Mindful Moments Reflection Worksheet

Name: ________________________ Date: ________________

Use the Emotion Thermometer Visual to help you rate your feelings, and refer to the Deep Breathing Technique Guide for a reminder of the steps. Complete the questions below after the guided breathing activity.

Part 1: Rate Your Feelings

1. Before the breathing exercise, on a scale from 0 (very calm) to 10 (extremely stressed), I felt: ______
   Explain why you chose this number:
   
   
   
   
   
   
   
   
   
   
   
   
2. After the breathing exercise, on the same scale from 0 to 10, I felt: ______
   Explain why you chose this number:
   
   
   
   
   
   
   
   
   
   
   
   
3. In one word, describe the main change you noticed in yourself:
   
   
   
   
   
   

Part 2: Reflection

1. What physical sensations did you notice during the exercise? (For example, a slower heartbeat, relaxed shoulders, lighter breathing.)
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
2. What thoughts or emotions came up as you focused on your breath?
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
3. Think of a situation at school, at home, or elsewhere that can make you feel stressed. How could you use this breathing technique in that moment? Be specific.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   

Part 3: Action Plan

1. This week, I will practice this breathing technique ___ times. I will use it at these times or in these situations:
   
   
   
   
   
   
   
   
   
   
   
   
2. List two additional strategies you can combine with deep breathing to manage stress (for example, going for a walk, journaling, listening to music):

   1. ---

      
      
      

   2. ---

      
      
      

Remember to keep this worksheet for future reference, and use these tools whenever you need a mindful moment.

Deep Breathing Technique Guide

Deep breathing is a simple yet powerful way to calm your body and mind. By focusing on each inhale and exhale, you can slow your heart rate, lower stress hormones, and bring yourself back to the present moment.

Why Deep Breathing Works

• Activates the parasympathetic nervous system, which helps you relax.
• Sends more oxygen to your brain, sharpening focus and reducing anxiety.
• Interrupts the “fight-or-flight” response, giving you space to choose how to react.

Steps for Deep Breathing

Follow these steps slowly and mindfully. Try to pause between each count and notice how your body feels.

1. Sit comfortably with your back straight and feet flat on the floor.
2. Place one hand on your belly and the other on your chest.
3. Inhale through your nose to a slow count of 4, feeling your belly rise under your hand.
4. Hold the breath gently for a count of 2.
5. Exhale through your mouth for a count of 6, allowing your belly to fall.
6. Repeat this cycle 4–5 times.

Pro tip: If counting feels too rigid, try picturing your breath as a wave—flowing in, pausing at the top, and then flowing out.

Tips for Success

• Breathe into your diaphragm, not just your chest. Your belly should expand more than your shoulders.
• Keep your shoulders relaxed and jaw soft.
• Close your eyes or gaze softly at a spot on the floor to minimize distractions.
• If your mind wanders, gently bring your focus back to the sensation of the breath.

When to Use This Technique

• Before a big test or presentation to steady your nerves.
• During a conflict or heated moment to pause and choose your response.
• Anytime you notice tension—tight shoulders, racing thoughts, or a fast heartbeat.
• Combine with other strategies like a short walk, journaling, or listening to music.

Refer back to the Emotion Thermometer Visual to notice how your stress level changes as you practice. Keep this guide handy and use it whenever you need a quick reset.

Emotion Thermometer Visual

Use this visual scale to notice and label how intense your feelings are from 0 (very calm) to 10 (extremely stressed). The colors help you quickly identify your emotional zone:

🔵 0: Very Calm
🟢 1–3: Calm/Relaxed
🟡 4–6: Mild Stress
🟠 7–8: Moderate Stress
🔴 9–10: High Stress

Vertical Thermometer Representation:

🔴 10 – Highest stress level (overwhelmed, panicked)
🔴 9 ️
🟠 8 – Heart racing, restless
🟠 7 ️
🟡 6 – Noticeable tension, distracted
🟡 5 ️
🟡 4 – Slightly uneasy, fidgety
🟢 3 – Still focused, minor tension
🟢 2 – Comfortable, alert
🟢 1 – Very calm, content
🔵 0 – Completely calm, peaceful

How to Use the Emotion Thermometer Visual:

• Before and after the breathing exercise, pick the number that matches how you feel.
• Notice when you move up or down the scale—use your breath to bring yourself toward a calmer zone.
• Keep this visual posted in the classroom or your notebook to check in with yourself anytime you notice stress creeping in.

Refer back to this Emotion Thermometer Visual throughout the session to track changes and guide your reflections.

Mindful Moments: Word-for-Word Teacher Script

Materials Ready (Before Class)

• Display the Emotion Thermometer Visual at the front of the room.
• Have your timer set to 15 minutes.
• Place soft, instrumental background music on standby.
• Gather these handouts on your desk:
  1. Deep Breathing Technique Guide
  2. Mindful Moments Reflection Worksheet
  3. Colored index cards

1. Introduction (2 minutes)

Teacher (calm, inviting tone):
“Good morning, everyone. Thank you for settling in so quickly. Today, we’re taking 15 minutes together for Mindful Moments—a short practice to notice our feelings and calm our minds when we feel stressed.

(POINT to the Emotion Thermometer Visual)
“Right now, I’d like you to take a look at our Emotion Thermometer. On a scale of 0 to 10, it shows how calm or stressed we feel. 0 is completely calm, and 10 is extremely stressed. I’ll ask you to check in with this scale a couple of times today.

“Let’s set a calm tone. Please push in your chairs, place your feet flat on the floor, and rest your hands in your lap. We’ll begin in just a moment.”

(Start timer for 2 minutes)

Check for understanding:
Teacher (softly): “Does everyone see the Emotion Thermometer? Any quick questions before we begin?”

Wait 10 seconds. If no questions, proceed.

2. Guided Mindfulness Activity (5 minutes)

Teacher (gently):
“Alright, let’s get comfortable. Sit up straight but relaxed. You can close your eyes if that feels okay—otherwise, softly rest your gaze on the floor a few feet in front of you.

(Hand-on-heart voice): “Place one hand on your belly and one hand on your chest. We’re going to practice a simple breathing exercise together, following the steps on our Deep Breathing Technique Guide.

(Show the guide or briefly flash it on screen.)

“Here’s how we’ll breathe:

1. Inhale slowly through your nose for a count of 4.
2. Pause gently for a count of 2.
3. Exhale through your mouth for a count of 6.

“I’ll guide you through four cycles. I’ll say each count—follow my voice, and simply notice how your body feels. Let’s try it now.”

(Start soft music. Lead students through one full cycle aloud: “Inhale 1…2…3…4. Hold 1…2. Exhale 1…2…3…4…5…6.” Pause. Repeat.)

After Cycle 2:
Teacher (quietly): “If your mind wanders, that’s okay—just bring your attention back to your breath.”

Complete four to five cycles (about 3–4 minutes total).

Teacher (soft bell or quiet tone): “And… gently open your eyes when you’re ready.”

(Stop music)

3. Reflection & Sharing (5 minutes)

Teacher: “Now that we’ve finished, let’s check in with our feelings. I’m passing out colored index cards and Mindful Moments Reflection Worksheets.”

(Distribute materials, help students as needed.)

Teacher (clear voice):
“On your worksheet, rate how you felt before the breathing exercise and after. Write the number from 0 to 10 and a short explanation.

“On your index card, write just one word describing the biggest change you noticed. Then, find a partner or small group to share your word and explanation.”

(Allow students 3 minutes to write and discuss in pairs.)

Teacher (after 3 minutes): “Thank you. Let’s hear from a few volunteers. Who would like to share their number and one-word change?”

(Select 2–3 volunteers. Use prompts if needed: “What number did you choose? Why?” “How did that one word capture your experience?”)

4. Closing (3 minutes)

Teacher (warm tone):
“Great sharing, everyone. To close, remember these key points:

• Deep breathing can slow your heart rate and calm your mind.
• You can use this tool anytime—before a test, after a disagreement, or whenever stress shows up.
• Keep your worksheet and index card as reminders.

“Before we wrap up, look one more time at our Emotion Thermometer. Do you feel a shift from where you started? Hold that mind-calming moment with you as you move into the rest of your day.

(Pause 5 seconds.)

Teacher (smiling): “Thank you for being present. Please hand your index cards to me as you leave, and tuck your reflection worksheets into your notebooks. Have a mindful afternoon!”

(Collect cards, ensure students have their worksheets.)

End of Session.

Emotion Thermometer Check-In

Time: 3 minutes
Purpose: A quick self-check to notice and label your current stress level and plan one small action to feel calmer.

Materials:

• Emotion Thermometer Visual
• Index card or notebook

Instructions:

1. Look at the Emotion Thermometer and choose a number from 0 (very calm) to 10 (extremely stressed) that matches how you feel right now.
   My number: ______
   Explain why you chose this number:
   
   
   
   
   
   
   
   
   
   
   
   
2. In one word, describe your main feeling in this moment:
   
   
   
   
   
   
3. Identify one simple action you can take immediately to move toward a calmer zone (for example, deep breathing, stretching, or positive self-talk):
   
   
   
   
   
   
   
   
   
   
   
   
   
   
4. Turn to a partner and share your number and chosen action (30 seconds each).

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Use this check-in to start class with awareness and to remind yourself of practical tools you can use whenever stress arises.