Worry

Human beings experience a wide variety of repetitive thoughts about themselves and their lives, not all of them negative. Reminiscing, savoring, anticipating, problem-solving, and emotional processing are positive examples of repetitive thinking, and go some way to explaining why we have the propensity to engage in repetitive thought. Some types of repetitive thought are unhelpful, though—even harmful. Rumination and worry are two key forms of unhelpful repetitive thought and use of these can predict anxiety and depression (Watkins, 2016). We can conceptualize repetitive thinking about the future as ‘worry,’ and repetitive thinking about the past as ‘rumination.’ They are maintenance factors in conditions such as generalized anxiety disorder and depression (Harvey et al, 2004). Read more

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33 of 33 resources

Intolerance Of Uncertainty

Uncertainty is a normal part of life – we can never be 100% sure about what will happen next. Many people feel good about uncertainty and live lives ... https://www.psychologytools.com/resource/intolerance-of-uncertainty/

Worry Flowchart

Worry is a cognitive process that involves thinking about problems that might happen in a way that causes anxiety. Not all worry is problematic – we ... https://www.psychologytools.com/resource/worry-flowchart/

Mastery Of Your Anxiety And Worry (Second Edition): Workbook

Mastery Of Your Anxiety And Worry comes in two volumes. This page is for the Workbook. Click on the following link to access the accompanying Therapis ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-worry-workbook/

Worry Postponement

Worry postponement ("worry time") is often prescribed as an exploratory or standalone intervention relatively early in the treatment of GAD, but ... https://www.psychologytools.com/resource/worry-postponement/

Understanding Generalized Anxiety And Worry

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-generalized-anxiety-and-worry/

Reactions To Trauma

Traumatic events are shocking and it is normal to feel overwhelmed. Not everybody reacts in the same way though and there is no ‘right’ way to res ... https://www.psychologytools.com/resource/reactions-to-trauma/

Decatastrophizing

Catastrophic thinking (magnification) is characteristic of many anxiety problems. This CBT worksheet for decatastrophizing is a tool for cognitive res ... https://www.psychologytools.com/resource/decatastrophizing/

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Client Workbook

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition) comes in two volumes. This page is for the Client Workbook. ... https://www.psychologytools.com/resource/unified-protocol-for-transdiagnostic-treatment-of-emotional-disorders-second-edition-client-workbook/

Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition): Therapist Guide

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (Second Edition) comes in two volumes. This page is for the Therapist Guide. ... https://www.psychologytools.com/resource/unified-protocol-for-transdiagnostic-treatment-of-emotional-disorders-second-edition-therapist-guide/

Understanding Health Anxiety

Self-Monitoring Record (Universal)

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/self-monitoring-record-universal/

Worry Thought Record

Anxiety stems from negative predictions about the future (and also from assumptions that one will not be able to cope with the magnitude of the threat ... https://www.psychologytools.com/resource/worry-thought-record/

Cognitive Behavioral Model Of Generalized Anxiety Disorder (GAD: Dugas, Gagnon, Ladouceur, Freeston, 1998)

Individuals with generalized anxiety disorder (GAD) report significant worry which they find difficult to control and experience as distressing. Numer ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-generalized-anxiety-disorder-gad-dugas-gagnon-ladouceur-freeston-1998/

Worry – Self-Monitoring Record

The Worry – Self-Monitoring Record worksheet is designed to help clients capture information about situations where they engaged in worry. Consisten ... https://www.psychologytools.com/resource/worry-self-monitoring-record/

What Keeps Death Anxiety Going?

The “What Keeps It Going?” series is a set of one-page diagrams explaining how common mental health conditions are maintained. Friendly and concis ... https://www.psychologytools.com/resource/what-keeps-death-anxiety-going/

Cognitive Behavioral Model Of Intolerance Of Uncertainty And Generalized Anxiety Disorder Symptoms (Hebert, Dugas, 2019)

Intolerance of uncertainty (IU) has been defined as “an underlying fear of the unknown”. Intolerance of uncertainty is a risk factor for the deve ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-intolerance-of-uncertainty-and-generalized-anxiety-disorder-symptoms-hebert-dugas-2019/

Mastery Of Your Anxiety And Worry (Second Edition): Therapist Guide

Mastery Of Your Anxiety And Worry comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying W ... https://www.psychologytools.com/resource/mastery-of-your-anxiety-and-worry-therapist-guide/

Understanding Death Anxiety

Rumination - Self-Monitoring Record

Cognitive Behavioral Model Of Health Anxiety (Salkovskis, Warwick, Deale, 2003)

Health anxiety is characterized by a preoccupation with having or acquiring a serious illness, and a high level of anxiety about health. People with h ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-health-anxiety-salkovskis-warwick-deale-2003/

Exposures For Fear Of Body Sensations

Fearful responses to physical sensations are common in several disorders. Interoceptive exposure (or ‘symptom induction’) is an effective treatmen ... https://www.psychologytools.com/resource/exposures-for-fear-of-body-sensations/

Problem Solving (CYP)

Effective problem solving is an essential life skill and this Problem Solving worksheet is designed to guide children and adolescents through steps wh ... https://www.psychologytools.com/resource/problem-solving-cyp/

Am I Experiencing Death Anxiety?

Am I Experiencing Death Anxiety? is an indicative screening tool, designed to help clients self-assess whether their experiences might warrant further ... https://www.psychologytools.com/resource/am-i-experiencing-death-anxiety/

Am I Experiencing Burnout?

‘Burnout’ is characterized by feeling emotionally drained, unmotivated, and ineffective as a result of prolonged stress during work. This can impa ... https://www.psychologytools.com/resource/am-i-experiencing-burnout/

Worry Diary (Archived)

NOTE: An improved version of this resource is available here: Worry – Self-Monitoring Record. Older versions of a resource may be archived in t ... https://www.psychologytools.com/resource/worry-diary-archived/

Am I Experiencing Generalized Anxiety Disorder (GAD)?

Generalized anxiety disorder (GAD) is a condition characterized by problematic worry. Am I Experiencing Generalized Anxiety Disorder? is an indicative ... https://www.psychologytools.com/resource/am-i-experiencing-generalized-anxiety-disorder-gad/

Am I Experiencing Social Anxiety?

Social anxiety disorder is characterized by persistent fear or anxiety concerning social or performance situations that is out of proportion to the ac ... https://www.psychologytools.com/resource/am-i-experiencing-social-anxiety/

Am I Experiencing Health Anxiety?

Health anxiety (also referred to as illness anxiety disorder and hypochondriasis) is a condition characterized by a preoccupation with, or fear about, ... https://www.psychologytools.com/resource/am-i-experiencing-health-anxiety/

Panic Attack Progress Record

Recovery often has a fluctuating course and it is important to monitor progress in cognitive behavioral therapy. Clients can use the Panic Attack Prog ... https://www.psychologytools.com/resource/panic-attack-progress-record/

Am I Experiencing Panic Attacks?

Panic attacks are discrete episodes of intense fear or apprehension. They are accompanied by the rapid and concurrent onset of characteristic symptoms ... https://www.psychologytools.com/resource/am-i-experiencing-panic-attacks/

Exposures For Fear Of Breathlessness

Fearful responses to benign physical sensations such as breathlessness are common in several disorders, most notably panic disorder (with and without ... https://www.psychologytools.com/resource/exposures-for-fear-of-breathlessness/

Cognitive Behavioral Model Of Insomnia (Harvey, 2002)

Insomnia is a highly prevalent sleep disorder characterized by difficulty initiating or maintaining sleep, or having non-restorative sleep for at leas ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-insomnia-harvey-2002/

Am I Experiencing Panic Disorder?

Panic attacks are discrete episodes of intense fear or apprehension, accompanied by the rapid and concurrent onset of several physiological and psycho ... https://www.psychologytools.com/resource/am-i-experiencing-panic-disorder/

Links to external resources

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Guides and workbooks

Dealing with worry in low intensity CBT | Chellingsworth, Farrand, Rayson | 2013
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Information Handouts

11 Steps To Stop Ruminating | Jay Uhdinger
Archived Link
Generalised anxiety and worry - information sheets | Centre For Clinical Interventions
- What Is Generalised Anxiety?
  Primary Link Archived Link
- What Is Mindfulness?
  Primary Link Archived Link
- Mindfulness and Letting Go
  Primary Link Archived Link
- How Worry Works
  Primary Link Archived Link
- Postpone Your Worry
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- Accepting Uncertainty
  Primary Link Archived Link

Information (Professional)

Get out of the TRAP and back on TRAC (for rumination and worry) | GoodMedicine
Primary Link Archived Link

Presentations

The how and why of rumination and worry | Watkins | 2012
Archived Link
Targeting rumination by changing processing style: experiential and Imagery exercises | Watkins | 2011
Archived Link
Unwanted intrusive thoughts | David Clark | 2019
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Video

Stopping spam from going bad | Blake Stobie | 2016
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Worksheets

Ruminating thought worksheet: What to do when thoughts are unhelpful
Archived Link
Generalised Anxiety And Worry (Worksheets) | Centre For Clinical Interventions
- Postpone Your Worry
  Primary Link Archived Link
- Letting Go With Mindfulness
  Primary Link Archived Link
- Accepting Uncertainty
  Primary Link Archived Link
- Challenging Intolerance of Uncertainty
  Primary Link Archived Link

What Are Rumination And Worry?

Disorders That Are Associated with Rumination and Worry

generalized anxiety disorder (GAD)
depression
social anxiety
post-traumatic stress disorder (PTSD)
pain
eating disorders
insomnia
psychosis

Helpful Questions for Assessing Rumination and Worry

How often do you find yourself ruminating or dwelling on your problems?
When do you tend to do most of your worrying or ruminating?
What are the consequences of ruminating and worrying for you? How does it make you feel?
Are there any particular feelings that are warning signs that you might worry?
What tends to stop your ruminating?

Treatment Approaches That Target Rumination and Worry

A variety of treatment approaches have been identified that target rumination and worry. These include:

approaching uncomfortable thoughts and feelings rather than avoiding them;
imaginal exposure to a ‘worry script’ or ‘worry story’;
problem-solving training;
processing information at a more concrete and less abstract level;
identifying and challenging positive and negative metacognitive beliefs that may contribute to repetitive thinking.

References

Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. New York: Oxford University Press.
Watkins, E. R. (2016). Rumination-focused cognitive-behavioral therapy for depression. New York: Guilford Press.

Worry

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What Are Rumination And Worry?

Disorders That Are Associated with Rumination and Worry

Helpful Questions for Assessing Rumination and Worry

Treatment Approaches That Target Rumination and Worry

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