16 Decatastrophizing Tools, Worksheets, and Role-Plays

Decatastrophizing ToolsIn moments of panic, we often assume the worst will happen.

However, when we continually overestimate the likelihood of disaster and doubt our ability to cope, and yet still see such negative thinking as rational and correct, we need support (Wilding, 2015).

Decatastrophizing is a form of cognitive reappraisal that can help us think differently about emotional situations, provide emotional regulation, and reduce catastrophic thinking and anxiety (Mashal et al., 2019).

Within this article, we explore approaches to identify faulty thinking styles and introduce worksheets, tools, and techniques that can help clients reduce catastrophic thinking.

Before you read on, we thought you might like to download our three Positive CBT Exercises for free.

These science-based exercises will provide you with detailed insight into Positive CBT and give you the tools to apply it in your therapy or coaching.

6 Tips for Decatastrophizing

While irrational and negatively impacting how we feel, mild cognitive distortion plays a part in our everyday thinking. Our mind convinces us that something is real when it isn’t.

When it becomes exaggerated or irrational, faulty thinking, such as catastrophizing, can damage our psychological wellbeing (Chan, Chan, & Kwok, 2014).

Research has shown that catastrophizing is common among those who suffer from anxiety and depression and even has physical implications.

Indeed, such repetitive negative thinking is a “major psychological determinant of negative outcomes for pain problems” (Flink, Boersma, & Linton, 2013).

While such thinking is unhealthy and ineffective as a coping strategy, some simple tips and techniques can help your client avoid habitual catastrophizing:

 

1. Take a step back

Try not to focus on the worst-case scenario; instead, consider how it has played out in the past.

 

2. Catastrophizing is negative

Recognize that while anxiety can help protect us from danger and motivate us to take action needed to avoid a problem, catastrophizing is negative. It stops us from giving focus to the actual situation and responding appropriately.

 

3. Recognize catastrophic thoughts

Are our thoughts and beliefs realistic and appropriate to what we know of the situation? By becoming more aware, we can choose how to manage our cognition.

Catastrophizing examples include:

  • If I fail this exam, I will never get the job I want.
  • If this relationship doesn’t work out, I will never find the right person.
  • If I admit I don’t know something at work, they will think I am useless and fire me.

 

4. Challenge our catastrophic thoughts with evidence

Based on experience, how likely is it that my worry will come true?

For example:

  • I took an exam in the same subject last month and passed.
  • If the worst happens and I fail, I can retake the exam next month.

 

5. Maintain perspective

Maintain perspective and focus on the reality of the situation.

  • How will I feel after a week, month, year?
  • How will it look in five years?

 

6. Imagination and visualization

Imagination and visualization are both valuable tools for facing up to problems and revisiting past experiences.

  • Imagine walking through the above steps while offering advice to a friend.
  • Imagine walking through them in the future, when nothing bad happened.

 

10 Decatastrophizing Worksheets

decatastrophizing worksheetsSpending large amounts of time and energy worrying about worst-case scenarios can make it more challenging to face, overcome, and ultimately learn from daily challenges.

After all, overcoming problems creates opportunities to learn and increases trust in our ability to handle situations.

 

Cognitive restructuring

The following six worksheets use CBT-based cognitive restructuring techniques to help clients resolve irrational and inappropriate thinking:

  • The Decatastrophizing Worksheet is an ideal starting point. Work with your client to understand and ‘talk down’ their catastrophic thinking.

  • The Challenging Catastrophic Thinking Worksheet is a deep dive into the event detail the client is catastrophizing. It provides a reality check regarding the certainty of the worst happening and their ability to cope.

  • Our What If? Bias worksheet captures the client’s thinking concerning what might go wrong and contrasts it with what would happen if it went well.

  • The Replacing ‘What if’ Statements exercise captures negative thoughts and beliefs, evaluates whether they are justified, and replaces them with more appropriate, positive thinking.

  • Socratic questioning is used to excellent effect in our Cognitive Restructuring Worksheet to challenge irrational or illogical thoughts.

  • When an event has happened, we often think the worst of how we performed. The Cognitive Restructuring of an Event helps us reframe our beliefs based on what we know and offers a more realistic outlook for the future.

 

Visualization

Visualizing challenging situations can reduce our negative pictures of the future, replacing them with positive ones and increasing self-belief and self-confidence, both crucial factors in lowering catastrophizing (Clough & Strycharczyk, 2015; Davey, Jubb, & Cameron, 1996).

The next two worksheets provide valuable visualization tools to mentally ‘walk through’ either existing or future problems and challenges.

Work through the following worksheets to help the client form a more realistic, confident perception of the challenges ahead:

  • Use the If-then Planning Worksheet to help clients plan how to respond to a situation causing them anxiety. With a considered response, being ready will provide them with increased confidence in advance of and during the event.

  • The Event Visualization Worksheet is a practical guide for exploring a situation for which the client feels ill prepared. It can provide an excellent opportunity to play out a scenario with multiple possible endings.

 

Mindfulness

With its many other benefits to physical and mental wellbeing, mindfulness has proven to reduce catastrophic thinking (Lazaridou, Franceschelli, Protsenko, Napadow, & Edwards, 2017).

While there are many excellent and valuable mindfulness meditations and exercises, try out the following two; they are particularly relevant for those confronting challenges:

  • The Personal Needs Meditation worksheet helps clients recognize their personal needs when they face difficult situations and provides a focus for clients on cultivating compassion for themselves and others.

  • The Wheel of Awareness is an engaging tool for helping clients increase their awareness of themselves and their place in the world. Ask clients to try out the script and use the Wheel of Awareness to experience connection with themselves and their environment through their senses, body, and mind.

 

3 Helpful Ways to Identify Catastrophizing

Being able to spot catastrophizing, or those prone to it, can be the first step in helping someone overcome faulty thinking (Wilding, 2015).

Several psychological questionnaires have proved successful in identifying individuals prone to catastrophizing. The following two use self-reported answers to multiple questions and scenarios (Chan et al., 2014):

1. The Cognitive Emotion Regulation Questionnaire measures negative cognitive responses, including catastrophizing, using answers and responses to a series of questions and statements, such as:

I often think that what I have experienced is much worse than what others have experienced.

2. The Children’s Negative Cognitive Errors Questionnaire measures four types of cognitive errors: catastrophizing, overgeneralization, personalizing, and selective abstraction.

Participants score how they interpret a situation, such as:

You forgot to hand in your spelling homework.
How likely is it that the teacher will think that you don’t care and will not pass your exam?

However, during Cognitive-Behavioral Therapy and counseling sessions, it may be more appropriate to listen for cues associated with or examples of catastrophizing.

The types of comments and statements linked to catastrophizing include the client dwelling on all the things that could go wrong, for example:

Discussing a forthcoming presentation:

    • I will forget my words.
    • No one will listen.
    • They will laugh at me.

Going for a job interview:

    • I will go to the wrong location.
    • They will think I’m stupid.
    • I will never get a job.
    • My family will be disappointed in me.

When something does go wrong, despite the absence of evidence, believing the outcome will be the worst possible scenario:

My car has broken down:

    • No one will be able to fix it.
    • It will cost more than I can afford.
    • I will have no way of getting to work in the future.

My wife isn’t answering her phone:

    • She has had an accident; she is in the hospital.
    • She has left me; I knew she didn’t love me.

If your client continually thinks that something will go wrong and will result in the worst possible outcome, they are very likely catastrophizing.

 

Role-Play in Decatastrophizing

Good vs evil in role-playRole-play has been successful in many different therapy types and counseling with clients from a range of backgrounds.

While useful in developing social skills, role-playing is also valuable in working on adaptive responses, uncovering automatic thoughts, and modifying beliefs (Beck & Beck, 2011; Laugeson & Park, 2014).

The ability to recognize and modify beliefs is essential when a client’s views are dysfunctional, leading them to think the worst and catastrophize.

Try out an Intellectual-Emotional Role-Play with the client. The therapist plays the intellectual part of the client’s mind, and the client plays the emotional side, arguing as hard as possible to reveal the beliefs leading to negative thoughts.

Modified from Beck’s Cognitive Behavior Therapy, in the following example, the client believes they will fail in school (Beck & Beck, 2011):

Client (talking as the emotional side of the client’s brain)
I’m incompetent, and I’m going to fail everything.

Therapist (talking as the intellectual side of the client’s brain)
I’m not going to fail. I have a belief that I’m going to fail, but I’ve been doing well in my other exams, and I’ve been studying hard.

Client (emotional side)
But I was just lucky last year, and I didn’t get straight A’s. Plus, it’s more difficult this semester.

Therapist (intellectual side)
That’s not right; I passed all my exams last year. I wasn’t at the top of the class, but I did well. This year I’ve been working much harder.

The roles can switch so that the client becomes the intellectual side of their brain, and the therapist becomes the emotional side.

Role-play uses the client’s own words to identify a genuine sense of where emotion is attempting to overpower rational thinking, leading to catastrophizing.

To get a sense of how effective role-play has been with a client, it can be worth revisiting some of the earlier worksheets that capture and score catastrophizing.

 

Other Relevant Cognitive Restructuring Tools

Many faulty thinking styles arise from cognitive bias, which can benefit from cognitive restructuring techniques, including (modified from Wilding, 2015):

  • Self-blame – believing you are responsible for the pain and happiness of everyone close to you

  • Rigid thinking – we know we are right, but other people will not always agree

  • Personalization – believing that everything that people say and do is in some way related to us

  • Blaming – other people, organizations, and the wider universe are all to blame for our problems

  • Generalizing the specific – making a general conclusion based on a single occurrence

  • Mind reading – we believe we ‘know’ what others think and why they act as they do, even though they haven’t told us

  • Magnification and filtering – we magnify negative feelings and filter out positive feelings

  • Polarized thinking – we think of situations and people as all or nothing (e.g., good versus bad, pass versus fail)

  • Catastrophizing – we expect the worst; everything will go wrong and have the most significant impact

While working with a client, it can be useful to hit the pause button and stop long enough to consider emotions and their legitimacy.

Complete the Thought Record (Cognitive Restructuring) Worksheet to help clients understand their thoughts while considering the above thinking styles.

 

Relevant Resources from PositivePsychology.com

We have many tools available at PositivePsychology.com that are particularly effective at identifying and reframing thoughts and beliefs that are unrealistic or causing psychological upset.

Try out some of the following with your clients, and tailor them as required:

 

A Take-Home Message

While sometimes terrible things do happen, it would be damaging to our physical and mental wellbeing to continually live in a state of heightened anxiety about every scenario that may occur.

There are times when catastrophic thinking is appropriate. Firefighters, pilots, and deep-sea divers must consider the absolute worst that can happen.

They must modify the inherent risk of a situation with a set of mitigating factors to reach a level of residual risk that is acceptable.

And at times, we must too. But it must be appropriate to the situation.

For example, knowing our children’s whereabouts is sensible and vital to their safety, but we must also allow some freedom for them to grow and develop a sense of independence.

We all worry, and it’s not always a bad thing. But when worry is negatively impacting our happiness, wellbeing, and the goals we have in our life, something needs to change.

When paralyzed by the fear of all that could go wrong, we are catastrophizing. If left unchecked, it can have a severe and negative impact on our lives and those around us.

Being able to spot catastrophic thinking is the first step toward replacing misguided thoughts and beliefs with more rational, healthy ones.

Trying out some of the exercises provided and educating clients regarding their thinking styles can disrupt the cycle of catastrophizing and offer a more positive outlook.

We hope you enjoyed reading this article. For more information, don’t forget to download our three Positive CBT Exercises for free.

  • Beck, J., & Beck, A. (2011). Cognitive behavior therapy: Basics and beyond. New York: Guilford Press.
  • Chan, S. M., Chan, S. K., & Kwok, W. W. (2014). Ruminative and catastrophizing cognitive styles mediate the association between daily hassles and high anxiety in Hong Kong adolescents. Child Psychiatry & Human Development, 46(1), 57–66.
  • Clough, P., & Strycharczyk, D. (2015). Developing mental toughness: Coaching strategies to improve performance, resilience, and wellbeing. Kogan Page.
  • Davey, G. C., Jubb, M., & Cameron, C. (1996). Catastrophic worrying as a function of changes in problem-solving confidence. Cognitive Therapy and Research, 20(4), 333–344.
  • Flink, I. L., Boersma, K., & Linton, S. J. (2013). Pain catastrophizing as repetitive negative thinking: A development of the conceptualization. Cognitive Behaviour Therapy, 42(3), 215–223.
  • Laugeson, E. A., & Park, M. N. (2014). Using a CBT approach to teach social skills to adolescents with autism spectrum disorder and other social challenges: The PEERS® method. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 32(1), 84–97.
  • Lazaridou, A., Franceschelli, O., Protsenko, K., Napadow, V., & Edwards, R. (2017). The association between mindfulness, catastrophizing, and pain interference among patients with fibromyalgia: The moderating role of mindfulness. The Journal of Pain, 18(4), S54–S55.
  • Mashal, N. M., Beaudreau, S. A., Hernandez, M. A., Duller, R. C., Romaniak, H., Shin, K. E., … Zinbarg, R. E. (2019). A brief worry reappraisal paradigm (REAP) increases coping with worries. Cognitive Therapy and Research, 44(1), 216–228.
  • Wilding, C. (2015). Cognitive-behavioral therapy: Techniques to improve your life. New York: Quercus.

About the Author

Jeremy Sutton, Ph.D., is a writer and researcher studying the human capacity to push physical and mental limits. His work always remains true to the science beneath, his real-world background in technology, his role as a husband and parent, and his passion as an ultra-marathoner.

Leave a Reply

Your email address will not be published. Required fields are marked *