Our Shared Map: A Free CBT Formulation and Goals Worksheet for Long COVID
Long COVID · CBT · Emerging
A page to fill in together at Session 1 and again at Session 8. It lists what is getting in the way most, walks down one recent hard moment (what was happening, what the mind said it meant, what was felt, what was done, what that bought and what it cost), records what matters most and three goals rated 0 to 10, and holds the clinician-completed measures at the start, at Session 8 and at the booster. The shared formulation comes from cognitive-behavioural therapy. A pilot trial found a medium reduction in fatigue against a waiting list, so the rating is emerging, but the trial was small and the pooled evidence is mixed.
Underlying mechanism: CBT-Informed Shared Formulation, Goals and Baseline Measures for Long COVID
What it helps with
- Building a formulation of what keeps distress going in plain words, without treating symptoms as imagined.
- Noticing the dominant symptom profile and baseline severity, which decide where sessions are spent.
- Agreeing three goals that matter to the client and rating them at the start and the end.
- Seeing whether the work is helping across several measures and not only one symptom total.
How clinicians use it
- Use it in the first session after confirming medical assessment and screening for red flags and post-exertional worsening, then repeat it at Session 8.
- Work down the shared map column with one recent hard moment, and keep the client's own words.
- Complete the numbers box yourself with licensed measures, and say that the numbers show whether this is helping and are not a test the client can fail.
- If brain fog makes reading or writing hard, complete the sheet together and keep the sitting short.
Clinical Implementation Guide
- Confirm medical assessment, screen for red flags and take baseline measures before building the map.
- Work down one recent hard moment together and agree three goals with a rating each.
- Repeat the goal ratings and measures at Session 8 and the booster.
What the worksheet looks like
| Step | In my words |
|---|---|
| What was happening | A flare on Tuesday afternoon after a short walk |
| What my mind said it meant | This is never going to get better |
| What I felt | Heavy chest, tearful, wanting to hide |
| What I did | Cancelled plans and stayed in bed |
| What that did for me | Less pressure for a few hours |
| What it cost me | Felt more alone and more worried about the next day |
Clinical cautions
The measures box is for the clinician to complete and is not a diagnostic or risk-assessment tool, so check licensing before using any suggested measure. Keep sittings short and allow breaks, since thinking and emotion can bring on a delayed worsening for some clients. Never use the map to suggest that symptoms are exaggerated. Where the map shows hopelessness, screen for suicidal thoughts and follow local risk procedures. This tool does not diagnose any condition and is not a substitute for individual face-to-face therapy or for emergency crisis support.
References
- Sauer, K. S., Bräscher, A.-K., Germer, S., Huth, D., Kolb, J., Mütze, K., & Witthöft, M. (2026). Cognitive-behavioral therapy for post COVID-19 condition: A pilot randomized controlled trial. Journal of Psychosomatic Research, 210, 112920. https://doi.org/10.1016/j.jpsychores.2026.112920.
- Garriga-Salvó, C., Navarro, E., Lidón-Moyano, C., Arévalo, A., Roca, R., Morera, M., & Llistosella, M. (2026). Psychological interventions for individuals with long COVID: A systematic review and meta-analysis. Health Psychology Review, 20(3), 665-686. https://doi.org/10.1080/17437199.2026.2646179.
- Rometsch, C., Colditz, K., Elgner, M., Allwang, C., Zipfel, S., Junne, F., & Binneböse, M. (2026). Efficacy of a psychotherapeutic group intervention for patients with post-COVID-19 condition: A randomized controlled trial (PsyLoCo study). BMC Psychology, 14(1), 1088. https://doi.org/10.1186/s40359-026-05149-2.
Copyright and use in research
© 2026 Dr Richard Pomfret and Third Wave Therapy Tools. May be used in research with the author and site cited. Version 1.1, approved 21 October 2026, revised as the evidence develops.
Suggested citation (APA 7th edition): Pomfret, R. (2026). Steady Ground: A stepped, measurement-led psychological protocol for adults with Long COVID (Version 1.1) [Therapist guide and worksheets]. Third Wave Therapy Tools. https://thirdwavetherapytools.com/
Part of
Steady Ground
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