Exercise plan and tracker

The evidence base for exercise as a depression intervention is robust enough that for moderate cases, structured exercise produces effect sizes comparable to first-line psychological interventions. For anxiety, particularly somatic anxiety, the data is similar. The clinical question isn’t whether to add exercise to the protocol. It’s how to add it without falling into the standard pattern where the client commits to five sessions a week and does zero by week three.

This worksheet pairs the plan with the tracker on the same form. The pairing matters. Most clients overcommit at the planning stage. They write “run three times a week” because that’s what an aspirational version of themselves does, not what the actual version of themselves at 7am on a Tuesday is going to do. The tracker on the same worksheet exposes the gap quickly, by week one.

Use it with depressed clients where exercise is part of the plan, anxiety clients where somatic regulation is needed, clients on long-term medication who would benefit from non-pharmacological adjuncts, and clients with chronic pain where exercise is recommended but engagement has been low. Don’t use it without considering medical contraindications, particularly for clients with eating disorders or significant cardiac history.

The clinical lever is the planned-versus-actual gap. A client who plans five days and does one is not failing. The plan is wrong. The therapy work is to set the bar at twice their realistic current baseline, not at what they think they should be doing. A client whose realistic baseline is zero gets a plan of two ten-minute walks. The plan succeeds, the habit forms, and the dose increases over weeks.

The mood-shift sliders alongside each completed entry tell you whether the exercise is working clinically. A client whose mood doesn’t shift much after completed exercise is still benefiting metabolically, but the immediate psychological return is low, which means motivation will need scaffolding from somewhere else. A client whose mood shifts noticeably is reporting their own dose-response data, which becomes the lever to get them through the harder weeks.

In my-cbt, the worksheet is one of the bundled system templates. The plan and tracker live in the same submission, so when you read it before next session you see both at once. Assign it from the case file with a personal message that names the realistic baseline you and the client agreed on, not the aspirational one.