Grief Reflection Worksheet

Part 1: Identify Your Emotions

Circle the emotions you’ve experienced in relation to your loss:

Sadness Anger Fear Confusion Guilt Loneliness Relief Numbness Anxiety Frustration Jealousy Regret Other: ___________


## Part 2: Deepen Your Reflection

1. Which three emotions did you circle? How do each of these feelings show up for you (e.g., in your body, in your thoughts)?
   
   
   
   
   
   
   
   
   
   
   

2. Describe a specific moment when you felt one of these emotions. What was happening? Who or what helped you in that moment?
   
   
   
   
   
   
   
   
   
   
   

3. When these emotions arise, what thoughts or questions run through your mind?
   
   
   
   
   
   
   
   
   
   
   

4. What part of the grief process has felt most challenging for you so far? Why?
   
   
   
   
   
   

5. Share one memory you cherish about the person or event you lost. What makes this memory special?
   
   
   
   
   
   

6. If you could say or do one thing differently in your healing journey, what would it be? Why?
   
   
   
   
   
   

Take your time—there are no right or wrong answers. This reflection is for you to better understand and honor your feelings. When you’re ready, bring this worksheet to our next session or keep it as a private space for your thoughts.

Healthy Coping Strategies Guide

Below are several evidence-based strategies you can try when you’re experiencing grief. Read each description and then use the space provided to note your thoughts, questions, or how you might put it into practice.

1. Journaling

Description: Writing down your thoughts and feelings can help you process emotions and see patterns in your grief journey.

My thoughts or plan for journaling:

2. Deep Breathing Exercises

Description: Focusing on slow, deep breaths can calm your nervous system, reduce anxiety, and bring you into the present moment.

My thoughts or plan for deep breathing:

3. Talking with a Trusted Friend or Adult

Description: Sharing your experience out loud with someone you trust can offer relief, new perspectives, and emotional support.

My thoughts or plan for talking with someone:

4. Physical Activity

Description: Moving your body—whether through walking, stretching, or sports—can release tension, boost mood, and improve energy.

My thoughts or plan for physical activity:

5. Creative Expression

Description: Drawing, painting, music, or other creative outlets let you express feelings that may be hard to put into words.

My thoughts or plan for creative expression:

6. Mindfulness or Meditation

Description: Spending a few minutes focusing on your breath or a guided meditation can ground you and reduce overwhelming thoughts.

My thoughts or plan for mindfulness/meditation:

Use this guide to experiment with different strategies and see what helps you most. Remember, it’s okay to try more than one at a time and switch things up as your needs change.

Personal Action Plan Template

1. My Support Network

Write down people you can reach out to when you’re feeling grief. Include their name, role, and how you’ll contact them.

1. Name & Role: ____________________ Contact: ________________
   
   
   
2. Name & Role: ____________________ Contact: ________________
   
   
   
3. Name & Role: ____________________ Contact: ________________
   
   
   
4. Name & Role: ____________________ Contact: ________________
   
   
   

2. My Preferred Coping Strategies

Choose three strategies from the Healthy Coping Strategies Guide you feel comfortable using and describe how you will apply them.

1. Strategy: ____________________
   How I will use it:
   
   
   
   
   
   
2. Strategy: ____________________
   How I will use it:
   
   
   
   
   
   
3. Strategy: ____________________
   How I will use it:
   
   
   
   
   
   

3. Triggers & Warning Signs

Identify situations, thoughts, or physical signs that may indicate you’re experiencing intense grief.

• Trigger/Warning Sign 1: ____________________
  
  
  
• Trigger/Warning Sign 2: ____________________
  
  
  
• Trigger/Warning Sign 3: ____________________
  
  
  

4. Action Steps

When you notice these triggers, what steps will you take? List at least three sequential actions.

1. ________________________________
   
   
2. ________________________________
   
   
3. ________________________________
   
   
   

5. Reflection & Next Follow-Up

After using this plan, reflect on what worked and what you might adjust. Also, note when you’ll check in or review your plan next.

Reflection:

Next check-in date: ____________________

Personal Action Plan Rubric

Use this rubric to evaluate the completeness and quality of the student’s Personal Action Plan. Score each criterion from 1 (Beginning) to 4 (Exemplary) and calculate a total score out of 20.