Rate yourself HONESTLY: True = √ Not True = ×
Being Kind and Caring About Yourself
□ I make sure I exercise and eat healthy food for my body on a daily basis.
□ I have kind thoughts about myself.
□ I am able to see my strengths and weaknesses.
□ I know how to comfort myself when I experience pain or feel down.
□ I like myself.
□ I often hear a critical voice in my head.
Describe some ways to take better care of your body and mind: _____________________________________________
Understanding My Moods and Emotions
□ It is ok to express my emotions.
□ I do not like it when I see others express their emotions. It makes me uncomfortable.
□ My typical mood is: _____________________________
□ The emotions I experience that I do not like are: ___________________________
□ When someone else shares emotions I feel: _______________________________
□ My most frequent negative emotions are: ____________________________________
Describe some ways to improve your moods and emotions: ___________________________
Flexibility in My Opinions
□ I enjoy seeing other perspectives that differ from mine.
□ I prefer to stay on one task at a time.
□ I get upset if I am interrupted when I am focused on something.
□ Conflict and challenges stress me out.
□ I love to learn and practice new skills.
□ I have been called judgemental.
□ I can easily put myself in another person’s shoes.
□ I know how to empathize with others.
Describe some ways to increase your flexibility _____________________________________
❒ I wish I didn’t procrastinate.
❒ I am often sarcastic.
❒ Other people upset me often
❒ I like to do things perfectly. Making mistakes is not ok for me.
❒ I work better under pressure.
❒ I can get overwhelmed with so many things to do.
❒ I love my work and may be a workaholic.
❒ I don’t know how to relax.
Describe some ways to improve your attitude: ___________________________________
❒ I love crowds.
❒ I like being alone.
❒ I talk to everyone even strangers.
❒ I wish I had more friends.
❒ I like visiting new places and meeting new people.
Describe some ways to improve my social interactions: _______________________________
❒ I prefer to follow a strong leader than to lead myself.
❒ I take time to ask open ended questions rather than give answers.
❒ I am always trying to improve my leadership skills.
❒ I walk the talk and lead by example.
❒ The best leaders are good listeners.
❒ You have to be charismatic to be a leader.
❒ I’d like to help other people improve and achieve.
Describe some ways to increase my leadership strength: ______________________________
Getting Stuff Done
❒ I trust my instincts and intuition rather than plan.
❒ I have a plan and I do what it takes to achieve it.
❒ I have no problem making decisions.
❒ I love making lists.
❒ Decisions are painful and overwhelm me.
❒ I can often regret decisions I make.
❒ I love to start many things to have variety and may not finish. I am ok with this.
❒ I am so tired of not meeting my goals.
❒ I find it very difficult to create healthy boundaries to get my stuff done.
Knowing My Strengths
- What is something you do in your free time or everyday that you love doing?
- My strengths are __________________________________________________________
Knowing My Improvement Areas
- Things I want to improve are ________________________________________________
- One action I can take now is ________________________________________________