Cognitive Behaviour Tracking Complete this form BEFORE and AFTER your walk Activity What? When? Where? How? Feelings Feelings Thoughts Thoughts Your feelings before doing the activity. (Rate feeling from 0 – 100%) Example: Your feelings after doing the activity. (Rate feeling from 0 – 100%) Example: Automatic thoughts before the activity. Automatic thoughts after the activity? Example: Example: Monday 8am Brisk Walk 30 minutes Numb: 40% Hopeless: 15% Sad: 30% Determined: 20% Numb: 0% Hopeless: 5% Sad: 15% Determined: 50% Happy: 10% Example: Example: Example: I’m lazy. I’m too busy to walk. I’ll never meet my goals. I’m lonely. I want to make a change. I usually feel better when I walk. Example: Maybe I’m too hard on myself. I’ve overcome hard things. I’m excited to see my friend tonight. I’d like to walk again tomorrow. Example: Tuesday 8pm Slow Walk after Dinner 45 minutes Sleepy: 80% Worried: 10% Content: 50 % Inspired: 20 % Sleepy: 70% Worried: 5% Content: 80 % Inspired: 20 % Proud: 15% I’m tired I should call my Mom I’m looking forward to getting some fresh air I like the progress I’m making Walk Monday 8:20 am 35 minutes Slow walk Happy 70 % Anxious 20% Sleepy 10% Happy 85% Anxious 10% Sleepy 5% Im too cold Im sleepy I’m proud of myself for taking good care of myself tonight My mind is ready for sleep I will reply to emails in the morning I deserve to rest Im so grateful about this walk Im not cold anymore Im present Example: Wellness Counselling: Physical Wellness ©Rhodes Wellness College Ltd. 2019 Walk Tuesday 3:00 pm 1 hour Slow Walk Walk Wednesday 2:30 pm 35 minutes Slow walk Walk Friday 3:00 – 3:3 30 pm Wellness Counselling: Physical Wellness Happy 80% Anxious 5 Sleepy 15% Happy 80% Sleepy 10% Tired 10% Happy 90% Anxious 0% Sleepy 10% Happy 90% Sleepy 5% Tired 5% Tired and sleepy Little bit anxious Not wanting to go work Tired and a little bit sleepy but happy and peaceful Happy and less anxious but sleepy Happy 70% Sleepy 10% Dizzy 20% Happy 80% Dizzy 20% Happy but really dizzy Happy but still dizzy ©Rhodes Wellness College Ltd. 2019 Happy, less sleepy and activated.
