A Patient's Guide to Living with Worries

1. Notice and write down

• Notice when you have a worrying thought.
• Write it down – for example, in a notebook, on a post-it note, or on your phone
• This helps you step back from the worry rather than getting caught up in it.

     2. Understand the type of worry

Ask yourself: Is this worry practical or hypothetical?

Hypothetical worry (future, “what if?”):

• Might happen in the future, not happening right now
• Often outside your control
• Not something you can act on right now

Practical worry (current, actionable):

• A real problem happening now or soon
• Something you can take steps to address
• Often something you have been avoiding

     3. Choose the most helpful approach

• If many of your worries are hypothetical >​ use Worry Time

This technique focuses on postponing and letting go of worries you cannot act on in the moment.

• If many of your worries are practical > use Problem Solving

This technique helps you work out what you can do and make a plan to solve the problem.

Worry Decision Tree

The rest of this page will explain how to use each of these approaches in more detail.

We will start by showing an example of how to write down your worries using a Worry Diary. This example will help you see how to notice your worries and sort them into practical or hypothetical worries.

Example of using a Worry Diary:

We have included a blank copy of this table at the end of the page.

You may find it helpful to use it regularly to notice your worries and classify them as practical or hypothetical.

Schedule

• Choose a specific time (as needed) for Worry Time (avoid just before bed).
• Put it in your calendar or diary. Using the same time daily helps build a routine.

Write down the worry

• Keep noting down any worries as they come.
• When you notice a Hypothetical Worry, remind yourself that you do not need to deal with it right now and can review it at Worry Time. Write it down and return to what you were doing.

Refocus attention

• Try to let go of your worry for now. This may feel difficult, but remember that you have set aside specific Worry Time when you can return to it when you are in a better position to think it through.
• Gently bring your attention back to the present moment and the activity you were doing.
• If that’s hard, take a moment to notice your surroundings (what you can see or hear) to help you anchor your attention before continuing with your task.
• You may find it helpful to switch to a simple activity, e.g., listening to music, reading, or doing something practical.

Worry time

During your scheduled Worry Time, look over your worries one by one. You may choose to rewrite them as you review them.

As you work through each worry, ask yourself:

• Do I feel any different about this worry now compared to when I first wrote it down?

• How truthful or helpful does this worry seem now?

• Did the thing I was worried about actually happen, and if so, how did I cope?

• Is this still a problem, or has it changed?

If a worry is a practical worry, switch to using the Problem Solving approach. Sometimes, by the time you revisit a worry, it already feels less intense or easier to manage.

• Try to keep your Worry Time to around 20 minutes. When you finish, it can help to let go of your list physically (e.g., rip it up, throw it away, or delete it if it’s on your phone or computer. When you come back to Worry Time next time, start with a fresh sheet.

Identify one problem

It is common to have more than one problem at the same time.

Start with one problem, ideally the one that would make the biggest difference to your wellbeing if it were resolved.

Example problem:

List all the solutions (aim for at least three)

Write down as many options as you can think of, even if some seem unrealistic.

If you are finding it difficult to come up with ideas, you could ask a trusted family member or friend for suggestions, or look online for examples of how others have approached similar problems.

If you still struggle to identify solutions after trying these steps, it may be helpful to return to the previous stage and choose a different problem to prioritise.

Example options:

Choose which solutions may work best

Once you have a list of possible solutions, consider the advantages and disadvantages of each one to help you decide which option might work best.

Select one solution and create a plan

After reviewing the advantages and disadvantages of each possible solution, rate how effective each option is likely to be.

You might use a scale from 1 to 10, where 10 = very likely to work and 1 = least likely to work.

Choose the option you believe will help most. If several are equal, pick the one that:

• Needs the least time/effort, or
• feels the most manageable, or
• you feel most confident to try first.

Create a specific action plan

Once you have chosen your solution, create a clear and detailed plan.
Start by identifying:

• The first step you need to take
• Where you will do it
• When you will do it
• Who will be involved (if anyone)

If the plan feels big or overwhelming, break it into smaller steps until each part feels achievable.

Implement the plan and review

Put the plan into action.
Afterwards, take some time to reflect:

• What went well?
• What did you learn?
• What, if anything, would you change next time?

If the solution did not fully solve the problem, consider whether you need to adjust the plan, or whether it might be helpful to return to your list and try a different solution.

Remember, problem solving is often a process of testing different options and learning what works best for you.

Worry Diary

Problem Solving

Advantages and disadvantages:

Action plan: