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A formulation based on Wells' metacognitive model of GAD — mapping the role of positive and negative beliefs about worry in maintaining the worry cycle.
This formulation maps how worry is maintained not just by what you worry about, but by what you believe about worrying itself. Work through it with your therapist. Start with a recent trigger, then distinguish between practical worry (real problems you can act on) and hypothetical worry ('what if' worries about the future). Then map your beliefs about worry, the Type 2 meta-worry, and the coping strategies that keep the cycle going.
Use early in therapy to develop a shared metacognitive formulation of the client's worry process. Particularly indicated when the client presents with Type 2 worry (worry about worry) or reports feeling unable to control their worrying.
Introduce collaboratively by explaining that understanding how worry works as a process is different from analysing the content of individual worries. Use Socratic questioning to elicit the client's own beliefs about worry before mapping them onto the model.
For clients unfamiliar with metacognitive concepts, spend additional time on psychoeducation about the difference between Type 1 and Type 2 worry. For clients with comorbid depression, acknowledge ruminative processes and distinguish them from worry.
Not appropriate as a standalone tool without adequate training in Wells' metacognitive therapy model. Avoid if the client is in acute crisis where stabilisation should take priority over formulation work.
Pay close attention to the client's positive meta-beliefs about worry, as these often maintain the worry cycle even when the client reports wanting to stop. Revisit and refine the formulation collaboratively across sessions as new maintaining factors emerge.
Suitable for clients working with gad, formulation, wells, metacognitive, worry, cbt, meta-worry, type 1, type 2. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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Identify and challenge negative beliefs about worry — the beliefs that worry is uncontrollable or dangerous.
Track Attention Training Technique (ATT) practice sessions with focus ratings and observations.
Practise noticing and tolerating everyday uncertainty to build your tolerance muscle.
Work through a structured process to decide whether a worry is practical (take action) or hypothetical (practise letting go).