Panic Practice — Fillable Worksheet

Double Board Certified Counseling Services, Inc. • Mark Zauss, LMHC, LPC, CCMHC, NBCC, BC-TMC, ADHD-CCSP, C-DBT, CCTP

Not for emergencies. If you are in immediate danger or having thoughts of self-harm, call 988 (US) or your local emergency number.

1) Quick Panic Plan (A-C-E)

Acknowledge (name the panic + rate now 0–10) Control breathing (4-in / 6-out for ~1 minute) Expand attention (grounding/values action)

Breathing Pacer Ready • 00s

2) Rescue Statements & Reframes

Prepare 3–5 phrases you can read during a surge.

3) Safety Behaviors (Reduce Gradually)

Staying near exits Constant pulse/oxygen checking Avoiding exercise/caffeine Carrying “rescue” items (water, meds) everywhere Leaving early/escape plans Reassurance seeking

My first tiny reduction step When/where I’ll do it

4) Triggers & Body Cues

Common triggers First body cues I notice

5) Panic Episode Log

Date & time	Situation	Body sensations	Hot thought	Peak SUDS (0–10)	Duration (min)	What helped	Remove

6) Interoceptive Exposure Ladder (Practice the Sensations)

Examples: spin 30s (dizzy), breathe through a straw 60s (air hunger), run stairs 1 min (heart rate). Practice safely and stop if medically contraindicated.

Exercise	Expected fear (0–10)	Plan (duration/reps)	After SUDS (0–10)	Notes/learning	Remove

7) Daily Practice Tracker (7 days)

Start date Breathing minutes/day goal Exposure days goal (per week)

Day	Breathing minutes	Exposure done?	Win/Note