Decatastrophizing worksheet

Are you a therapist looking for resources, like a decatastrophizing worksheet, to explain thought distortions to clients? You’re in the right place. 

This article briefly describes this common cognitive distortion, along with examples and instructions on using a catastrophizing worksheet with clients. 

You can also download a free printable catastrophizing worksheet PDF to save to your electronic health record (EHR) for repeated use with clients.

What is catastrophic thinking?

Catastrophic thinking is a type of maladaptive thinking. In cognitive behavioral therapy (CBT), this is referred to as a thought distortion. 

When clients think catastrophically, they often think about the worst possible outcome of a situation, blowing things out of proportion. 

While people may exaggerate from time to time, persistent catastrophic thinking may exacerbate symptoms of anxiety and depression—which is why using a decatastrophizing worksheet can be helpful.

The key features of catastrophic thinking include:

• Overexaggeration of a situation: A client might think their upcoming birthday party will be a complete disaster, and no one will show up.
• Limits attention and increases anxiety: By fearing the worst possible outcome, people who catastrophize will become preoccupied with worst-possible scenarios, which can fuel stress, anxiety, panic, depression, and it can even exacerbate pain. 
• Future-focused: Spending time worrying about an event distracts clients away from the present moment and reduces the possibility of social interaction and enjoyment.
• Neglects positive outcomes: By focusing on the worst possible outcome, clients dismiss or ignore the possibility of positive outcomes.

‌

Examples of catastrophic thinking

Here are some common examples of catastrophizing to help your clients use the decatastrophizing worksheet in your therapy practice:

Health-related catastrophizing

• “My chest feels tight today. I might have a heart attack.” 
• “There is no way to escape this pain.”
• “My headache is really bad. It must be a brain tumor.”

Relationship-related catastrophizing 

• “They haven’t responded to my friend request. They must think I’m a loser.”
• “She is late. I bet she decided that I’m ugly and doesn’t want to keep dating me.”

Work-related catastrophizing 

• “If my boss spots an error in my presentation, I won’t get that promotion and will probably get fired.”
• “If my train is late, I’ll be late for work and it will ruin my day.”

The benefits of using a decatastrophizing worksheet

Decatastrophizing is the process involved in challenging and reframing catastrophic thinking. One way to achieve this is by using a decatastrophizing worksheet. 

Clients can benefit from reframing their thoughts in several ways, including:

Improves self-awareness 

Using a catastrophizing worksheet, clients can identify ways they are catastrophizing in their lives and how it is impacting their behavior, relationships, and mental health. 

Strengthens emotional regulation 

Once clients can identify their catastrophizing thoughts, they’ll become more adept at thought stopping, which will have a positive impact on their mental and emotional well-being.

Enhances self-confidence 

By increasing self-awareness and developing more adaptive thought processes, clients will improve their confidence and self-efficacy to tackle a problem successfully.

Promotes mindfulness 

Challenging thought distortions using a catastrophizing worksheet encourages clients to take a step back and more mindfully consider their thought processes. Mindfulness practices can promote calm and reduce stress and anxiety.

‌

How to use the decatastrophizing worksheet

Therapists can use the catastrophic thinking worksheets with clients in several ways:

• To identify catastrophic thoughts: The decatastrophizing worksheet uses examples to identify these thought distortions and how they impact the client’s life.
• To reality test: Tools like a catastrophizing worksheet can help to challenge thought distortions by questioning the evidence supporting the thoughts. This can help clients see if there is a factual basis for continuing to think this way or if their thoughts are maladaptive.
• Consider alternatives: Part of reframing thought distortions includes considering alternative explanations or outcomes, and to assess the likelihood of a particular outcome occurring.
• To strengthen coping skills: Once the client has identified their thought distortions and alternative explanations, they have developed a new coping strategy. 

Sources

• Arocho, J. (2022). Catastrophizing: What It Is and How to Best Handle It. Manhattan CBT. 
• Berg, S. (2023). What doctors wish patients knew about stopping catastrophic thoughts. AMA. 
• Cox A. R. (2021). "It's all in your head": Managing catastrophizing before it becomes a catastrophe. Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 
• Kishikawa, Y., Tanaka, S., Iwanaga, K., Nakagawa, I., Shiotsuka, T., et al. (2022). Effects of pain-related catastrophic thinking, anxiety, and depression on pain intensity and quality of life in patients with knee and low back pain. Journal of physical therapy science. 
• Pike, A. C., Serfaty, J. R., & Robinson, O. J. (2021). The development and psychometric properties of a self-report Catastrophizing Questionnaire. Royal Society open science. 

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 streamline appointment bookings, reminders, and rescheduling and simplify the billing and coding process—so you get more time for the things that matter most to you.

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

‌