Self-Care Reflection Worksheet

Use this worksheet to explore your current self-care habits and identify areas for growth. Be as honest and detailed as you can.

1. List Your Current Self-Care Activities

Write down all the self-care practices you use regularly (physical, emotional, social, creative, etc.).

2. How Do These Activities Make You Feel?

For each activity above, describe the emotions or sensations you experience (e.g., calm, energized, peaceful).

3. Self-Care Satisfaction Rating

On a scale from 1 (not satisfied) to 5 (very satisfied), how would you rate your overall self-care routine? Explain your choice.

Rating: 1 2 3 4 5

4. Stress Triggers

Identify two situations or times when you feel most stressed or overwhelmed. Briefly describe each.

5. Barriers to Self-Care

What prevents you from engaging in self-care more often? Consider time, resources, mindset, or other obstacles.

6. New Self-Care Ideas

What is one new self-care activity you would like to try this week? Why does it appeal to you?

7. Additional Reflections

Use this space for any extra thoughts, insights, or questions about your self-care journey.

Mindfulness Prompt Cards

Use these cards to guide brief mindfulness exercises. Choose one card and follow the steps.

1. Box Breathing

• Inhale slowly through your nose for a count of 4.

• Hold your breath for 4 counts.

• Exhale gently through your mouth for 4 counts.

• Hold again for 4 counts.

Repeat this cycle 3 times. Notice how your body relaxes with each breath.

2. Body Scan

1. Sit or lie down comfortably and close your eyes.
   
2. Bring attention to your toes—notice any sensations.
   
3. Slowly move awareness up through your feet, legs, hips, torso, arms, neck, and head.
   
4. At each spot, pause and observe any tension or ease.
   
5. If you notice tension, breathe into that area, then release on the exhale.

3. 5–4–3–2–1 Grounding

• Look around and name 5 things you can see.

• Touch 4 objects and note their textures.

• Listen for 3 sounds (e.g., birds, traffic, your breath).

• Identify 2 scents in the room or from a nearby source.

• Notice 1 thing you can taste or imagine tasting.

Pause and take one deep breath when you finish.

4. Mindful Listening

1. Close your eyes and sit quietly for 1–2 minutes.
   
2. Direct your full attention to sounds around you—near and far.
   
3. Notice pitch, volume, and tone, but avoid labeling sounds as “good” or “bad.”
   
4. When your mind wanders, gently bring it back to listening.

5. Loving-Kindness Meditation

1. Close your eyes and take a few deep breaths.
   
2. Silently repeat phrases: “May I be safe. May I be happy. May I be healthy. May I live with ease.”
   
3. After a minute, direct the same phrases toward someone you care about.
   
4. Finally, extend these wishes to someone neutral and then to someone you find challenging.

6. Mindful Walking

1. Stand and feel your weight on both feet.
   
2. Begin walking slowly, paying attention to each step—how your heel lifts and your toe presses down.
   
3. Notice the movement of your legs and shift of balance.
   
4. Breathe naturally and observe the rhythm of steps for 1–2 minutes.

7. Sensory Exploration

1. Choose an object (e.g., a leaf, a stone).
   
2. Observe its color, shape, and texture.
   
3. Hold it and notice temperature, weight, and fine details.
   
4. Reflect on how focusing on one item changes your awareness.

Tip: Use the cards whenever you feel stressed, distracted, or need a quick mental break.

Self-Care Toolkit Template

Use this template to organize your self-care strategies by frequency and category. Fill in each section with specific activities you can commit to.

Daily Self-Care

Physical

List daily physical activities (e.g., morning stretch, 10-minute walk).

Emotional

List daily emotional check-ins or practices (e.g., journaling, positive affirmations).

Social

List daily social or connection activities (e.g., sending a good-morning message).

Creative

List daily creative outlets (e.g., doodling, listening to music).

Weekly Self-Care

Physical

List weekly physical practices (e.g., yoga class, weekend hike).

Emotional

List weekly emotional supports (e.g., therapy session, gratitude review).

Social

List weekly social engagements (e.g., call a friend, family dinner).

Creative

List weekly creative activities (e.g., crafting, writing short stories).

As-Needed Self-Care

Physical

List quick physical strategies for moments of stress (e.g., 5-minute breathing break).

Emotional

List on-demand emotional supports (e.g., self-compassion mantra, relaxation app).

Social

List connection options for when you need support (e.g., texting a friend, joining a support group).

Creative

List brief creative breaks (e.g., 1-minute sketch, quick playlist).

Additional Notes

Use this space for reflections, reminders, or adjustments to your toolkit.