Free Safety Behaviours Worksheet: Clinician Guide to Identifying & Dropping Hidden Coping Blocks
Avoidance · CBT · Research-supported
A highly structured clinical tool to audit and drop "stealth" safety behaviours (reassurance-seeking, holding escape medications, sitting close to doors). These habits are critical to identify because they block processing of expectancy violation and keep fear loops alive.
Underlying mechanism: Safety-Seeking Behaviours & Threat Habituation Blockers
What it helps with
- Auditing subtle, invisible cognitive and physical safety-seeking behaviours.
- Clarifying the difference between healthy, adaptive coping skills and fear-maintaining safety behaviours.
- Designing a step-by-step ladder for systematically dropping safety-seeking actions.
- Empowering clients to realise that they are safe because of who they are, not because of their safety props.
How clinicians use it
- In exposure planning stages (Session 3-5) to audit hidden habits that could undermine the exposure experience.
- As a collaborative whiteboard categorisation exercise: "Which of these tools are keeping your fear alive?"
- To schedule specific "dropping homework experiments" (e.g., attending a social dinner without checking mobile phone).
Clinical Distinction Cheat-Sheet
- Coping Skill vs Safety Behaviour: Coping skills aim at emotional regulation to allow task engagement. Safety behaviours aim at preventing a catastrophised fantasy.
- Uncover Cognitive Props: Look closely for mental avoidance strategies (e.g., repeating comforting phrases, counting steps).
- Direct Extinction: Frame the dropping of safety props as the vital key to proving the situation is inherently safe.
What the worksheet looks like
| Anxious Situation | Identified Safety Behaviour (The Prop) | How it Keeps the Fear Alive (Loop) | Planned Dropping Trial / Action |
|---|---|---|---|
| Attending social dinner | Holding water glass tightly with both hands to hide tremor. | Convinces brain that hands would shake uncontrollably without the prop. | Hold glass naturally with one hand, or rest hands open on table. |
| Driving on motorways | Clinging to slow lane, keeping window fully open, clutching rescue meds. | Prevents experiential discovery that driving is safe even with windows closed. | Drive in middle lane for 3 miles with windows closed and meds in glovebox. |
| Answering work emails | Asking partner to re-read and double-approve email drafts before sending. | Belief: "If I do not get approval, I will write something offensive." | Send three non-critical emails immediately without partner review. |
Clinical cautions
Do not drop all safety behaviours simultaneously. Gradual reduction within a collaboratively built hierarchy supports successful, sustainable inhibitory learning.
References
- Salkovskis, P. M., Clark, D. M., Hackmann, A., Wells, A., & Gelder, M. G. (1999). An experimental investigation of the role of safety-seeking behaviours in the maintenance of panic disorder with agoraphobia. Behaviour Research and Therapy, 37(6), 559-574.
- Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23.
Part of
Systematic Exposure Protocol
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