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General CBT skills~15 min

Facing a fear of death: step ideas

Step ideas to choose from with your therapist for facing a fear of death, from words and films to funeral wishes and living more fully now. Based on Furer and Walker (2008) and Craske et al. (2014): a list of graded practice ideas for fear of death, with safety behaviours to drop and steps to carry to the exposure hierarchy.

Written by Tarun Vermani, Trainee Clinical Psychologist Updated

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This sheet gives you ideas for facing a fear of death, one small step at a time. Read through the ideas and tick any you could try, including ones that feel hard right now. Ticking an idea does not mean you have to do it. You will not do any of these steps on your own or before you have agreed them with your therapist. Together you will choose the steps that fit what you fear and add them to your graded exposure hierarchy. That is where you rank them and plan when and how to practise. Write the ones you choose in the last section. If someone close to you has died recently, or you are seriously ill, tell your therapist before you use this sheet. Therapist note: This is a menu of step ideas, not a ladder. Carry the chosen items into the graded exposure hierarchy, where each step is ranked by expected anxiety and paired with a prediction and the safety behaviours to drop.

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How facing the fear helps

When something frightens you, it makes sense to avoid it or to do things that make you feel safer. But pushing away every reminder of death, or only facing it with your safety behaviours, stops you finding out what really happens. The fear never gets tested.

Each step on this sheet is a chance to test what you fear. Before a step, you and your therapist write down what you expect to happen. Afterwards, you write down what did happen. Your anxiety does not have to go down before you start or before you stop: what matters is finding out. Feeling anxious during a step is expected.

Practise each step more than once, and vary it: a different time, place or length. This helps what you learn carry over to everyday life.

Only practise steps you have agreed with your therapist, and leave out anything that would put your health or safety at real risk.

Reading and talking about death

These steps bring death into everyday life in small ways. What feels hard is different for everyone, so tick what fits you.

Reading and talking I could try

Films, places and reminders

These steps take you to films, places and people you avoid because they remind you of death. What feels hard is different for everyone, so tick what fits you.

Films, places and reminders I could face

Thinking about my own death

These steps ask you to think or write about your own death. Take them slowly, and only once you and your therapist have agreed them.

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.

Steps about my own death I could try

Living more fully now

A fear of death can make life smaller. These steps are about doing what matters to you now, with the fear still there.

Ways I could live more fully

Safety behaviours to drop

Safety behaviours are things you do to feel safer. They can stop you finding out what really happens, so dropping them is part of each test. Tick the ones you use.

Choose which safety behaviours to drop with your therapist. Keep precautions that protect your real health or safety. Do not stop or change any prescribed medication on your own; talk to your prescriber first.

Still see a doctor about new or different symptoms, and keep any checks or appointments your doctor has asked for.

Safety behaviours I use

Steps to add to my ladder

With your therapist, write down the steps you would like to try and what you fear will happen in each. Then rate how anxious you expect to feel, from 0 (no anxiety) to 100 (the most anxious you can imagine).

You and your therapist will add these steps to your graded exposure hierarchy, where you rank them and plan your practice.

#Step I could tryWhat I fear will happenExpected anxiety (0 to 100)Actions
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2
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When to use ‘Facing a fear of death: step ideas’

‘Facing a fear of death: step ideas’ 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 15 minutes. It moves through six short steps:

  1. How facing the fear helps: When something frightens you, it makes sense to avoid it or to do things that make you feel safer. But pushing away every reminder of…
  2. Reading and talking about death: These steps bring death into everyday life in small ways. What feels hard is different for everyone, so tick what fits you.
  3. Films, places and reminders: These steps take you to films, places and people you avoid because they remind you of death. What feels hard is different for everyone, so…
  4. Thinking about my own death: These steps ask you to think or write about your own death. Take them slowly, and only once you and your therapist have agreed them. If…
  5. Living more fully now: A fear of death can make life smaller. These steps are about doing what matters to you now, with the fear still there.
  6. Safety behaviours to drop: Safety behaviours are things you do to feel safer. They can stop you finding out what really happens, so dropping them is part of each…

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, ‘Facing a fear of death: step ideas’ works by gradually and safely facing avoided situations so anxiety can subside (exposure). 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:

  • Craske, M.G., Treanor, M., Conway, C.C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23. doi:10.1016/j.brat.2014.04.006
  • Iverach, L., Menzies, R.G., & Menzies, R.E. (2014). Death anxiety and its role in psychopathology: Reviewing the status of a transdiagnostic construct. Clinical Psychology Review, 34(7), 580-593. doi:10.1016/j.cpr.2014.09.002
  • Furer, P., & Walker, J.R. (2008). Death anxiety: A cognitive-behavioral approach. Journal of Cognitive Psychotherapy, 22(2), 167-182. doi:10.1891/0889-8391.22.2.167
  • Menzies, R.E., Coutts-Bain, D., Richmond, B., & Helgadottir, F.D. (2025). Protocol for a randomised controlled trial of Overcome Death Anxiety: An online cognitive behavioural therapy intervention in a clinical sample. Behavioural and Cognitive Psychotherapy, 53(2), 197-205. doi:10.1017/S1352465824000493

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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