Anxiety Coping Session Log
Document each anxiety coping session to track progress, strategies, and outcomes.
Session Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Participant's Full Name
*
First Name
Last Name
Facilitator/Professional Name
*
First Name
Last Name
Pre-Session Anxiety Level (1 = Very Low, 10 = Very High)
*
Very Low
1
2
3
4
5
6
7
8
9
Very High
10
1 is Very Low, 10 is Very High
Coping Strategies Used
*
Deep Breathing
Progressive Muscle Relaxation
Mindfulness/Meditation
Grounding Techniques
Journaling
Visualization
Other
Describe How the Coping Strategies Were Used
*
Post-Session Anxiety Level (1 = Very Low, 10 = Very High)
*
Very Low
1
2
3
4
5
6
7
8
9
Very High
10
1 is Very Low, 10 is Very High
Session Outcome
*
Significant Improvement
Some Improvement
No Change
Increased Anxiety
Additional Notes or Observations
Recommended Follow-Up Actions
Session Log Signature
*
Submit Session Log
Submit Session Log
Should be Empty: