Self-Care Workshop - Self Assessment Worksheet 1

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Self-Care Workshop - Self Assessment Worksheet 1


Self assessment worksheet for the Self-Care Workshop 2018


A self assessment for the Self-Care Workshop 2018. The assessment uses a grading scale of 1-5 and is split into sections of self-care: Physical, psychological, emotional, spiritual. The second page of the worksheet invites people to develop their self-care plan through examining current habits and patterns and identifying healthier ones.


Womanist Working Collective


28 June 2018

Text Item Type Metadata


Self-Care Assessment Worksheet
This assessment tool provides an overview of effective strategies to maintain self-care. After completing the full assessment, you can move on to developing a full self-care plan.
Using the scale below, rate the following areas in terms of frequency:
5 = Frequently 4 = Occasionally 3 = Rarely 2 = Never 1 = It never occurred to me
Physical Self-Care
___ Eat regularly (e.g. breakfast, lunch and dinner) ___ Eat healthy
___ Exercise
___ Get regular medical care for prevention
___ Get medical care when needed
___ Take time off when needed
___ Get massages
___ Dance, swim, walk, run, play sports, sing, or do some other physical activity that is fun ___ Take time to be sexual—with yourself, with a partner
___ Get enough sleep
___ Wear clothes you like
___ Take day trips or mini-vacations
___ Other:
Psychological Self-Care
___ Make time for self-reflection
___ Have your own personal psychotherapy
___ Write in a journal
___ Read literature that is unrelated to school
___ Let others know different aspects of you
___ Notice your inner experience—listen to your thoughts, judgments, beliefs, attitudes, and feelings
___ Engage your intelligence in a new area, e.g. go to an art museum, history exhibit, sports event, theater performance ___ Practice receiving from others
___ Be curious
___ Say “no” to extra responsibilities sometimes
___ Other:
Emotional Self-Care
___ Spend time with others whose company you enjoy
___ Stay in contact with important people in your life
___ Give yourself affirmations, praise yourself
___ Love yourself
___ Re-read favorite books, re-view favorite movies
___ Identify comforting activities, objects, people, relationships, places and seek them out
___ Allow yourself to cry
___ Find things that make you laugh
___ Express your outrage in social action, letters and donations, marches, protests
___ Play with children
___ Other:
Spiritual Self-Care
___ Make time for reflection
___ Spend time with nature
___ Find a spiritual connection or community
___ Be open to inspiration
___ Cherish your optimism and hope
___ Be aware of nonmaterial aspects of life
___ Try at times not to be in charge or the expert
___ Be open to not knowing
___ Identify what is meaningful to you and notice its place in your life
___ Have experiences of awe
___ Read inspirational literature (talks, music, etc.)
___ Other:
Adapted by BWell Health Promotion from: Transforming the Pain: A Workbook on Vicarious Traumatization. Saakvitne, Pearlman & Staff of TSI/ CAAP (Norton, 1996)
Develop a Self-Care Plan
1. List the self-care habits you are using now to manage stress and stay healthy: (I get at least 8 hours of sleep at night)

2. List the self-care habits you would like to use but are not currently practicing: (Practicing yoga regularly)
  
3. Identify the obstacles keeping you from practicing these habits:
(I don’t practice yoga regularly because I don’t have the time to) 

4. What solutions can you come up with to address the obstacles you listed:
(I could free up time for myself by watching less TV or waking up earlier) 

5. Reread the self-care habits you wrote down for item 2. Select one of the habits you would like to begin practicing and complete the sentences below.
Today, I commit to...
I want to do this because...
I will accomplish this by...


self care assessment and planning.pdf



Womanist Working Collective, “Self-Care Workshop - Self Assessment Worksheet 1,” Womanist Working Collective Archive, accessed July 4, 2022,

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