Anxiety Hierarchy worksheet

What is the theory behind this anxiety hierarchy worksheet? 

An anxiety hierarchy is a  progression of graduated anxiety-inducing stimuli focused on the person’s particular anxiety source. It is utilised in CBT to cure phobias and other anxiety related disorders and found beneficial for these disorders. Patients move up the hierarchy, from the least hazardous situation to the most threatening one.

How will the worksheet help?

Having identified fears or a specific fear to address is a key step in managing anxiety. This worksheet will help clients to understand the level of the fears and in the management of the anxiety.     

How to use the worksheet?  

The therapists will use this worksheet to work with clients to create a list based on situations that make them anxious. The client has to identify his fear and list them out, the therapist will be there to guide the client.  

Anxiety Hierarchy worksheet

List down your anxiety provoking situations from most anxiety provoking situations to least anxiety provoking situations. Rate each situation on the scale of “0-100”. “0” is “no distress at all” and “100” is the “most distressful situation”.

Anxiety provoking situations or activitiesRate them from 0-100
Most anxiety provoking situation

Least anxiety provoking situation


Kaczkurkin, A. N., & Foa, E. B. (2015). Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues in clinical neuroscience, 17(3), 337–346. 

Desensitization, hierarchies and social anxiety. (2008, August 28). Verywell Mind.

You can download this worksheet here.

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