The vicious cycle of worry

This resource explains how worry can become a repeating cycle, helping young people understand the links between anxious thoughts, physical sensations, and coping behaviours such as reassurance-seeking and avoidance. It is designed as a therapeutic, engaging activity to support formulation work, normalise worry experiences, and help young people reflect on how short-term coping strategies can sometimes keep the worry going.

References & Further Reading

  • Creswell, C., Waite, P., & Hudson, J. (2020). Anxiety disorders in children and young people: Assessment and treatment. Journal of Child Psychology and Psychiatry, 61(4), 399–411. https://doi.org/10.1111/jcpp.13186
  • Davey, G.C.L. and Meeten, F. (2016) ‘The perseverative worry about: A review of cognitive, affective and motivational factors that contribute to worry perseveration’, Biological Psychology, 121, pp. 233–243. doi:10.1016/j.biopsycho.2016.04.003
  • Donovan, C.L. et al. (2017a) ‘Thinking about worry: Investigation of the cognitive components of worry in children’, Journal of Affective Disorders, 208, pp. 230–237. doi:10.1016/j.jad.2016.09.061.
  • Ewing, D. L., Monsen, J. J., Thompson, E. J., Cartwright-Hatton, S., & Field, A. (2015). A meta-analysis of transdiagnostic cognitive behavioural therapy in the treatment of child and young person anxiety disorders. Behavioural and Cognitive Psychotherapy, 43(5), 562–577. https://doi.org/10.1017/S1352465813001094
  • Kendall, P. C., & Peterman, J. S. (2015). CBT for adolescents with anxiety: Mature yet still developing. American Journal of Psychiatry, 172(6), 519–530. https://doi.org/10.1176/appi.ajp.2015.14081061
  • Kingery, J. N., Roblek, T. L., Suveg, C., Grover, R. L., Sherrill, J. T., & Bergman, R. L. (2006). They’re not just “little adults”: Developmental considerations for implementing cognitive-behavioral therapy with anxious youth. Journal of Cognitive Psychotherapy: An International Quarterly, 20(3), 263–273. https://doi.org/10.1891/jcop.20.3.263
  • Kishita, N., & Laidlaw, K. (2017). Cognitive behaviour therapy for generalized anxiety disorder: Is CBT equally efficacious in adults of working age and older adults? Clinical Psychology Review, 52, 124–136. https://doi.org/10.1016/j.cpr.2017.01.003
  • Perrin, S., Bevan, D., Payne, S., Bolton, D., & Perrin, S. (2019). GAD-specific cognitive behavioral treatment for children and adolescents: A pilot randomized controlled trial. Cognitive Therapy and Research, 43, 1051–1064. https://doi.org/10.1007/s10608-019-10020-3
  • Watts, R., Cossar, J., & Ferreira, N. (2021). Applicability of the intolerance of uncertainty model to generalized anxiety disorder symptoms in young people. Mediterranean Journal of Clinical Psychology, 9(2).