Coping Skills Self-Assessment Handout

Part 1: Rate Your Current Use

For each coping strategy below, circle or check the frequency that best describes how often you use it: 0 = Never 1 = Rarely 2 = Sometimes 3 = Often 4 = Always

Part 2: Reflection and Planning

1. Which two strategies do you use most often? Why do they work for you?

1. Which two strategies do you use least often? What might be holding you back?

1. Choose one strategy to focus on this week. Describe when and how you will practice it:

1. What potential barriers could prevent you from practicing this skill? List at least two.

1. For each barrier, note one solution or reminder you can use to stay on track:

Thank you for completing your self-assessment!

Use this handout to inform your Personal Coping Plan on the Personal Coping Plan Template.

Personal Coping Plan Template

Use insights from your Coping Skills Self-Assessment Handout to build a personalized action plan. Choose 3–5 strategies and complete the sections below.

Action Plan for Strategy 1

Strategy Name:

When/Where I Will Use It:

Steps or Reminders to Follow:

Action Plan for Strategy 2

Strategy Name:

When/Where I Will Use It:

Steps or Reminders to Follow:

Action Plan for Strategy 3

Strategy Name:

When/Where I Will Use It:

Steps or Reminders to Follow:

(Optional: Add Action Plan for Strategy 4 or 5 on the back of this sheet.)

Potential Barriers and Solutions

Barrier 1:

Solution 1:

Barrier 2:

Solution 2:

Commitment Statement

I commit to practicing my Coping Skills Toolbox as planned above.

Date: ____________________ Signature (optional): ____________________