Worksheets

Professional Resilience Program
Building Resilience Worksheets
Worksheets
In conjunction with the information above, the attached worksheets provide a platform for awareness and action planning in relation to building resilience.
By completing and acting on the worksheets below, you can build new conditioning in the brain.
The worksheets can be used in a variety of contexts. Examples include:
 Individually as an aid to reflection, planning, and practice

 In dyads as an aid to reflection, planning, and practice in a peer-supported resilience building process
 In a senior-junior mentoring relationship
 In a small (6-8 people) facilitated peer group as part of a broader resilience promotion program
 As part of structured conversations on the topic of resilience in a large group workshop
Resilience Worksheets – Forrest James Page 1 of 10

WORKSHEET INSTRUCTIONS:
The worksheets are presented sequentially and may be used to assist in developing and implementing a resilience action plan. They can be
incorporated into an individual or in a peer relationship resilience action plan. Exclude steps 8 and 10 (marked with *) for individual plans.
Alternatively, use may use the worksheets in other contexts (see p17 above for suggestions).
1. Complete the Resilience Questionnaire, your Time Diary, and your Window of Tolerance.
2. Review your Resilience Questionnaire, your Time Diary, and your Window of Tolerance.
3. Identify the areas for which you are at wish to address.
4. List ALL areas where you want to make changes.
5. Rank the items, with 1 being the highest priority.
6. Prepare a Resilience Activities Plan
7. Identify on any barriers or resistances to your plan
8. *Discuss your plan with a close colleague, friend or your partner. If you wish, ‘buddy-up’ with someone who is also doing their
own Resilience Plan and arrange to check in and support each other with making the changes happen.
9. Act on your plan (check-in regularly with your ‘buddy’)
10. *Meet and formally evaluate your progress with your support person regarding your plan (e.g., in a month)
11. Reflect and learn from what helped and hindered your progress
12. Start again from the top of these instructions!
PERSONAL RESILIENCE QUESTIONNAIRE
Read the left hand column after reading the document above. Tick Yes or No in each domain, and note a goal that comes to mind
Yes No Goal
SLEEP
Do I usually get sufficient sleep – enough that I feel

refreshed (average is 8 hours)
FOCUS
Do I spend sufficient time where I feel focused in the

activities I’m doing - where I feel I’m ‘in the zone’?
EXERCISE
Do I get enough physical exercise?

IDLING
Do I spend time in solitude and self-reflection – with no goal

or agenda?
IDLING
Do I spend enough time just relaxing – nothing else to do?

RELATING
Do I spend enough time with those closest to me?

RELATING
Am I satisfied with how much time I spend with friends,

socialising, in community activities, or making new
acquaintances?
PLAY
Do I spend time doing things I enjoy, that are new, or just for
‘fun’? (like learning an instrument, playing with children,
playing with pets)
MINDFULNESS
Do I have a way (a practice) of focusing my attention on

exactly what I am feeling in the present moment?
DIET
Do I usually eat mostly fresh unprocessed food every day?

SUPPORT
Do I have friends I can call when I am down, friends who

really listen?
SUPPORT
Can I honestly ask them for help when I need it?

SOC Comprehensibility
Do I have a clear sense of what is happening in my life and

work, including a sense of my future?
SOC Manageability
Do I know the skills and attributes I have that assist me to

manage in times of stress, and a clear idea of how can assist
if I need help?
SOC Meaningfulness
Am I clear about why I do what I do, of what gives me

satisfaction in my work and life?
Self Compassion
Do I forgive myself when I make a mistake?

General Health
Do I see a GP for a health check regularly?

General Health
Do I see a Dentist every 6 months?

WINDOW OF TOLERANCE
The "window of tolerance" (Siegel 1999) is a mud-map for our level of stress and activation in relation to our comfort or flow zone. When we are within our
window we function well. When we find ourselves too far outside our window, we can go beyond our capacity in that moment to stay present and function
optimally. We may flip into a fight/flight or freeze mode. When we are outside our window, our survival brain has switched on, and the basic question is
“How can I be safe?” We may find ourselves being defensive (fight), withdrawing (fleeing), or closing down (freezing). When we find ourselves outside our
window, our conditioned tendencies have been triggered. All the resilience-building practices that we undertake are – in effect – expanding our window of
tolerance.
Instructions: Think of the last month. Record any incidents or activities where you were stressed to the degree you felt overwhelmed (hyper-aroused) or
disengaged (hypo-aroused) for a period of time. Record these on the sheet below. Look for any patterns.
SELF-REFLECTION Diary. Fill out the Time diary using the colour codes for a week. Reflect on the patterns. What is missing and needs attention?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

am 5 to 6
6 to 7
7 to 8
8 to 9
9 to 10
10 to 11
11 to 12
pm 12 to 1
1 to 2
2 to 3
3 to 4
4 to 5
5 to 6
6 to 7
7 to 8
8 to 9
9 to 10
10 to 11
11 to 12
am 12 to 1
1 to 2
2 to 3
3 to 4
4 to 5
Focus = Red; Exercise = Brown; Idle- = Black; Relating (quality) = Green; Play = Yellow;
Yellow Mindfulness = Orange; Sleep = Grey
RESILIENCE GOALS
FOCUS AREA
GOALS (RANK IN PRIORITY FROM 1…)
From:
 Questionnaire
 Diary
 Window of Tolerance
RESILIENCE PLAN
Resilience Factors (see left hand column of questionnaire)
Resilience Goal (e.g. practice mindfulness 3 times a week for 15 mins)
Resilience Goal When/where Support Needed Feedback

(e.g.) mindfulness 15 minutes - 3 Monday, Wednesday & Friday Structural: Self assessment:
times per week lunch time Block out time in calendar
(12.30 -12.45pm)
Social: Partner/Peer:
Inform husband, walk with colleague
1/ Structural: Self assessment:
Social: Partner/Peer:
Partner/Peer
Social:
Social: Partner/Peer
IDENTIFY BARRIERS TO YOUR PLAN
IDENTIFY:
Yes No (circle one)
Are there barriers to the
acting on or not completing
If yes, what are they?
my plan?
Time Money Motivation Fear “I’m bullet proof and immortal”
Other (please specify): ___________________________________________________
STRATEGISE:
Yes No (circle one)
Are the any supports I can
draw on to assist me?
If Yes, which ones?
If no, how will you overcome your obstacles to resilience plan (discuss this with a support person)?
Note: If barriers cannot be overcome, then it may be appropriate to seek the assistance of a professional who
specialises in resilience, self-care, or professional supervision.
Notes:

Worksheets

Uploaded by

Copyright:

Available Formats

Worksheets

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Worksheets

Uploaded by

Copyright:

Available Formats

What are the components of building personal resilience according to the document?

What are the components of building personal resilience according to the document?

What steps are involved in developing a personal resilience plan?

What steps are involved in developing a personal resilience plan?

Professional Resilience Program

Building Resilience Worksheets

The worksheets can be used in a variety of contexts. Examples include:

 Individually as an aid to reflection, planning, and practice

Resilience Worksheets – Forrest James Page 1 of 10

Do I usually get sufficient sleep – enough that I feel

Do I spend sufficient time where I feel focused in the

Do I get enough physical exercise?

Do I spend time in solitude and self-reflection – with no goal

Do I spend enough time just relaxing – nothing else to do?

Do I spend enough time with those closest to me?

Am I satisfied with how much time I spend with friends,

Do I have a way (a practice) of focusing my attention on

Do I usually eat mostly fresh unprocessed food every day?

Do I have friends I can call when I am down, friends who

Can I honestly ask them for help when I need it?

Do I have a clear sense of what is happening in my life and

Do I know the skills and attributes I have that assist me to

Am I clear about why I do what I do, of what gives me

Do I forgive myself when I make a mistake?

Do I see a GP for a health check regularly?

Do I see a Dentist every 6 months?

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Resilience Goal (e.g. practice mindfulness 3 times a week for 15 mins)

Resilience Goal When/where Support Needed Feedback

1/ Structural: Self assessment:

2/ Structural: Self assessment:

3/ Structural: Self assessment:

5/ Structural: Self assessment:

6/ Structural: Self assessment:

Other (please specify): ___________________________________________________

You might also like