Downward Arrow Worksheet

When to use the Downward Arrow Worksheet

The Downward Arrow Worksheet is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for depression and low mood.

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 15 minutes. It moves through three short steps:

1. Starting Point
2. Downward Arrow — For each thought, ask: "If that were true, what would that mean?"
3. Core Belief Identified

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, the Downward Arrow Worksheet 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:

• Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive Therapy of Depression. New York: Guilford Press.
• Greenberger, D. & Padesky, C.A. (2016). Mind Over Mood (2nd ed.). New York: Guilford Press.