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Pain Monitoring Diary

Track pain levels alongside activity, mood, and coping strategies to identify patterns.

Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed

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Worksheet preview

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Record pain levels, activity, mood, and what you did to cope at regular intervals. This reveals patterns — which activities help, which aggravate, and how mood and pain interact.

Live preview — type in any field to try it. Nothing is saved here.

Pain Diary

#DateTimePain (0–10)ActivityMood (0–10)Coping UsedActions
1
Average pain—

Patterns

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When to use the Pain Monitoring Diary

The Pain Monitoring Diary is an interactive cognitive behavioural therapy (CBT) worksheet, most often used in CBT for chronic pain.

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 two short steps:

  1. Pain Diary
  2. Patterns

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 Pain Monitoring Diary works by noticing the links between situations, thoughts, feelings, physical sensations and behaviour — and finding practical ways to change unhelpful patterns. 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:

  • Vlaeyen, J.W.S. & Linton, S.J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain. Pain, 85(3), 317-332. doi:10.1016/S0304-3959(99)00242-0
  • Turk, D.C. & Winter, F. (2006). The Pain Survival Guide. Washington, DC: APA.

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
  • Samaritans: 116 123 — free, day or night, 365 days a year
  • SANEline: 0800 689 5555 — 4:30pm–10:30pm, every day

More Chronic Pain worksheets

View all Chronic Pain worksheets →

Want to assign this to a client?

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