Fear worksheets

These fear worksheets help therapy clients understand and face their fears.

While fear is a normal human response to danger, it can lead to anxiety-related mental health conditions. 

This article provides an overview of fear worksheets, examples of when fear becomes problematic, and techniques for using the fear worksheets. 

We’ve also included a free downloadable overcoming fears worksheet to save to your electronic health record (EHR) and use in your practice. 

What is fear?

Fear is one of the most basic human responses. 

As part of the body’s survival system, fear is the built-in alarm system that detects and responds to specific stimuli to protect us from danger. That might mean running from a bear or swerving from a car that has entered your lane unexpectedly.

While fear is sometimes a whole-body response, it begins in the amygdala, the part of the brain responsible for detecting threats. 

Once triggered, the amygdala sends signals throughout your body that lead to physical symptoms like:

• Increasing heart rate

• Tensing muscles

• Widening eyes

• Quickening breathing

• Stopping digestion and signaling to empty your bowels

These signals tell the body to fight, flee, or freeze. 

While this happens quickly—one-tenth of a second—the brain's rational part (the prefrontal cortex) also receives and interprets the signal from your amygdala. 

Most of the time, the brain's executive functioning can find other information to decide whether or not to react to the threat. 

However, the ability to discern threats is impacted by trauma and indirect experiences of world events, like war and terrorist attacks, which alter the brain and make it more susceptible to misperceiving threats when they do not exist. 

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Common types of fear

There are several different types of fear, which are also explained in the fear worksheets.

Acute fears

These fears are triggered by an immediate threat, such as hearing a loud noise, being assaulted, or being chased. 

Anticipatory fears

These include fears about the potential for a threat, such as public speaking, a medical procedure, or surgery.

Phobias

Phobias are intense or irrational fears about specific objects or situations—for example, spiders, fear of heights, or flying.

Emotion-related fears

These fears might include the fear of abandonment, rejection, conflict, embarrassment, vulnerability, or failure. 

Trauma-related fears

This is a learned response in which the body might think the trauma will happen again, such as war, accidents, sudden death, or assault. The brain may respond to stimuli that remind the person of the trauma.

Responses to fear

Unaddressed fear can appear in everyday situations, which may impact relationships, work, and other vital areas of functioning, making an overcoming fears worksheet a helpful tool for clients. 

Some of the signs a person is feeling activated by fear when there is no immediate threat include:  

• Avoidance: Staying away from people, places, or things that trigger reminders of the trauma.

• Hyperarousal: Feeling jumpy, on-edge, irritable, or unable to sleep. 

• Emotional numbing: Avoiding emotions by drinking or using substances, or other ways to avoid feeling emotions.

• Hypervigilance: Feeling on edge and constantly scanning the environment for threats.

• Safety behaviors: Carrying protective items, only going to certain places, or associating with safe people. 

• Dissociation: Mentally checking out or feeling disconnected from oneself and/or reality.

• Panic attacks or flashbacks: People with PTSD may reexperience the trauma, vividly recall the details, experience flashbacks, experience panic attacks, and/or have nightmares. 

• Rumination: Mentally replaying feared situations or imagining worst-case scenarios.

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Examples of how to overcome fear

Interventions to overcome fear vary depending on the type of fear, mental health conditions, and trauma. 

These techniques can all incorporate fear worksheets and may include:

• Cognitive behavioral therapy (CBT): Learning to cognitively restructure maladaptive thoughts.

• Exposure therapy: Creating a hierarchy of fears, listing triggers, and making an exposure plan with a trained therapist.

• Eye movement desensitization and reprocessing therapy (EMDR): Helps process the trauma into an adaptive response.

• Mindfulness: Self-awareness-based practices to increase present time awareness and provide grounding.

• Dialectical behavioral therapy (DBT): DBT teaches distress tolerance and emotional regulation skills to cope more effectively with triggers and calm the nervous system. 

How to use the fear worksheets 

You can download and use our overcoming fears worksheet in several ways.

For example, print or screen share the fear worksheets and use them as session psychoeducational prompts.

Give the overcoming fears worksheet to the client to remind them of what you discussed during therapy. 

If your client is in substance use recovery, you could collaboratively work through the fears in recovery worksheet in session with a client.

Another way to use the fear worksheets is to ask the client to reflect on the overcoming fears worksheet between sessions, explore their fears, and report their progress at their next therapy appointment. 

Sources

• Adolphs R. (2013). The biology of fear. Current biology. 

• LeDoux, J. E., & Pine, D. S. (2016). Using Neuroscience to Help Understand Fear and Anxiety: A Two-System Framework. American Journal of Psychiatry.

• Menting, A, M. (2011.) The Chill of Fear. Harvard Medicine. 

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