CBT · Self-Monitoring
Depression Worksheet
A symptom check-in plus one behavioral activation step for this week
About this worksheet
Depression has more good-quality treatment evidence behind it than almost any other mental-health condition, and the active ingredients aren't a mystery: behavioral activation, cognitive work, sleep and routine repair, social re-engagement, and where indicated, medication. The trouble is implementation. Depression itself convinces clients that none of those steps are worth taking — that the small things are pointless and the big things impossible. This worksheet is built to push back against that exact distortion. The top half is a symptom check-in across the nine PHQ-9-aligned domains, plus a 0–10 mood rating, so client and therapist can track whether things are moving at all. The bottom half is the active ingredient: one behavioral activation step, scheduled with time and place, with an accountability person attached. The worksheet closes with a safety-plan prompt for any client where suicidal ideation could surface. It is small on purpose. Depression-treatment research is clear that a single, specific, scheduled action between sessions outperforms a long list of vague intentions.
When to use it
- Depression treatment monitoring between sessions.
- Behavioral activation homework after introducing the model.
- Post-discharge follow-up — the symptom checklist plus one action gives a structured weekly touch.
- Avoid as a standalone for clients in acute suicidal crisis — pair with a full safety plan and direct contact.
How to use it
- 1Check the symptoms
All that apply this week. Visual at a glance — clients often underestimate until they see the count.
- 2Rate overall mood
0–10 scale. Track week-over-week to give the client evidence of movement they otherwise miss.
- 3Name the depression story
What is depression telling you about yourself? Then write what you'd say to a friend with that same story.
- 4Pick three small mastery/pleasure moments
From history — things that used to give even a flicker. Mastery and pleasure both, not just one.
- 5Schedule ONE
Pick one, attach a day, a time, a place, and how long. Specificity is the whole intervention.
- 6Add accountability
One person who will know. Tell-someone effects in behavioral activation research are not small.
Frequently asked questions
Is this a depression screening tool?+
Not a diagnostic instrument — for screening, use the validated PHQ-9. This worksheet is a between-session tracker and intervention tool, designed to pair with whatever assessment your practice uses.
What is behavioral activation and why is it on this worksheet?+
Behavioral activation is a behavioral treatment for depression where clients schedule small actions that produce mastery or pleasure, regardless of mood. Several large randomized trials (Jacobson, Dimidjian, Richards) have found it as effective as cognitive therapy and antidepressant medication for moderate depression — and it works through behavior change without requiring cognitive restructuring first.
What if my client is too depressed to do any activity?+
Then the activity is smaller. A 10-minute walk becomes 'put on shoes.' A shower becomes 'sit on the edge of the tub.' BA's principle is to go small enough that the activity actually happens, then build from successful completion. The number on the page matters less than the streak of doing.
When should I escalate care instead of using this worksheet?+
Active suicidal ideation with plan or intent, severe functional impairment (not eating, not sleeping, can't work), psychotic features, or PHQ-9 ≥20. Pair with safety planning, medication consultation, and possibly higher level of care. The worksheet supports treatment — it does not replace clinical judgment.
Can clients use this without a therapist?+
Symptom tracking and one-action scheduling are safe to self-direct. For clients dealing with hopelessness or suicidality, the worksheet should be embedded in a treatment relationship — not used solo.
Related worksheets
Worksheet — Depression Worksheet — provided by TherapistAssist for clinical use. Not a substitute for assessment or treatment.