About this resource
Worries often show up at bedtime. This exercise, done early in the evening, has the client write each worry and the next step they could take, then deliberately put the list aside, so worries are less likely to keep them awake.
Purpose
To reduce bedtime worry by dealing with worries earlier in the evening.
Who it is for
Primary profession: Psychologists. Also relevant for counsellors and therapists.
Client or participant group: Adolescents and adults whose worries keep them awake.
Practice setting: Between psychology sessions, early in the evening.
Suggested uses
- Sleep problems linked to worry
- Generalised worry
- Insomnia treatment
- Between-session practice
Instructions for practitioners
- Explain the rationale.
- Schedule it a few hours before bed.
- Encourage brief, practical next steps.
- Review effects on sleep.
Instructions for clients or participants
- Write each worry.
- Write one next step.
- Fold the page and put it away.
Accessibility considerations
Can be done on a phone.
Scope and limitations
An educational worksheet for use within treatment.
Research basis
Scheduling worry and shifting from abstract to concrete thinking are supported strategies for reducing unhelpful worry and rumination. Behavioural sleep strategies such as regular sleep and wake times and stimulus control are core parts of cognitive behavioural therapy for insomnia (CBT-I), which improves sleep in adults with chronic insomnia; where poor sleep persists, refer for CBT-I or medical review.
- Borkovec, T., Wilkinson, L., Folensbee, R., & Lerman, C. (1983). Stimulus control applications to the treatment of worry. Behaviour Research and Therapy, 21(3), 247–251. https://doi.org/10.1016/0005-7967(83)90206-1
- Trauer, J. M., Qian, M. Y., Doyle, J. S., Rajaratnam, S. M., & Cunnington, D. (2015). Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis. Annals of Internal Medicine, 163(3), 191–204. https://doi.org/10.7326/m14-2841
- Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134(2), 163–206. https://doi.org/10.1037/0033-2909.134.2.163
What is included
A 2-page printable A4 PDF, including a practitioner notes page with the research basis (version 1.0).
Originality
Original Practitioner Plus content: wording, activity structure, layout and icons were created for this resource. No third-party worksheets, illustrations or text were reproduced. Reflects widely described cognitive behavioural strategies for bedtime worry.
