Hypervigilance & Safety Behaviours Log
A CBT for PTSD worksheet for identifying hypervigilance and safety behaviours, the feared outcomes behind them and their costs, then planning a gradual behavioural experiment.
1-page fillable PDF · US Letter (prints on A4) · CBT for PTSD
- Approach / concern
- Trauma & PTSD
- Technique
- CBT for PTSD
- Format
- Fillable PDF, 1 page (US Letter / A4)
- Access
- Pro and Advanced plans (3-day free trial)
- For
- Licensed clinicians to use with clients
- Updated
- October 2026
Key facts
What is the Hypervigilance & Safety Behaviours Log?
Safety behaviours are actions people take to prevent a feared outcome, such as constantly scanning, avoiding crowds or checking locks. In the cognitive model of PTSD, these behaviours maintain a sense of current threat and prevent the person from learning that the world is safer than it feels (Ehlers & Clark, 2000).
Why it works
Reducing safety behaviours and testing threat beliefs is a central component of cognitive therapy for PTSD. Done gradually and collaboratively, it helps update the sense of ongoing danger (Ehlers & Clark, 2000).
When to use it
- PTSD with hypervigilance
- Avoidance limiting daily life
- Later stages of trauma therapy after stabilization
- Anxiety disorders with safety behaviours
How to use it in session
- Normalize safety behaviours as understandable responses.
- Identify behaviours, feared outcomes and costs.
- Choose one small behaviour to reduce.
- Make a specific prediction and rate belief.
- Review what happened and update beliefs.
Clinician tips
- Ensure the client is genuinely safe in their current environment first.
- Start with low-risk behaviours.
- Don’t drop safety measures that protect against real, current danger.
Worked example
Sharing with clients
Members can download the PDF to print or email, or copy a private client link from the download box. Your client opens the link and downloads the worksheet on any device. No client account is needed, and nothing your client writes is stored on TherapyAid.
Frequently asked questions
Are all safety behaviours bad?
No. Reasonable safety precautions are healthy. The concern is excessive behaviours driven by a sense of danger that no longer matches reality.
Should this be done early in therapy?
Usually after stabilization and with a strong therapeutic alliance, as part of trauma-focused treatment.
References
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319-345.
Herman, J. L. (2015). Trauma and recovery: The aftermath of violence, from domestic abuse to political terror (Rev. ed.). Basic Books.
This worksheet is an educational tool for use by, or under the guidance of, a licensed or registered mental-health professional. It is not a diagnostic instrument or a substitute for clinical judgement. If a client is in crisis in Canada, call or text 9-8-8 or call 9-1-1.
