CBT records
Staying well plan for the end of anxiety or OCD treatment
Written in the last few sessions and kept somewhere you will find it. It records what you learned, the first signs that the problem is coming back, and what you will do about them.
A4, free, no sign-up. The PDF is tagged for screen readers.
Why a plan at the end
Finishing treatment well does not mean the anxiety will never return. Research on exposure
suggests the original fear is not erased, so the old response can come back after a long
gap, in a new setting or under stress, and some symptoms in a hard month are different from
being back where you started. The plan helps you spot the first signs quickly and meet them
with the practice that worked. It is written with adults, or with teenagers and parents
together, in the last few sessions and in your own words.
Making the warning signs specific
Vague signs such as “feeling more anxious” arrive too late, so aim for something
you could spot on an ordinary Tuesday. For someone treated for contamination OCD, the four
lines might read like this.
Example warning signs | On the sheet | What they wrote |
|---|
| First situation I would start swerving | Using the bins at the end of the road rather than ours |
|---|
| First ritual to creep back | Wiping my phone when I get in from work |
|---|
| Sleep, temper or concentration | Snapping at the kids about shoes in the hall |
|---|
| What someone close would notice | Tom says I start asking “did you wash your hands?” again |
|---|
The next section works the same way. “Do my exposures again” is too loose to act
on when you are anxious, while “touch the bin lid and make a sandwich, three evenings
this week, without wiping my hands” is a plan you can follow. Getting back in touch for
one or two sessions when the signs appear is a normal part of the plan, not a sign it has
failed.
What the numbers say
A 2021 meta-analysis by Levy, O’Bryan and Tolin pooled 17 studies of people whose
anxiety disorder had remitted after CBT and found an overall relapse rate of 14 per cent.
That covers only people who reached remission, and relapse was defined differently across
the studies, so it says less about people who finish treatment with some symptoms left.