GAD Longitudinal Formulation

When to use the GAD Longitudinal Formulation

The GAD Longitudinal Formulation is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for generalised anxiety (GAD).

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 25 minutes. It moves through six short steps:

1. Early Experiences and Environment — Relevant background that may have shaped a worry-prone style.
2. Core Beliefs and Assumptions — Enduring beliefs about the self, the world, uncertainty, and worry itself.
3. Critical Incidents and Onset — What activated or escalated the worry into a clinical problem.
4. Current Worry Process — Map the two levels of worry and how the person responds to each.
5. Maintaining Cycles — The processes that keep worry and anxiety going, including how each one prevents the belief from being disconfirmed.
6. Consequences and Impact — The toll the problem is taking across life domains.

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 GAD Longitudinal Formulation works by mapping how the parts of a problem connect and keep it going (formulation). 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.
• Wells, A. (1995). Meta-cognition and worry: A cognitive model of generalized anxiety disorder. Behavioural and Cognitive Psychotherapy, 23(3), 301-320.
• Wells, A. (2009). Metacognitive Therapy for Anxiety and Depression. .