PTSD Worksheet
PTSD Worksheet
Thought Record Sheet
Situation Trigger
What happened? Where? When? Who with? How?
What did I react to? (something I saw, heard, smelt, felt…)
0% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources for Post Traumatic Stress Disorder Page to learn more about PTSD and to get in touch with one of iTherapy's counselors.
Emotions / Moods
(rate 0 - 100%)
What emotion did I feel at that time? What else? How intense was it?
16% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources for Post Traumatic Stress Disorder Page to learn more about PTSD and to get in touch with one of iTherapy's counselors.
Physical Sensations
What did I notice in my body? Where did I feel it?
33% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources for Post Traumatic Stress Disorder Page to learn more about PTSD and to get in touch with one of iTherapy's counselors.
Unhelpful Thoughts and Images
What went through my mind? What disturbed me?
What did those thoughts/images/memories mean to me, or say about me or the situation? What am I responding to?
What ‘button’ is this pressing for me? What would be the worst thing about that, or that could happen?
50% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources for Post Traumatic Stress Disorder Page to learn more about PTSD and to get in touch with one of iTherapy's counselors.
Alternative response / Healthier
more balanced perspective
STOPP! Take a breath….
Is this fact or opinion?
Am I in danger NOW, or is it that I believe I'm in danger now because of my past trauma?
What's REALLY happening now? How would someone else see this situation?
What's the bigger picture? What adive would I give someone else?
Is my reaction in proportion to the actual event?
66% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources for Post Traumatic Stress Disorder Page to learn more about PTSD and to get in touch with one of iTherapy's counselors.
What I did / What I could do /
Action Plan / Defusion Technique
What’s the best response?
Re-rate Emotion 0-100%
What could I do differently? What would be more effective?
Do what works! Act wisely.
What will be most helpful for me or the situation? What will the consequences be?
84% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources for Post Traumatic Stress Disorder Page to learn more about PTSD and to get in touch with one of iTherapy's counselors.
To learn more about PTSD and to get in touch with one of iTherapy's counselors visit our Education and Resources for Post Traumatic Stress Disorder Page.
See also: PTSD Self-Assessment
Situation | Emotions / Moods |
Physical Sensations |
Unhelpful Thoughts and Images | Alternative Response/ Healthier More balanced perspective |
What I did / What I could do / Action Plan / Defusion technique / What’s the best response? |
---|---|---|---|---|---|
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Answer Question to Complete Worksheet |
Situation |
---|
Answer Question to Complete Worksheet |
Emotions / Moods |
Answer Question to Complete Worksheet |
Physical Sensations |
Answer Question to Complete Worksheet |
Unhelpful Thoughts and Images |
Answer Question to Complete Worksheet |
Alternative Response/ Healthier More balanced perspective |
Answer Question to Complete Worksheet |
What I did / What I could do / Action Plan / Defusion technique / What’s the best response? |
Answer Question to Complete Worksheet |
100% Complete
Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources for Post Traumatic Stress Disorder Page to learn more about PTSD and to get in touch with one of iTherapy's counselors.
PTSD, or post-traumatic stress disorder, is an anxiety problem that develops in some people after extremely traumatic events, such as combat, crime, an accident or natural disaster. To learn more about PTSD and to get in touch with one of iTherapy’s counselors visit Education and Resources Page for Post Traumatic Stress Disorder.