Self-Care Assessment
The following worksheet for assessing self-care is not exhaustive, merely suggestive.
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
____ Get enough sleep
____ Wear clothes I like
____ Take vacations
____ Other:
