Baseline Coping Assessment Worksheet

Instructions: For each coping strategy you currently use, list it below, then rate its frequency and effectiveness. Use 1 (low) to 5 (high).

1. Strategy: _______________________________
   
   Frequency (1–5): ____ Effectiveness (1–5): ____
   
   
   
   
2. Strategy: _______________________________
   
   Frequency (1–5): ____ Effectiveness (1–5): ____
   
   
   
   
3. Strategy: _______________________________
   
   Frequency (1–5): ____ Effectiveness (1–5): ____
   
   
   
   
4. Strategy: _______________________________
   
   Frequency (1–5): ____ Effectiveness (1–5): ____
   
   
   
   
5. Strategy: _______________________________
   
   Frequency (1–5): ____ Effectiveness (1–5): ____
   
   
   
   

Reflection Questions

1. Which strategy do you use most often? Why do you think that is?
   
   
   
   
   
   
2. Which strategy feels most effective for you? What makes it helpful?
   
   
   
   
   
   
3. Are there any strategies you haven’t tried yet but would like to? Which ones?
   
   
   
   
   
   
4. What patterns or gaps do you notice in your coping strategies? (e.g., activities, triggers, timing)
   
   
   
   
   
   

Coping Skills Checklist

Instructions: Review the skills below and check (✓) those you’d like to try. Then answer the reflection questions.

• Deep breathing exercises (e.g., 4-7-8 breathing)
  
  
• Progressive muscle relaxation
  
  
• Grounding techniques (5-4-3-2-1)
  
  
• Mindfulness meditation
  
  
• Journaling thoughts and feelings
  
  
• Positive self-talk
  
  
• Physical activity (walking, stretching)
  
  
• Creative expression (drawing, music)
  
  
• Social support (talking with a friend or family member)
  
  
• Seeking professional help (e.g., counselor, therapist)
  
  
• Other: _______________________________
  
  
  

Reflection Questions

1. Which skill interests you the most and why?
   
   
   
   
   
   
2. When and where do you think you could practice this skill?
   
   
   
   
   
   
3. What might get in the way of practicing this skill, and how could you overcome it?
   
   
   
   
   
   
4. How will you remind yourself to use this skill when you feel anxious? (e.g., phone reminder, note, buddy)
   
   
   
   
   
   

Anxiety Psychoeducation Infographic

What Is Anxiety?
Anxiety is your body’s natural response to stress. It can help you stay alert and prepared for challenges. However, when anxiety becomes intense or lasts too long, it can interfere with everyday life.

Physical Signs

• Racing or pounding heart
• Shortness of breath or rapid breathing
• Sweaty palms or cold hands
• Muscle tension or trembling

Thought Patterns

• Persistent “What if…?” questions
• Difficulty concentrating
• Overthinking situations

Emotional Signs

• Feeling nervous or on edge
• Restlessness or irritability
• Sense of impending doom or helplessness

Why Anxiety Happens

• Triggered by stressors (e.g., tests, social situations, major changes)
• Activation of the brain’s “fight-or-flight” response
• Can sometimes occur without an obvious trigger

When to Seek Support

• Anxiety affects your schoolwork, sleep, or friendships
• You feel unable to control your anxious thoughts or feelings
• Symptoms persist for weeks or worsen over time

For practical ways to manage these signs, explore the Coping Skills Checklist.

Counselor Session 1 Guide

1. Build Rapport (5 minutes)

Counselor: "Hi [Student Name], it’s so good to see you today! How are you doing?"
(Pause; allow student to respond.)

Counselor: "Thanks for sharing. Tell me a little bit about your week—what’s been going well, or what’s been on your mind?"
(Listen actively; nod and use reflective statements.)

Counselor: "You mentioned that [repeat key detail]. That sounds important. I’m here to support you, and anything you share is confidential between us.

Counselor: "Before we dive in, what’s one thing you really enjoy doing—like a hobby, a class at school, or something fun with friends?"
(Let student describe; follow up with, “That sounds awesome. What do you like most about it?”)

2. Psychoeducation on Anxiety (10 minutes)

Counselor: "Today, I want to help you understand what anxiety is and how it shows up in our bodies and minds. Let’s look at this together."

Show Anxiety Psychoeducation Infographic

Counselor: "This infographic breaks down three parts: physical signs, thought patterns, and emotions. Let’s start with the physical signs—things like a racing heart or tense muscles. Have you ever noticed your body doing something like that when you feel worried?"
(Pause for student examples—"Can you tell me about a time your heart felt like it was pounding?")

Counselor: "Great observation. On the next part, you see thoughts like ‘what if…?’ questions or difficulty concentrating. Have you had thoughts that keep replaying in your head? What do those thoughts sound like?"
(Follow up: “How do those thoughts make you feel?”)

Counselor: "Finally, emotions. You might feel on edge, irritable, or like something bad is going to happen. Which of these emotional signs feel familiar to you?"
(Validate whatever the student shares: “That makes sense—I appreciate you sharing that.”)

3. Baseline Coping Assessment (10 minutes)

Counselor: "Now, I’d like to find out what you’re already doing to cope when you feel anxious. There’s no right or wrong answer—this is just to help us see your strengths and where we might add a new skill or two."

Hand out Baseline Coping Assessment Worksheet

Counselor: "You’ll list up to five strategies you use—anything from listening to music to taking deep breaths—and then rate how often you use them and how well they work for you. Take a few minutes to fill that out, and I’ll be right here if you have any questions."
(Give student ~5 minutes; walk over to check in.)

Counselor: "How did that feel? Which strategy did you notice you use most often?"
(Student answers—listen and reflect.)

Counselor: "And which strategy felt most effective for you? What makes it helpful?"
(Discuss patterns or gaps: “I see that you use [Strategy A] a lot but maybe haven’t tried [Strategy B].”)—prepare to introduce new options.

4. Select Initial Strategy & Wrap-Up (5 minutes)

Counselor: "I’d like to introduce a few more skills you might try, and together we’ll pick one to focus on this week. Here’s a checklist of evidence-based strategies."

Show Coping Skills Checklist

Counselor: "Take a look and check any that sound interesting. Which one jumps out at you the most?"
(If student hesitates, prompt: “Some people like deep breathing; others find writing in a journal helpful. What do you think you’d give a try?”)

Counselor: "Perfect. Let’s make a simple plan:

1. Your chosen skill: ____________________
2. When will you practice it? (day/time)
3. Where will you practice it?
4. How will you track it?

Why don’t you tell me your answers, and I’ll write them here."
(Complete plan together.)

Counselor: "That’s a great start. You’re setting yourself up for success with a clear plan. We’ll check in on how it went next time.

Counselor: "Before we finish, do you have any questions or concerns?"
(Answer questions.)

Counselor: "Thank you for your honesty and effort today. I’m proud of the work you did. I’ll see you next session, where we’ll reflect on this practice and learn another new coping strategy. Take care, and remember, I’m here if you need anything."

End of Session 1

Session 1 Warm-Up: Mood & Anxiety Check-In

Instructions (5 minutes)

Let’s start by noticing how you’re feeling right now. Answer the prompts below to help us tune in before we begin.

1. On a scale of 1 (calm) to 5 (very anxious), circle how you feel in this moment:

   1 2 3 4 5
   
   
   

2. What single word best describes your current mood?

   ___________________________
   
   
   

3. Name one thing you’re looking forward to today or one concern on your mind:

   ____________________________________________________________________
   
   
   
   
   
   

4. Let’s try a quick grounding breath together:
   • Breathe in slowly for a count of 4
   • Hold for a count of 4
   • Exhale for a count of 4

   After that breath, how do you feel now on the same 1–5 scale? __

Take a moment to notice any shift in your body or mind before we move into our session activities.

Session 1 Cool-Down: Reflection & Check-Out

Instructions (5 minutes)

Thank you for your hard work today. Before we finish, please answer the prompts below to help us wrap up and prepare for next time.

1. What is one key thing you learned about anxiety or yourself in today’s session?
   _________________________________________________________________
   
   
   
   

2. Which coping skill did you choose to practice this week, and why does it feel right for you?
   _________________________________________________________________
   
   
   
   

3. On a scale of 1 (not confident) to 5 (very confident), how confident do you feel in using this skill when you next notice anxiety?
   1 2 3 4 5 __
   
   
   

4. What’s one question, concern, or topic you’d like us to explore in our next session?
   _________________________________________________________________
   
   
   
   

Great work today! I look forward to hearing how your practice goes and diving deeper next time.

Counseling Progress Rubric

This rubric is designed to assess the student’s growth and engagement across individual counseling sessions. Use a 1–4 scale for each criterion, where 4 = Exemplary, 3 = Proficient, 2 = Developing, and 1 = Beginning.

Reflection Journal Template

Use this journal to reflect on your experiences practicing your chosen coping skill last week. Be honest and detailed to help guide our discussion.

1. Confidence & Anxiety Ratings

   • How confident did you feel using your new skill? (1 = not confident, 5 = very confident): __
     
     
   • How anxious have you felt overall since our last session? (1 = very low, 5 = very high): __
     
     
     

2. One Success
   Describe one time you successfully used the skill. What happened, and how did it feel?
   _________________________________________________________________
   
   
   
   
   
   

3. One Challenge
   Describe a time you struggled to use the skill. What got in the way?
   _________________________________________________________________
   
   
   
   
   
   

4. Impact on Mood or Stress
   How did using (or attempting) the skill affect your mood, anxiety, or body?
   _________________________________________________________________
   
   
   
   
   
   

5. Self-Discovery
   What did you learn about yourself through practicing this skill?
   _________________________________________________________________
   
   
   
   
   
   

6. Next Steps
   What will you try the same or differently next time you practice?
   _________________________________________________________________
   
   
   
   
   
   

7. Questions or Thoughts for Next Session
   Is there anything you’d like to explore or ask about in our next meeting?
   _________________________________________________________________
   
   
   
   
   
   

Progressive Muscle Relaxation Guide

Progressive Muscle Relaxation (PMR) is a technique that helps you notice and release tension in your body. Follow these steps in a quiet, comfortable space:

1. Get Comfortable
   Find a quiet spot where you can sit or lie down without being disturbed. Loosen any tight clothing and close your eyes if you’re comfortable.

2. Focus on Your Breathing
   Take two or three slow, deep breaths. Inhale through your nose for a count of 4, hold for a count of 2, then exhale slowly through your mouth for a count of 6.

3. Start at Your Feet
   • Tense the muscles in your feet by curling your toes and flexing them tightly. Hold this tension for about 5 seconds.
   • Notice the feeling of tightness.

4. Release and Notice
   • Gently release the tension in your feet and let them go completely limp.
   • Pay attention to the contrast between tension and relaxation for 10–15 seconds.

5. Move Up the Body
   Repeat the tension–release sequence for each muscle group, holding the tension for 5 seconds and then relaxing for 10–15 seconds:

   • Calves: Point your toes toward your face and tense; then release.
   • Thighs: Squeeze your thigh muscles; then release.
   • Buttocks: Clench your glutes; then release.
   • Abdomen: Pull your belly in; then let go.
   • Chest: Take a deep breath and hold your chest tight; then exhale and relax.
   • Shoulders: Lift your shoulders up toward your ears; then drop them.
   • Arms & Hands: Make tight fists and bend your arms; then release both.
   • Neck: Gently press your head back against the floor or chair; then relax.
   • Face: Scrunch up your forehead, eyes, and mouth; then let your face go soft.

6. Full-Body Relaxation
   After working through all the muscle groups, take another slow, deep breath. Allow your whole body to remain as relaxed as possible.

7. Reflect
   Notice any changes in your body or mind:

   • Where do you feel more relaxed?
   • Did any area remain tense?
   • How has your breathing or mood shifted?

8. Tip for Practice
   Aim to practice PMR for 5–10 minutes each day. Over time, you’ll become more aware of tension as it builds and will be able to release it more quickly.

For further reflection, record how you feel before and after in your journal or use this alongside your other coping strategies to manage anxiety throughout your day.

Session 2 Action Plan Worksheet

Instructions: Use this worksheet to plan how you will practice both Progressive Muscle Relaxation (PMR) and the coping skill you chose last session. Be as specific as possible about timing, location, support, and tracking.

1. Progressive Muscle Relaxation (PMR)

   • When will you practice PMR? (day/time): ________________________
     
     
     
   • Where will you practice PMR? _________________________________
     
     
     
   • Who or what will remind you to practice? ______________________
     
     
     
   • How will you track or record your PMR practice? _______________
     
     
     
   • Goal: I will practice PMR ___ time(s) this week.
     
     
     
     

2. Previous Coping Skill: __________________________

   • When will you practice this skill? (day/time): ________________
     
     
     
   • Where will you practice it? _________________________________
     
     
     
   • Who or what will remind you to practice? ______________________
     
     
     
   • How will you track or record this practice? ____________________
     
     
     
   • Goal: I will practice this skill ___ time(s) this week.
     
     
     
     

3. Anticipated Challenges & Solutions

   • Challenge 1: ________________________________________________
     Solution: ______________________________________________________
     
     
     
   • Challenge 2: ________________________________________________
     Solution: ______________________________________________________
     
     
     
     

4. Reflection Plan

   • When will you check in on your progress? (e.g., journal time, check-in with counselor): _____________________________________________________
     
     
     
     
     
     

5. Additional Notes or Strategies
   _________________________________________________________________
   
   
   
   
   
   

Great work planning out your practices! We’ll review your progress and adjust as needed in our next session.

Counselor Session 2 Guide

1. Warm-Up & Reflection (5 minutes)

Counselor: "Hi [Student Name], it’s great to see you again! How have you been since our last session?"
(Pause for response.)

Counselor: "Let’s start by checking in. Please have your Reflection Journal Template out. First, on a scale of 1 to 5, how confident do you feel using the skill we practiced last week? And how anxious have you felt overall?"
Show Session 2 Slides – slide 'Warm-Up: Weekly Reflection'

Counselor: "Go ahead and fill in those two ratings, then complete the prompts about one success and one challenge you experienced when using the skill."
(Give student ~2 minutes to write.)

Counselor: "When you’re ready, tell me about the success you wrote down. What happened, and how did it feel to use the skill effectively?"
(Listen; validate and reflect.)

Counselor: "Thank you. Now, what about the challenge you noted? What got in the way of practicing the skill, and how did you respond?"
(Listen; normalize obstacles and praise effort.)

2. Review Practice Insights (10 minutes)

Counselor: "I appreciate you sharing both the wins and the roadblocks. Let’s dig a bit deeper:"

Counselor: "What felt most helpful when you practiced the skill?"
(Encourage detail.)

Counselor: "What strategies did you use to overcome any obstacles?"
(Highlight problem-solving.)

Counselor: "What did you learn about yourself through this practice?"
(Affirm self-awareness.)

3. Guided Progressive Muscle Relaxation (10 minutes)

Counselor: "Today I’d like to introduce a new relaxation tool called Progressive Muscle Relaxation, or PMR. It can help you notice and release tension in your body."
Show Session 2 Slides – slide 'Guided Progressive Muscle Relaxation'

Counselor: "Please open the Progressive Muscle Relaxation Guide. We’ll go step by step together. Make sure you’re sitting comfortably or lying down, and let’s start with two slow, deep breaths. Inhale... hold... exhale..."

Counselor: "Now, tense the muscles in your feet—curl your toes tightly—hold for 5 seconds... and release. Notice the difference between tension and relaxation."
(Pause.)

Counselor: "Next, tense your calves... hold... release. Then thighs... hold... release. Continue up through your body: glutes, abdomen, chest, shoulders, arms, hands, neck, and face. Take your time with each, holding for 5 seconds and relaxing for 10–15 seconds."
(Guide through each muscle group slowly.)

Counselor: "Great. Now keep your eyes closed and take another deep breath. Notice how your body feels compared to just a few minutes ago."
(Pause for 5–10 seconds.)

Counselor: "When you’re ready, tell me what you noticed in your body during the tensing and after you released. Did your mood or breathing shift?"
(Listen and validate.)

4. Next Steps & Action Plan (5 minutes)

Counselor: "Fantastic work today! Let’s make a plan to practice both PMR and the skill you chose last week."
Show Session 2 Slides – slide 'Session 2 Action Plan'

Counselor: "Grab the Session 2 Action Plan Worksheet. First, when and where will you practice PMR this week? Who or what will remind you? How many times will you aim for?"
(Student responds; counselor writes.)

Counselor: "Next, let’s schedule your previous skill practice. When, where, and how will you track it?"
(Complete details together.)

Counselor: "Finally, what challenges might come up, and how could you solve them?"
(Help brainstorm obstacles and solutions.)

Counselor: "This plan sets you up for success. We’ll check back on it in our next session."

Counselor: "Do you have any questions about what we did today or about your action plan?"
(Answer questions.)

Counselor: "Thank you for your honesty, effort, and courage in trying new strategies. I look forward to hearing how these practices go next time. Take care and remember—you’ve got tools to help you feel more calm and in control."

End of Session 2

Anxiety Toolkit Builder Worksheet

Instructions: Use this worksheet to compile your personal toolkit of coping strategies you’ve learned. Keep it handy—carry a printout or screenshot on your device so you can refer to it whenever you need support.

1. All Learned Strategies:

   1. _______________________________
      
      
   2. _______________________________
      
      
   3. _______________________________
      
      
   4. _______________________________
      
      
   5. _______________________________
      
      
   6. _______________________________
      
      

2. Top 3 Go-To Tools:

Top Tool #1: _______________________________

• When / Trigger to use it: ____________________________________________
  
  
• Where / Time: ____________________________________________
  
  
• Steps to use this tool (quick instructions):
  ________________________________________________________________
  
  
  
• Why it helps me (what makes it effective?):
  ________________________________________________________________
  
  
  

Top Tool #2: _______________________________

• When / Trigger to use it: ____________________________________________
  
  
• Where / Time: ____________________________________________
  
  
• Steps to use this tool (quick instructions):
  ________________________________________________________________
  
  
  
• Why it helps me (what makes it effective?):
  ________________________________________________________________
  
  
  

Top Tool #3: _______________________________

• When / Trigger to use it: ____________________________________________
  
  
• Where / Time: ____________________________________________
  
  
• Steps to use this tool (quick instructions):
  ________________________________________________________________
  
  
  
• Why it helps me (what makes it effective?):
  ________________________________________________________________
  
  
  

3. Personal Reminders & Supports:
   How will I remind myself to use my toolkit?
   ____________________________________________________________________
   
   
   
   

4. Carrying My Toolkit:
   How will I keep this toolkit accessible? (e.g., screenshot, printout, planner note)
   ____________________________________________________________________
   
   
   
   

5. Backup Plan:
   If my top tool doesn’t work, what will I try next?
   ____________________________________________________________________
   
   
   
   

Great job building your Anxiety Toolkit! Use it whenever you notice anxiety creeping in—you’ve got effective strategies ready to go.

Relapse Prevention Guide

Relapse prevention helps you maintain the skills you’ve built and catch early warning signs of rising anxiety before they become overwhelming. Use this guide alongside your Anxiety Toolkit Builder Worksheet and Session 3 Action Plan Worksheet.

1. Understand Early Warning Signs

Pay attention to subtle changes that often come before a spike in anxiety:

• Physical: muscle tension, headaches, stomach aches, racing heart
• Emotional: increased irritability, mood swings, feeling overwhelmed
• Cognitive: racing or negative thoughts, difficulty concentrating
• Behavioral: withdrawing from activities or people, changes in sleep or appetite

2. Identify Common Triggers

Reflect on situations or thoughts that tend to spark your anxiety:

• Academic pressures (tests, deadlines)
• Social stressors (peer interactions, feeling judged)
• Major transitions (moving schools, family changes)
• Internal pressures (perfectionism, “what if” thinking)

3. Prevention Strategies

Use these proactive steps to interrupt the build-up of anxiety:

1. Daily Self-Checks: Schedule a brief mood check-in each morning or evening—rate your anxiety on a 1–5 scale.
2. Consistent Practice: Integrate top tools from your toolkit (e.g., deep breathing, PMR) into daily routines—even 2–3 minutes helps.
3. Healthy Habits: Prioritize sleep, nutrition, and regular physical activity to bolster resilience.
4. Social Connection: Reach out to a trusted friend, family member, or your school counselor early—don’t wait until anxiety peaks.
5. Mindful Breaks: Set reminders for micro-breaks (1–2 minute grounding exercises) during stressful tasks.

4. Action Steps When You Notice Rising Anxiety

Follow a clear, step-by-step plan:

• Pause & Breathe: Stop what you’re doing and take 3–4 slow, deep breaths.
• Consult Your Toolkit: Refer to your top 1–3 go-to tools from the Anxiety Toolkit Builder Worksheet.
• Apply a Strategy: Practice a grounding technique (e.g., 5-4-3-2-1), a PMR segment, or positive self-talk for 2–5 minutes.
• Record & Reflect: Note which strategy you used and its effect in a journal or on your Session 3 Action Plan Worksheet.
• Seek Support: If anxiety continues rising, connect with a supportive adult or consider professional help.

5. Build Your Support Network

List and keep accessible the contacts and resources you can turn to:

• Trusted Adults: Name(s) of family, teachers, counselors
• Peer Supports: Friends who understand and listen
• School Resources: Counseling office, wellness center
• Crisis Lines: If you ever feel unsafe with your thoughts, call or text 988 (US) or your local emergency number.

6. Stay on Track

• Regular Check-Ins: Schedule weekly brief meetings with yourself (in your planner) or with your counselor.
• Celebrate Small Wins: Acknowledge each time you notice a warning sign and apply a strategy—it’s progress!
• Adjust as Needed: Review and revise your Session 3 Action Plan Worksheet if a strategy isn’t working as expected.

By recognizing early signs, using your personalized toolkit, and engaging your support network, you’ll strengthen your ability to manage anxiety long-term. Keep this guide and your action plan where you can see them—your resilience is in your hands!