Anticipatory anxiety worksheet

If you’re a therapist in need of an anticipatory anxiety worksheet as part of an anti-anxiety workbook PDF, you’re in the right place.

Anticipatory anxiety can be all-consuming for some clients, taking over day-to-day functioning and creating a feedback loop of fear and worry. 

This article provides an overview of anticipatory anxiety, its causes, and suggested coping strategies for clients. 

We’ve also included a free downloadable anticipatory anxiety worksheet to use with clients and save to your electronic health record (EHR) as an anti-anxiety workbook PDF.

What is anticipatory anxiety?

Anticipatory anxiety is fear or dread about a future situation or event in which you might perceive the worst possible outcome. 

While it is normal to experience anxious thoughts about transitions, like moving, transitioning between jobs, or achieving a professional milestone, anticipatory anxiety can be more extreme and is typically experienced over an extended period.

Those experiencing anticipatory anxiety may fear routine or day-to-day events, like:

• Social phobias, such as a fear of public speaking or being in social situations

• Using a public restroom

• Being alone

• Going to restaurants or eating in public

• Insomnia

• Fear of flying

• Annual medical appointments or routine screening examinations

Anticipatory anxiety is also a feature of obsessive-compulsive disorder (OCD), motivating the compulsions that people with OCD experience, such as a fear of an intrusive thought or agonizing over a medical test result. 

While not a specific mental health condition, anticipatory anxiety is a feature of anxiety-related disorders, like generalized anxiety disorder, phobias, and panic disorder. 

‌

Symptoms of anticipatory anxiety include: 

• Emotional distress with feelings of fear and panic

• Hyperventilating

• Chest pain

• Digestive symptoms, like nausea, vomiting, and diarrhea

• Headache

• Difficulty sleeping

• Muscle tension

• Avoidant behaviors, such as avoiding the situation or event or social isolation

• Racing thoughts

• Rumination

• Difficulty concentrating

• Panic attacks

• Anticipating catastrophic outcomes, like fear of having a panic attack, making a fool of yourself, or damaging a relationship

Anticipatory anxiety can have a significant impact on day-to-day functioning and negatively impact relationships and job performance, which is why an anti-anxiety workbook PDF can be especially helpful.

What causes anticipatory anxiety?

Anticipatory anxiety develops from conditioned responses to memories, an overactive imagination, heightened anxiety sensitivity, or a depressed state. 

For example, negative past experiences, such as childhood bullying, can lead to a fear of rejection or embarrassment in social situations.

Other causes of anticipatory anxiety may include:

• Obsessive-compulsive disorder

• Automatic thoughts and negative beliefs

• Fear of judgement

• Social anxiety

• Generalized anxiety disorder

How to deal with anticipatory anxiety

The good news is that there are several ways to cope with anticipatory anxiety, including:

Cognitive behavioral therapy (CBT)

Cognitive restructuring, a part of CBT, can help to identify and challenge unhelpful thoughts and beliefs. 

Clients can identify and challenge these thoughts by answering prompts found in the anticipatory anxiety worksheet.

Exposure therapy

Gradual or graded exposure therapies can be helpful to gently face the fear instead of avoiding it, which helps to decrease anxiety.

Mindfulness

Grounding and mindfulness-based activities, such as mindful breathing, progressive muscle relaxation, or the 5-4-3-2-1 technique, can help bring attention back to the present and decrease the body’s stress response. 

Self-compassion

Practicing self-compassion can help ease tension and alleviate feelings of anxiety and panic. 

For example, you might say something like “It’s OK to be nervous, but remember how many things you’ve overcome. You can do this.”

Eye movement desensitization and reprocessing therapy (EMDR)

EMDR can help with anticipatory anxiety if the fear is related to a past trauma. This is done through processing the trauma and reducing the emotional charge related to these fears.

‌

How to use the anticipatory anxiety worksheet

You can download and use the anticipatory anxiety worksheet in several ways.

For example, use it as a session psychoeducational prompt about anticipatory anxiety and automatic thoughts. Provide the anticipatory anxiety worksheet to the client to remind them of what you discussed during therapy. Then, ask the client to reflect on the anti-anxiety workbook PDF between sessions, reflect on their anxiety, and report their findings at their next therapy appointment. 

Combine the worksheet with other anxiety or CBT-related worksheets, such as CBT for anxiety, cycle of anxiety worksheet, CBT thought record, introduction to anxiety, or the CBT triangle worksheet to use as an anti-anxiety workbook PDF.

Feel free to share the anticipatory anxiety worksheet with coworkers and supervisees, or simply print copies of the worksheet for your office or therapy room.

Sources

• Grupe, D. W., & Nitschke, J. B. (2013). Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective. 

• Huff, C. (2025). Understanding anticipatory anxiety during key life transitions. American Psychological Association. 

• Winston, S, & Seif, M. (2022). Anticipatory Anxiety: Bleeding Before You Are Cut. Anxiety and Depression Association of America. 

How SimplePractice streamlines running your practice

SimplePractice is HIPAA-compliant practice management software with everything you need to run your practice built into the platform—from booking and scheduling to insurance and client billing.

If you’ve been considering switching to an EHR system, SimplePractice empowers you to run a fully paperless practice—so you get more time for the things that matter most to you.

Try SimplePractice free for 30 days. No credit card required.

‌