •Psychotherapy•Research•Training
9. Weekly Activity Schedule Use the schedule below to plan your activities for the coming week. Make sure you balance fun and pleasurable activities with your daily responsibilities and duties. Mon 8 to 9am 9 to 10 10 to 11 11 to 12pm 12 to 1 1 to 2 Tues Wed Thur Fri Sat Sun 2 to 3 3 to 4 4 to 5 5 to 6 6 to 7 7 to 8 8 to 10 10 to 12 am Centre for linicalC Interventions •Psychotherapy•Research•Training This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the information from this website before making use of such information. See website www.cci.health.wa.gov.au for more handouts and resources.
10. Weekly Goals Record Name: Signature: TASKS TO BE COMPLETED Reading Calming Technique Thought Diaries Pleasant Events How often? Monday Date: T Tuesday Date: T Wednesday Thursday T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T A T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T S T A T L U N G A T L U N G A T L U N G A T L U N G E T E R D E S I G N F O R A N O T H E R M A N U A L L A B O R J O B I N T H E F A L L O F 2 0 1 3 W H E N T H E Y C A M E B A C K T O M Y S T U D I O T O S H O W M E T H E I N V E S T I G A T I O N S T H E Y H A D B E E N D O I N G A B O U T T H E W H I T E T A B L E C L O T H T H E Y H A D B E E N W O R K I N G W I T H T H E I R F A M I L Y S I Z E T A B L E C L O T H F O R A B O U T 2 Y E A R S B Y T H E N A N D I T W A S T H E I R W O R K W H I C H H A D B E E N G O I N G O N F O R M A N Y Y E A R S T H A T W A S T H E I N S P I R A T I O N T O T H E W O R K I H A D D O N E I N T H E I N T E R I M T H E T H R E A D S A N D T H E T E X T U R E S T H E Y H A D D E V E L O P E D W E R E S O M U C H M O R E E X C I T I N G T H A N A N Y T H I N G I H A D E V E R S E E N B E F O R E I H A D S T A R T E D T O R E A L I S E T H E I M P O R T A N C E O F T H E W H I T E T A B L E C L O T H I N T H E W O R L D O F T H E I R F A M I L Y A N D T H E I M P O R T A N C E O F T H E W H I T E T A B L E C L O T H I N T H E W O R L D O F T H E I R F A M I L Y A N D T H E I M P O R T A N C E O F T H E W H I T E T A B L E C L O T H I N T H E W O R L D O F T H E I R F A M I L Y A N D T H E I M P O R T A N C E O F T H E W H I T E T A B L E C L O T H I N T H E W O R L D O F T H E I R F A M I L Y A N D T H E I M P O R T A N C E O F T H E W H I T E T A B L E C L O T H I N T H E W O R L D O F T H E I R F A M I L Y A N D T H E I M P O R T A N C E O F T H E W H I T E T A B L E C L O T H I N T H E W O R L D O F T H E I R F A M I L Y A N D T H E I M P O R T A N C E O F T H E W H I T E T A B L E C L O T H I N T H E W O R L D O F T H E I R F A M I L Y Date: Date: T T Friday Date: T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T
