Testing feared movements, one step at a time

When to use ‘Testing feared movements, one step at a time’

‘Testing feared movements, one step at a time’ 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 20 minutes. It moves through four short steps:

1. Agree before testing
2. Step 1
3. Step 2
4. Step 3

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, ‘Testing feared movements, one step at a time’ 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:

• Vlaeyen, J. W. S., & Linton, S. J. (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain.
• Bennett-Levy, J., Butler, G., Fennell, M., Hackmann, A., Mueller, M., & Westbrook, D. (Eds.) (2004). Oxford Guide to Behavioural Experiments in Cognitive Therapy. Oxford University Press.