Self-Reflection Worksheet

Name: _________________________ Date: ________________

1. On a scale of 1 (very mild) to 10 (very intense), how strong were these feelings?
   Rating: _____ Why did you choose this number?
   
   
2. Think of a recent moment when you felt sad, anxious, or down. Describe what happened.
   
   
   
   
   
   
   
   
   
   
3. What emotions did you notice in that moment? (e.g., sadness, worry, frustration)
   
   
   
   
   
   
4. What physical sensations or changes did you experience? (e.g., tight chest, butterflies, headache)
   
   
   
   
   
   
5. What thoughts were going through your mind at the time?
   
   
   
   
   
   
   
   
6. Can you identify any trigger or event that led to these feelings?
   
   
   
   
   
   
7. Looking back, do you see a pattern or common theme in these experiences?
   
   
   
   
   
   
8. What might you do differently next time to help manage your mood? (Hint: try one of the strategies from the Depression Coping Strategies Handout.)
   
   
   
   
   
   
   
   
9. Is there anything else you want to note about how you felt or what you learned about yourself during this reflection?
   
   
   
   
   
   

Depression Coping Strategies Handout

Use these three strategies when you notice your mood dipping. Practice each one below, then pick the strategy that feels most helpful.

1. Deep Breathing (4-7-8 Technique)

Why it helps: Slows your heart rate and calms the mind.

Steps:

1. Sit comfortably with your back straight.
2. Close your eyes or soften your gaze.
3. Inhale quietly through your nose for a count of 4.
4. Hold your breath for a count of 7.
5. Exhale slowly through your mouth for a count of 8.
6. Repeat 3–4 times, noticing how your body relaxes.

Practice:
Take 2 minutes right now and follow the steps above.

Notes:

2. Grounding Exercise (5-4-3-2-1)

Why it helps: Brings your focus into the present moment and distracts from overwhelming thoughts.

Steps:

• 5 Things You Can See: Look around and name five objects (e.g., a pencil, a poster).
• 4 Things You Can Touch: Notice textures (e.g., your shirt, the chair).
• 3 Things You Can Hear: Identify three sounds (e.g., clock ticking, birds).
• 2 Things You Can Smell: Find two scents near you (e.g., your drink, fresh air).
• 1 Thing You Can Taste: Focus on one taste (e.g., a mint, your last meal).

Practice:
Pause and complete one full 5-4-3-2-1 cycle whenever you feel anxious.

Notes:

3. Positive Self-Talk

Why it helps: Challenges negative thoughts and builds confidence.

Steps:

1. Identify a negative thought (e.g., “I can’t do this”).
2. Question its truth: “Is it always true?”
3. Reframe into a kinder statement (e.g., “I may find this hard, but I can learn and improve”).
4. Repeat the positive statement out loud or write it down.

Practice:
Write two negative thoughts you’ve had recently and create a positive reframe for each.

Notes:

Next Steps:

• Choose one strategy to try today when you notice a low mood.
• Record your experience on your Mood Monitoring Chart.
• In our next session, we’ll discuss which strategy felt most helpful and refine your plan.

Calming Techniques Infographic

🫁 Deep Breathing (4-7-8)
• What: Slow, controlled breaths
• Why: Calms your nervous system and reduces stress
• How:
1. Inhale through nose for 4 seconds
2. Hold for 7 seconds
3. Exhale through mouth for 8 seconds
4. Repeat 3–4 times

✋ Grounding Exercise (5-4-3-2-1)
• What: Sensory check-in to stay present
• Why: Distracts from overwhelming thoughts and brings focus to the moment
• How:
• 5 things you can see
• 4 things you can touch
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

🧠 Positive Self-Talk
• What: Turning negative thoughts into supportive messages
• Why: Builds confidence and challenges unhelpful stories
• How:
1. Notice a negative thought (e.g., “I can’t do this.”)
2. Ask: “Is this always true?”
3. Reframe to a kinder statement (e.g., “I’m learning and getting stronger.”)
4. Repeat it out loud or write it down

Use this infographic as a quick reminder whenever you need to shift your mood. Keep it visible—on your desk, locker, or phone background—and pick one icon to guide you back to calm and clarity.

Mood Monitoring Chart

Name: _________________________ Date: ________________

Use this chart to track your mood each day, note any triggers, record which coping strategy you tried, and rate how helpful it felt. Aim to fill out one entry per day for a week.

Day 1
Date: ______________ Mood Rating (1–10): _____

Trigger/Event:






Strategy Used:



Helpfulness (1–5): _____
Notes:

Day 2
Date: ______________ Mood Rating (1–10): _____

Trigger/Event:






Strategy Used:



Helpfulness (1–5): _____
Notes:

Day 3
Date: ______________ Mood Rating (1–10): _____

Trigger/Event:






Strategy Used:



Helpfulness (1–5): _____
Notes:

Day 4
Date: ______________ Mood Rating (1–10): _____

Trigger/Event:






Strategy Used:



Helpfulness (1–5): _____
Notes:

Day 5
Date: ______________ Mood Rating (1–10): _____

Trigger/Event:






Strategy Used:



Helpfulness (1–5): _____
Notes:

Day 6
Date: ______________ Mood Rating (1–10): _____

Trigger/Event:






Strategy Used:



Helpfulness (1–5): _____
Notes:

Day 7
Date: ______________ Mood Rating (1–10): _____

Trigger/Event:






Strategy Used:



Helpfulness (1–5): _____
Notes:

At the end of the week, review your notes and think about which strategies helped the most. We’ll discuss your observations in our next session!