Decatastrophising: what if the worst happened?
A worksheet for "what if?" thinking: name the feared outcome, weigh the worst, best and most likely outcomes, then work out how you would cope even if the worst happened.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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Decatastrophising: what if the worst happened?
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The worry
Based on the cognitive model of anxiety (Clark & Beck, 2010) and Ellis's (1962) idea of catastrophising.
Catastrophising is when the mind jumps to the worst outcome and treats it as certain. This sheet helps you slow that jump down and look at the fuller picture. It is for worries that feel bigger than the facts. If what you fear is happening now, deal with that first.
The worst that could happen
If filling this in leaves you feeling hopeless or thinking about ending your life, use your safety plan if you have one, and tell your therapist or care team. If you feel unsafe right now, call 999 or go to A&E. To talk to someone now, call Samaritans free on 116 123.
The best that could happen
What is most likely
Coping if the worst happened
Anxiety overestimates the threat and underestimates you. Even if the worst came true, you would respond to it.
A more balanced view
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When to use ‘Decatastrophising: what if the worst happened?’
‘Decatastrophising: what if the worst happened?’ is an interactive cognitive behavioural therapy (CBT) worksheet. As a core CBT skill it is used right across the model, with presentations including depression, anxiety, OCD, trauma and low self-esteem, rather than being tied to a single diagnosis.
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device or download it as a print-ready PDF.
How it works
Most people work through it in around 10 minutes. It moves through six short steps:
- The worry: Based on the cognitive model of anxiety (Clark & Beck, 2010) and Ellis's (1962) idea of catastrophising. Catastrophising is when the mind…
- The worst that could happen: If filling this in leaves you feeling hopeless or thinking about ending your life, use your safety plan if you have one, and tell your…
- The best that could happen
- What is most likely
- Coping if the worst happened: Anxiety overestimates the threat and underestimates you. Even if the worst came true, you would respond to it.
- A more balanced view
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, ‘Decatastrophising: what if the worst happened?’ works by noticing and re-evaluating unhelpful automatic thoughts (cognitive restructuring). The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Clark, D.A., & Beck, A.T. (2010). Cognitive Therapy of Anxiety Disorders: Science and Practice. New York: Guilford Press.
- Ellis, A. (1962). Reason and Emotion in Psychotherapy. New York: Lyle Stuart.
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- NHS 111 (NHS 24 in Scotland): 111 — choose the mental health option for urgent help, in England, Scotland and Wales (in Wales, press 2)
- Lifeline: 0808 808 8000 — for urgent help in Northern Ireland, free, day or night
- Samaritans: 116 123 — free, day or night, 365 days a year
- Shout: 85258 — text SHOUT, free, day or night
- SANEline: 0300 304 7000 — 4pm–10pm, every day
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