From avoidance to an alternative action
A behavioural activation worksheet linking an avoidant response to its immediate relief and later cost. Supports a small, chosen alternative action and a review of what actually happened when the client tried it.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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From avoidance to an alternative action
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The moment and your response
Describe one occasion, rather than everything you tend to do.
What the response did for you
Avoidance can bring relief and still leave you with difficulties later. Neither part is a judgement about you.
A small alternative you choose
Choose an action for what it could help you reconnect with. It does not have to lift your mood immediately.
After you try it
Compare what happened with what you hoped the action would do. A difficult result can help you change the plan.
Try it here — nothing you type is saved. Sign up to assign it and let clients complete it on any device.
When to use ‘From avoidance to an alternative action’
‘From avoidance to an alternative action’ 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 20 minutes. It moves through four short steps:
- The moment and your response: Describe one occasion, rather than everything you tend to do.
- What the response did for you: Avoidance can bring relief and still leave you with difficulties later. Neither part is a judgement about you.
- A small alternative you choose: Choose an action for what it could help you reconnect with. It does not have to lift your mood immediately.
- After you try it: Compare what happened with what you hoped the action would do. A difficult result can help you change the plan.
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, ‘From avoidance to an alternative action’ works by re-engaging with meaningful and rewarding activity (behavioural activation). 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:
- Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2010). Behavioral Activation for Depression: A Clinician's Guide. Guilford Press.
- Jacobson, N. S., Martell, C. R., & Dimidjian, S. (2001). Behavioral activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice, 8(3), 255-270.
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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