Self-Awareness - Worksheet 1
Name_______________________________________Date:______________________
How frequently do you do the following? Check the box.
Physical Self-Care
BEHAVIOR
Get medical care when needed
Get enough sleep
Take time off when you’re sick
Wear clothes you like
Dance, swim, walk, run, play sports, sing, or do other
physical activity you enjoy
Take vacations
Eat healthy food
Eat regularly (e.g., breakfast, lunch, and dinner)
Take time to be sexual-with yourself, with a partner
Exercise
Get massages
Get regular medical care for prevention
Other:
0
NEVER
1
RARELY
2
SOMETIMES
3
OFTEN
2
SOMETIMES
3
OFTEN
Psychological Self-Care
BEHAVIOR
Engage your intelligence in a new area-go to an art
museum, history exhibit, sport event, auction,
theater performance
Practice receiving from others
Make time away (or turn off) from
telephones/pagers/sidekicks
Contact support network members for help
Notice your inner experience-listen to your thoughts,
beliefs, attitudes, and feelings
Be curious
Read literature that is unrelated to work
Say no to extra responsibilities
Make time for self-reflection
Take day trips, a mini-vacation, or enjoyable retreat
Write in a journal
Go to your own personal counseling or
psychotherapy
Do something at which you are not expert or in
charge
Decrease stress in your life
Let others know different aspects of you
Stand up for yourself
Focus on your needs first
Ask for help
Examine priorities
0
NEVER
1
RARELY
EMOTIONAL SELF-CARE
Behavior
0
NEVER
1
RARELY
2
SOMETIMES
3
OFTEN
0
NEVER
1
RARELY
2
SOMETIMES
3
OFTEN
Express yourself in social action, letters, donations,
marches, protests instead of complaining
Find things that make you laugh
Stay in contact with important people in your life
Spend time with others whose company you enjoy
Play with children
Reread favorite books, review favorite movies
Give yourself affirmations, praise yourself
Identify comforting activities, objects, people,
relationships, places and seek them out
Love yourself
Allow yourself to cry
Do something to nurture yourself
SPIRITUAL SELF-CARE
Behavior
Find a spiritual connection or community
Be aware of nonmaterial aspects of life
Be open to not knowing
Spend time with nature
Be open to inspiration
Be mindful of what is happening in your body and
around you now
Identify what is meaningful to you and notice its place
in your life
Make time for reflection
Allow yourself to not be in charge or the expert
Cherish your optimism and hope
Give up trying to control
Listen to music
Spend time with children
Meditate
Have experiences of awe
Read inspirational literature (talks, music, etc.)
Pray
Sing
Contribute to causes in which you believe
Let go of blame
Focus on the present moment
Focus on what you are grateful or thankful for
Self-Care at Work
BEHAVIOR
0
NEVER
1
RARELY
2
SOMETIMES
3
OFTEN
0
NEVER
1
RARELY
2
SOMETIMES
3
OFTEN
Take time to eat lunch
Take time to chat with co-workers—but not about
work
Make quiet time to complete tasks
Identify projects or tasks that are exciting and
rewarding
Set limits with clients and colleagues
Arrange your work space so it is comfortable and
comforting
Get regular supervision or consultation
Negotiate for your needs (benefits, pay raise)
Develop or contact a peer support group
Develop a non-intense area of professional interest
Take time to debrief
Go out with colleagues and do not talk about
work/students
Take a leave of absence
Choose to become burned out for a set period of time
Inform others of feelings of burnout and of personal
plans to take a “sabbatical”
Other:
Balance
BEHAVIOR
Strive for balance within your work-life and work day
Strive for balance among work, family, relationships,
play, and rest
Other areas of self-care that are relevant to you:
Adapted from © Sidran Foundation & Press, 2000
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