Self-Care Questionnaire

APPENDIX A | Self-Care Questionnaire
You can choose to read this book in alphabetical order or prioritize certain chapters. This questionnaire is designed to help you discover the self-care areas that would benefit from your immediate attention vs. ones that you can work on later. Read each statement and decide if it fits best in the True or False category and put a check mark in the corresponding box.
This is for your eyes only or to share with your Accountability Partner. The quality of your results will depend on how honest you are when answering. Do your best to answer quickly and not overanalyze the statements. Go with your first instinct.

1.I often compare myself to others then feel despair.
2.I often feel inadequate as a spouse, parent, friend, sibling, coach, or leader.
3.I often have trouble making minor decisions without input from a trusted advisor.
4.I often feel hurt by negative comments received on social media.
5.I often bring up the same stories over and over, both to myself and to others, with the same amount of feeling attached, as if it occurred yesterday.
6.I feel like I’m stuck in a cycle of victimhood – to people, circumstances, and outcomes.
7.I review my work over and over to make sure everything is of the highest quality.
8.I am often stuck and do nothing toward achieving my dreams, fearing imperfect results.
9.I like to have control over processes and outcomes in life.
10.I would say that my coping strategies for anxiety need improvement.

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