01732 808 626 info@thinkcbt.com

01732 808 626 info@thinkcbt.com

01732 808 626 info@thinkcbt.com

Health Anxiety Change Record
The purpose of this exercise is to identify and alter the negative thinking and behavioural patterns that maintain distress, interfere with key relationships and place limits on daily tasks and longer-term goals. Complete all sections of the exercise before submitting your results. You can respond anonymously, and no data will be retained from this assessment. If you choose to include your initials and an email address, your results will be automatically sent to the email address provided. Please check that the email address has been entered correctly before submitting this form. All client information is managed on a strictly confidential basis. Please Note: Whilst every effort is made to ensure that our system is securely encrypted, email is not a completely secure means of communication. Think CBT does not accept liability for loss or theft of personal data where any individual chooses to transmit or receive information via email.
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1. Trigger / Intrusion: What was the situation, feeling, intrusive thought or image that triggered the health worry?
2. Initial Reaction: What initial feelings, physical sensations and reactive behaviours did I notice?
3. Health Worry: What obsessional thoughts, doubts or worries did I get caught up in?
4. Cognitive Distortions / Thinking Errors: Which of the following cognitive processes amplified the worry?






5. Checking, Safety and Reassurance Seeking Behaviours: What did I do to attempt to control or avoid the health worry?







6. Effectiveness of Checking, Safety and Reassurance Seeking Behaviours: How effective are these attempts to control or avoid health worry and uncertainty?




7. Alternative Response to the Health Worry: What helpful, workable and sustainable action can you take in considered response to the health worry?
8. Acceptance / Willingness: What uncomfortable thoughts, feelings and sensations are you willing to experience in the service of your personal values and goals?
9. Purpose: How will this help you to be present, take perspective and do what matters in the face of the health worry?