# Progress Monitoring Sheets Pack A collection of all progress-monitoring tools referenced in the 36-Week Counseling Outline. Distribute the relevant sheet at each session. *** ## Baseline Self-Regulation Survey {#baseline-self-regulation-survey} Instructions: Rate how often you do each behavior (1 = Never, 5 = Always). 1. I notice when my body feels tense or upset. 1 2 3 4 5

2. I can calm myself down when I’m stressed. 1 2 3 4 5

3. I ask for help when I feel overwhelmed. 1 2 3 4 5

4. I use a coping strategy when I feel strong emotions. 1 2 3 4 5

5. I set personal goals to manage my feelings. 1 2 3 4 5

*** ## Emotion Identification Chart {#emotion-identification-chart} List each emotion you experience and identify physical cues and situations when it occurs. | Emotion | Physical Signs (heart racing, sweating…) | When/Where? | | | ------- | ---------------------------------------- | ----------- | ------------------------------------------------------------------ | | | | |

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| *** ## Stressors Mapping Worksheet {#stressors-mapping-worksheet} Write down three things that trigger stress and rate their intensity (1–5). | Trigger | Description | Intensity (1=low,5=high) | | | ------- | ----------- | ------------------------ | ------------------ | | 1. | | |

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| *** ## Thought–Feeling Log {#thought-feeling-log} Record a situation, your thought, and the feeling that followed. Situation: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Thought: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Feeling & Intensity (1–5): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*** ## Coping Strategy Exploration Sheet {#coping-strategy-exploration-sheet} List coping strategies you’ve tried and rate how well they worked (1–5). | Strategy | How I Used It | Effectiveness (1–5) | | | -------- | ------------- | ------------------- | ------------------ | | | | |

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| *** ## Weekly Reflection Form {#weekly-reflection-form} 1. What went well this week?

1. What challenges did I face?

1. Which strategies helped me the most?

1. My goal for next week:

*** ## Breathing Practice Log {#breathing-practice-log} Date: \_\_\_\_\_\_\_\_\_\_\_\_ Time: \_\_\_\_\_\_\_\_ Technique used: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ How I felt before (1–5): \_\_\_\_ After (1–5): \_\_\_\_ Notes:

*** ## Relaxation Session Record {#relaxation-session-record} Date: \_\_\_\_\_\_\_\_\_\_\_\_ Technique (PMR, visualization…): \_\_\_\_\_\_\_\_\_\_\_\_ Muscle groups/timing: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Stress level before (1–5): \_\_\_\_ After (1–5): \_\_\_\_ Reflections:

*** ## Mindfulness Exercise Guide {#mindfulness-exercise-guide} Exercise: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Duration: \_\_\_\_\_\_\_\_ Observations (thoughts, sensations):

What distracted me and how I refocused:

*** ## Grounding Technique Tracker {#grounding-technique-tracker} Date: \_\_\_\_\_\_\_\_\_\_\_\_ Technique (5-4-3-2-1, scent…): \_\_\_\_\_\_\_\_\_\_\_\_ Effectiveness (1–5): \_\_\_\_ Notes:

*** ## Self-Talk Journal {#self-talk-journal} Date: \_\_\_\_\_\_\_\_\_\_\_\_ Negative thought: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Balanced response: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Outcome: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*** ## Coping Strategy Practice Log {#coping-strategy-practice-log} Scenario: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Chosen strategy: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Effectiveness (1–5): \_\_\_\_ What I’ll adjust:

*** ## Cognitive Distortions Checklist {#cognitive-distortions-checklist} Check the distortions you notice today: \[ ] All-or-Nothing \[ ] Overgeneralization \[ ] Mental Filter \[ ] Discounting Positives \[ ] Jumping to Conclusions \[ ] Emotional Reasoning \[ ] Should Statements \[ ] Labeling

Situation & Notes:

*** ## Thought Record Sheet {#thought-record-sheet} Situation: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Automatic thought: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Evidence for: \_\_\_\_\_\_\_\_\_\_ Against: \_\_\_\_\_\_\_\_
Alternative thought: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*** ## Self-Compassion Letter Template {#self-compassion-letter-template} Dear \[Your Name],

I know you’re feeling…

I understand because…

You deserve kindness and care; here’s what I’ll do for you:

*** ## Emotion Regulation Toolbox Planner {#emotion-regulation-toolbox-planner} List 2–3 tools in each category: 1. Physical (breathing, PMR):

1. Cognitive (self-talk, reframe):

1. Creative (art, music):

1. Social (talking, support):

*** ## Integrated Skills Practice Log {#integrated-skills-practice-log} Scenario: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Skills used: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ How I combined them: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Result & next steps: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*** ## Midpoint Progress Review {#midpoint-progress-review} Review your goals and ratings from the first 18 weeks: What’s improved?

What still needs work?

Adjusted goals:

*** ## Advanced Mindfulness Log {#advanced-mindfulness-log} Date: \_\_\_\_\_\_\_\_\_\_\_\_ Exercise: Thought watching/choiceless awareness Observations & insights:

*** ## Guided Imagery Reflection {#guided-imagery-reflection} Imagery theme: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Duration: \_\_\_\_\_\_\_\_ Sensations & emotions:

*** ## Overwhelm Management Worksheet {#overwhelm-management-worksheet} Rate overwhelm (1–5): \_\_\_\_ Choose a coping strategy: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Steps I took:

Outcome: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Next time I will:

*** ## Gratitude Journal {#gratitude-journal} Today I’m thankful for: 1. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

2. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

3. \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

How this made me feel:

*** ## Creative Coping Reflection {#creative-coping-reflection} Creative activity: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ What I created: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Emotions before/after (1–5): \_\_\_\_ / \_\_\_\_ Insights:

*** ## Real-World Application Plan {#real-world-application-plan} Context (school/home): \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Strategy I’ll use: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ When & how: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Check-in date: \_\_\_\_\_\_\_\_ Outcome: \_\_\_\_\_\_\_\_\_

*** ## Problem-Solving Model Sheet {#problem-solving-model-sheet} STEP Model: S: Describe problem: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
T: Think of solutions: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

E: Evaluate pros/cons: \_\_\_\_\_\_\_\_\_\_\_\_\_\_

P: Plan & try: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*** ## Solutions Brainstorm Chart {#solutions-brainstorm-chart} Challenge: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Potential solutions: 1. \_\_\_\_\_\_\_\_\_\_\_ 2. \_\_\_\_\_\_\_\_\_ 3. \_\_\_\_\_\_\_\_\_

Most feasible: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*** ## Decision Matrix {#decision-matrix} List options and rate criteria (e.g., Ease, Impact). | Option | Ease (1–5) | Impact (1–5) | Total | | | ------ | ---------- | ------------ | ----- | ------------------ | | | | | |

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| *** ## Action Plan Template {#action-plan-template} Goal: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Steps: 1. \_\_\_\_\_\_\_\_\_\_ 2. \_\_\_\_\_\_\_\_\_\_ 3. \_\_\_\_\_\_\_\_ Timeline: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Support needed: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

*** ## Implementation Monitoring Log {#implementation-monitoring-log} Date: \_\_\_\_\_\_\_\_\_\_\_\_ Step implemented: \_\_\_\_\_\_\_\_ Outcome: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Challenges: \_\_\_\_\_\_\_

Adjustments for next time:

*** ## Progress Celebration Reflection {#progress-celebration-reflection} What progress am I proud of?

How will I celebrate?

What’s next?

*** ## Relapse Prevention Plan {#relapse-prevention-plan} High-risk situations: 1. \_\_\_\_\_\_\_\_ 2. \_\_\_\_\_\_\_\_ 3. \_\_\_\_\_\_\_\_ Early warning signs: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Coping plan steps:

Support person/contact: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ *** ## Support Network Map {#support-network-map} List people you trust or can ask for help: | Name | Role (friend, teacher…) | How they can help | | | ---- | ----------------------- | ----------------- | ------------------------------------ | | | | |

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| *** ## Long-Term Goals Worksheet {#long-term-goals-worksheet} 1-year goal: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Steps to achieve it: 1. \_\_\_\_\_\_\_\_\_\_ 2. \_\_\_\_\_\_\_\_\_\_ 3. \_\_\_\_\_\_\_\_

Checkpoints & dates: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ *** ## Skills Refresher Checklist {#skills-refresher-checklist} Check off each skill you can teach or demonstrate: \[ ] Breathing \[ ] PMR \[ ] Grounding \[ ] Mindfulness \[ ] Self-talk \[ ] Problem-solving

Notes/refresher needed on:

*** ## Post-Self-Regulation Survey {#post-self-regulation-survey} (Re-administer the Baseline Self-Regulation Survey to measure growth.) *** ## Maintenance Contract {#maintenance-contract} I commit to using my coping strategies and support plan. Name: \_\_\_\_\_\_\_\_\_\_\_\_ Date: \_\_\_\_\_\_\_\_

Project Guide

Worksheet

Script

Regulation Roadmap

Madelyn Moorhouse