Participant Worksheet

Part 1: Mood Check-In

Mood rating (0 = lowest, 10 = highest): __________


Describe your current mood and any factors influencing it:

Part 2: Thought Record (Cognitive Restructuring)

Use the guided steps on the Cognitive Restructuring Worksheet.


Situation (what happened?):

Automatic Negative Thought (ANT):

Evidence for the ANT:

Evidence against the ANT:

Balanced Alternative Thought:

Emotion after reframing (label & rate 0–10): __________

Part 3: Mindfulness Reflection

Reflect on today’s guided practice:
What physical sensations did you notice?

What thoughts arose?

How did you respond to these thoughts/emotions?

Part 4: Action Plan Brainstorm

Based on today’s session and using the Personalized Action Plan Template, brainstorm your goals below.

Goal 1:

Potential Barriers:

Coping Strategies:

Timeline:

Goal 2:

Potential Barriers:

Coping Strategies:

Timeline:

Part 5: Summary & Next Steps

What is your main takeaway from today’s session?

How will you practice these skills this week?

Cognitive Restructuring Worksheet

1. Describe the Situation

What happened?

2. Automatic Negative Thought (ANT)

What immediate negative thought went through your mind?

3. Evidence Supporting the ANT

What facts or observations seem to support this thought?

4. Evidence Against the ANT

What facts or experiences contradict or weaken this thought?

5. Balanced Alternative Thought

Based on the evidence above, write a more balanced or realistic thought:

6. Emotion Rating

Rate your emotional intensity before and after reframing (0 = none, 10 = extreme):

• Before: ______ After: ______
  
  

Tips for Effective Restructuring
• Use objective evidence rather than assumptions.
• Keep alternatives realistic, not overly positive.
• Practice regularly to build new thinking habits.

Action Plan Template

Use this worksheet to develop a clear, SMART action plan to help you achieve your goals. Duplicate this template for each additional goal you wish to set.

Goal Name and Description

Goal Title:

Brief Description of the Goal:

SMART Criteria

Specific (What exactly will you do?):

Measurable (How will you track your progress?):

Achievable (Is this realistic given your resources?):

Relevant (Why is this goal important to you?):

Time-Bound (What is your target deadline?):

Action Steps

List the specific steps you will take to move toward your goal. Break the goal into manageable tasks.

1. Step 1:
   
   
   
2. Step 2:
   
   
   
3. Step 3:
   
   
   
4. (Add more steps as needed)

Potential Barriers

Identify any obstacles that might prevent you from reaching your goal.

• Barrier 1:
  
  
  
  
  
  
• Barrier 2:
  
  
  
  
  
  
• (Add more barriers as needed)

Coping Strategies

For each barrier, describe a strategy you can use to overcome it.

• Barrier 1 Strategy:
  
  
  
  
  
  
• Barrier 2 Strategy:
  
  
  
  
  
  
• (Add more strategies as needed)

Timeline & Checkpoints

Start Date: __________ End Date: __________

Checkpoint 1 (Date): __________

• Progress Notes:
  
  
  
  
  
  

Checkpoint 2 (Date): __________

• Progress Notes:
  
  
  
  
  
  

(Include additional checkpoints as needed.)

Review & Next Steps

At each checkpoint, reflect on what’s working and what needs adjustment. Use the space below to plan your next steps or revise your goal.

Reflection and Next Steps:

Welcome to your guided mindfulness practice. This session will take around 10 minutes. Let’s begin.

1. Get Comfortable (30 seconds)
   Sit or lie down in a quiet, comfortable position. Let your hands rest gently in your lap or by your sides. Close your eyes if that feels safe, or soften your gaze.

2. Grounding & Breath (1 minute)
   Bring your attention to your breath. Notice the natural rhythm—no need to change anything yet.

3. Deepening the Breath (2 minutes)
   – Inhale slowly through your nose for a count of four: 1…2…3…4…
   – Pause for one second.
   – Exhale gently through your mouth for a count of six: 1…2…3…4…5…6…
   Repeat this cycle four more times. If your mind wanders, kindly guide it back to the breath.

4. Body Scan (5 minutes)
   Now, allow your breath to return to its natural pace. Direct your awareness to the top of your head. Notice any sensations—warmth, tension, tingling, or ease.
   Slowly move your attention down to your forehead and eyes. Soften any tightness.
   Next, scan your jaw, relaxing your teeth and tongue.
   Shift to your neck and shoulders. If you notice tightness, imagine breathing into that area, then let it soften on the exhale.
   Continue down your arms, through your chest and belly, feeling each inhale expand your ribs and each exhale release tension.
   Bring awareness to your hips and lower back. Notice how they support you. Allow any stiffness to melt away with each breath.
   Scan your thighs, knees, calves, and ankles. Finally, bring attention to your feet and toes. Feel the connection to the floor or chair beneath you.

5. Closing & Reflection (1 minute)
   Return your focus to your breath for a few more natural cycles. Gently wiggle your fingers and toes. When you’re ready, open your eyes or lift your gaze.
   Take a moment to notice how you feel—calmer, more aware, or simply more present. Carry this sense of grounded attention with you into the rest of your day.

Thank you for practicing mindfulness today.

Mood Check-In Warm-Up

Time: 5 minutes
Materials: Pen/paper or Participant Worksheet

Purpose

Quickly gauge current emotional state to tailor today’s session and build rapport.

Instructions

1. Rate your mood right now on a scale from 0 (very low) to 10 (very high):
   Mood rating: ______

2. In one sentence, describe the main factor influencing your mood at this moment:
   
   
   
   
   
   
   

3. Choose a single word that best captures how you feel (e.g., hopeful, anxious, tired):
   
   
   
   

4. (Optional, if time allows) Note any immediate thought or concern on your mind:
   
   
   
   
   
   
   
   

Facilitator Tip: Use the participant’s responses to tailor examples and check in on these points throughout the session.

Reflection Exit Ticket

1. Key Takeaway

What is one new strategy or insight you gained today?

2. Goal & First Step

Which goal will you focus on first, and what specific action will you take?

3. Confidence Rating

On a scale from 0 (not at all confident) to 10 (very confident), how confident are you in using these skills?
Rating: ______

4. Anticipated Barriers

What is one potential obstacle you might encounter, and how will you address it?

5. Practice Plan

When and where will you practice this strategy this week?

6. Questions & Support

Do you have any questions or need additional support before we finish?

Thank you for reflecting! Keep this ticket as a reminder of your commitment and next steps.

Understanding Depression Handout

What Is Depression?

Depression is more than just feeling sad. It’s a medical condition that affects your thoughts, emotions, and behaviors. Common symptoms include:

• Persistent low mood or irritability
• Loss of interest or pleasure in activities
• Changes in appetite or sleep patterns
• Low energy or fatigue
• Difficulty concentrating or making decisions
• Feelings of worthlessness or excessive guilt
• Thoughts of death or suicide

If you’ve noticed several of these symptoms lasting for at least two weeks, you may be experiencing depression.

The Thought–Emotion–Behavior Cycle

Depression often follows a cycle in which unhelpful thoughts influence emotions and actions:

1. Automatic Negative Thought (ANT)
   You notice a negative idea (e.g., “I always mess things up”).
2. Emotional Response
   That thought triggers feelings like sadness or anxiety.
3. Behavioral Reaction
   You might withdraw from activities or avoid challenges.
4. Cycle Continues
   Avoidance reinforces negative thinking and low mood.

Breaking this cycle is a key goal of our work.

Evidence-Based Strategies

Below are three proven approaches you will explore during the session. Each section of this handout includes links to practice tools.

1. Cognitive Restructuring

Cognitive restructuring helps you identify and challenge unhelpful thoughts. By examining evidence for and against an ANT, you can develop a more balanced perspective.
Practice using the Cognitive Restructuring Worksheet.

2. Mindfulness

Mindfulness involves paying attention to the present moment without judgment. Through guided breathing and body scans, you learn to observe thoughts and sensations rather than react to them.
Listen to the Mindfulness Audio Guide for a 10-minute practice.

3. Action Planning (Behavioral Activation)

Behavioral activation encourages you to reintroduce meaningful activities into your routine. Setting SMART goals—Specific, Measurable, Achievable, Relevant, and Time-Bound—can help you move forward even when motivation is low.
Use the Action Plan Template to outline your goals, steps, and coping strategies.

How to Use This Handout

1. Review the Strategies
   Read through each section and consider which approaches resonate most with you.
2. Complete the Worksheets
   Use the Participant Worksheet to check in on your mood, record your thoughts, and reflect after practice.
3. Practice Regularly
   Consistency strengthens new habits. Schedule daily or weekly times to review your worksheets and engage in mindfulness.

Building Your Personalized Plan

At the end of our session, you will create a personalized action plan. This plan will:

• Identify 2–3 specific goals (e.g., “Go for a 15-minute walk, 3 times this week”).
• Anticipate barriers and outline coping strategies.
• Set a timeline and checkpoints to monitor progress.

You’ll develop this plan in detail using the Action Plan Template.

Where to Go from Here

Remember, managing depression is a journey. Small, consistent steps add up over time. Keep this handout and your worksheets nearby as tools you can return to whenever you need support. If questions arise or you need further guidance, revisit our session notes or reach out for additional resources.

You’re not alone—these strategies have helped many people find light in the darkness.

Action Plan Rubric

Use this rubric to assess the completeness, clarity, and quality of the personalized action plan developed with the Action Plan Template.

Scoring Guide:

• 16–14 points: Exemplary action plan—ready for implementation without revisions.
• 13–10 points: Proficient plan—minor refinements recommended to optimize clarity or feasibility.
• 9–6 points: Developing plan—requires significant elaboration in one or more areas.
• 5–4 points: Beginning level—needs comprehensive revision in multiple criteria.

Total Score: _____ / 16