Self-Care Assessment
Adapted from Saakvitne, Pearlman, & Staff of TSI/CAAP (1996). Transforming the pain: A
workbook on vicarious traumatization. Norton.
The following worksheet for assessing self-care is not exhaustive, merely suggestive. Feel
free to add areas of self-care that are relevant for you and rate yourself on how often and
how well you are taking care of yourself these days.
When you are finished, look for patterns in your responses. Are you more active in some
areas of self-care but ignore others? Are there items on the list that make you think, "I
would never do that"? Listen to your inner responses, your internal dialogue about self-care
and making yourself a priority. Take particular note of anything you would like to include
more in your life.
Rate the following areas according to how well you think you are doing:
3 = I do this well (e.g., frequently)
2 = I do this OK (e.g., occasionally)
1 = I barely or rarely do this
0 = I never do this
? = This never occurred to me
Physical Self-Care
____ Eat regularly (e.g. breakfast, lunch, and dinner)
____ Eat healthily
____ Exercise
____ Get regular medical care for prevention
____ Get medical care when needed
____ Take time off when sick
____ Get massages
____ Dance, swim, walk, run, play sports, sing, or do some other fun physical activity
____ Take time to be sexual - with myself, with a partner
____ Get enough sleep
____ Wear clothes I like
____ Take vacations
____ Other:
Psychological Self-Care
____ Take day trips or mini-vacations
____ Make time away from telephones, email, and the Internet
____ Make time for self-reflection
____ Notice my inner experience - listen to my thoughts, beliefs, attitudes, feelings
____ Have my own personal psychotherapy
____ Write in a journal
____ Read literature that is unrelated to work
____ Do something at which I am not expert or in charge
____ Attend to minimizing stress in my life
____ Engage my intelligence in a new area, e.g., go to an art show, sports event, theatre
____ Be curious
____ Say no to extra responsibilities sometimes
____ Other:
Emotional Self-Care
____ Spend time with others whose company I enjoy
____ Stay in contact with important people in my life
____ Give myself affirmations, praise myself
____ Love myself
____ Re-read favorite books, re-view favorite movies
____ Identify comforting activities, objects, people, places and seek them out
____ Allow myself to cry
____ Find things that make me laugh
____ Express my outrage in social action, letters, donations, marches, protests
____ Other:
Spiritual Self-Care
____ Make time for reflection
____ Spend time in nature
____ Find a spiritual connection or community
____ Be open to inspiration
____ Cherish my optimism and hope
____ Be aware of non-material aspects of life
____ Try at times not to be in charge or the expert
____ Be open to not knowing
____ Identify what is meaningful to me and notice its place in my life
____ Meditate
____ Pray
____ Sing
____ Have experiences of awe
____ Contribute to causes in which I believe
____ Read inspirational literature or listen to inspirational talks, music
____ Other:
Relationship Self-Care
____ Schedule regular dates with my partner or spouse
____ Schedule regular activities with my children
____ Make time to see friends
____ Call, check on, or see my relatives
____ Spend time with my companion animals
____ Stay in contact with faraway friends
____ Make time to reply to personal emails and letters; send holiday cards
____ Allow others to do things for me
____ Enlarge my social circle
____ Ask for help when I need it
____ Share a fear, hope, or secret with someone I trust
____ Other:
Workplace or Professional Self-Care
____ Take a break during the workday (e.g., lunch)
____ Take time to chat with co-workers
____ Make quiet time to complete tasks
____ Identify projects or tasks that are exciting and rewarding
____ Set limits with clients and colleagues
____ Balance my caseload so that no one day or part of a day is “too much”
____ Arrange work space so it is comfortable and comforting
____ Get regular supervision or consultation
____ Negotiate for my needs (benefits, pay raise)
____ Have a peer support group
____ (If relevant) Develop a non-trauma area of professional interest
Overall Balance
____ Strive for balance within my work-life and work day
____ Strive for balance among work, family, relationships, play, and rest
Other Areas of Self-Care that are Relevant to You
____
____
____
(Retrieved8/6/2010from
http://www.ballarat.edu.au/aasp/student/sds/self_care_assess.shtmlandadaptedbyLisaD.
Butler,Ph.D.)