Skip to main content

Self-Care Assessment

A gentle review of how well you are looking after yourself across the different parts of life - body, feelings, relationships, day-to-day demands and a sense of meaning. The aim is to spot where you are running low and choose one or two small things to top yourself back up.

Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed

Assign and Download open signup, then return you to this worksheet. No card required. Resource access depends on your plan or trial. Already have an account? Sign in

Worksheet preview

Preview
Therapist note: A self-care inventory for use in low mood, burnout, stress, and as part of relapse prevention or behavioural activation. The domains (physical, emotional, social, practical/professional, spiritual/meaning) reflect widely used self-care assessment tools - this is an original adaptation rather than a single copyrighted scale. Frame self-care as maintenance and a legitimate need, not an indulgence, and watch for clients who treat every domain as another 'should'. The scores matter less than the conversation they open and the one or two realistic actions chosen at the end.

Live preview — type in any field to try it. Nothing is saved here.

What self-care really means

Self-care is not bubble baths and treats - though it can include them. It is the everyday business of meeting your own basic needs so you have enough in the tank to cope with life. Like a phone, you need regular recharging. When we are busy, stressed or low, self-care is usually the first thing to slip, which is exactly when we need it most. This is a chance to check, honestly and without judgement, how each part of your self-care is doing right now.

Physical - looking after your body

This covers sleep, eating regularly and reasonably well, moving your body, drinking enough water, taking rest when you are tired, and seeing a doctor or dentist when you need to. Your body is the ground everything else stands on. Rate how well you have been doing this lately.

Not at allSo-soReally well
Choose a value

Emotional - looking after your feelings

This is about letting yourself feel and name your emotions, doing things that bring comfort or joy, being kind to yourself rather than harshly self-critical, and reaching out for support when you are struggling. It also means giving yourself permission to laugh, cry and switch off. Rate how well you have been doing this lately.

Not at allSo-soReally well
Choose a value

Social - connection with others

This covers spending time with people who matter to you, staying in touch with friends and family, asking for help, doing things that are fun or playful, and setting boundaries so you are not always giving and never receiving. Humans are wired for connection, and even small contact counts. Rate how well you have been doing this lately.

Not at allSo-soReally well
Choose a value

Practical and work life

This is about managing the demands of daily life without grinding yourself down: keeping your workload at a level you can handle, taking proper breaks, having time off, keeping on top of money and admin, and asking for help when tasks pile up. Constant pressure with no let-up wears anyone out. Rate how well you have been doing this lately.

Not at allSo-soReally well
Choose a value

Meaning - what matters to you

This covers the things that give life a sense of purpose: living in line with your values, spending time in nature, faith or reflection if that fits for you, creativity, helping others, or simply moments of awe and gratitude. It is the part of self-care that feeds the spirit. Rate how well you have been doing this lately.

Not at allSo-soReally well
Choose a value

Small self-care actions to choose from

Looking at your lowest-scoring domains, here are some small, doable actions. You do not need to do them all - tick any that you would be willing to try.

Actions I would be willing to try

My plan for this week

Pick just one or two small things to focus on this week - the ones most likely to make a difference. Trying to fix everything at once usually backfires. Small and regular beats big and rare.

Try it here — nothing you type is saved. Sign up to assign it and let clients complete it on any device.

When to use the Self-Care Assessment

The Self-Care Assessment is an interactive cognitive behavioural therapy (CBT) worksheet. As a core CBT skill it is used right across the model, with presentations including depression, anxiety, OCD, trauma and low self-esteem, rather than being tied to a single diagnosis.

It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device — or download it as a print-ready PDF.

How it works

Most people work through it in around 10 minutes. It moves through six short steps:

  1. What self-care really means — Self-care is not bubble baths and treats - though it can include them. It is the everyday business of meeting your own basic needs so you…
  2. Physical - looking after your body — This covers sleep, eating regularly and reasonably well, moving your body, drinking enough water, taking rest when you are tired, and…
  3. Emotional - looking after your feelings — This is about letting yourself feel and name your emotions, doing things that bring comfort or joy, being kind to yourself rather than…
  4. Social - connection with others — This covers spending time with people who matter to you, staying in touch with friends and family, asking for help, doing things that are…
  5. Practical and work life — This is about managing the demands of daily life without grinding yourself down: keeping your workload at a level you can handle, taking…
  6. Meaning - what matters to you — This covers the things that give life a sense of purpose: living in line with your values, spending time in nature, faith or reflection if…

Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.

The CBT approach behind it

In common with other CBT methods, the Self-Care Assessment works by noticing the links between situations, thoughts, feelings, physical sensations and behaviour — and finding practical ways to change unhelpful patterns. The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going — and practical, testable ways to change it.

Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.

It follows the same evidence-based cognitive behavioural therapy structure as the rest of the Formulate library.

For use alongside professional support

Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.

If you need urgent help now:

  • Emergency services: 999 — if you or someone else is in immediate danger
  • Samaritans: 116 123 — free, day or night, 365 days a year
  • SANEline: 0800 689 5555 — 4:30pm–10:30pm, every day

More Psychoeducation worksheets

View all Psychoeducation worksheets →

Psychoeducation

Understanding the CBT Model

An introduction to how thoughts, feelings, body sensations and behaviour connect in a loop, and how CBT uses this to help you feel differently.

Formulation~10 minInteractive

Psychoeducation

The Stress Response: Fight, Flight or Freeze

An explainer on how the body's threat system works, why the physical feelings of fear are uncomfortable but harmless, and why false alarms happen.

Handout~7 min

Psychoeducation

Understanding Core Beliefs

A plain-language explainer on the levels of thinking in CBT: automatic thoughts, underlying assumptions, and the deep core beliefs about ourselves, others, and the world.

Handout~12 min

Psychoeducation

The Window of Tolerance

A plain-language guide to your window of tolerance: the zone where you can think, feel, and cope. Learn what it looks like when you go above it (overwhelmed) or below it (shut down), and simple ways to come back.

Handout~10 min

Psychoeducation

The Three Emotion Systems

A simple introduction to the three systems that shape our feelings: threat, drive, and soothe. Learn why modern life and self-criticism can leave the soothe system underused, and how compassion helps bring them back into balance.

Handout~10 min

Psychoeducation

Naming Your Emotions

Putting accurate words to feelings can lower how strong they feel. This handout explains the idea of name it to tame it and gives you an emotion-word list, from basic feelings out to more precise ones, to help you say what is going on inside.

Handout~8 min

Want to assign this to a client?

Create a free therapist account to use the assignment and library download tools. Clients can complete assigned homework online or use a blank PDF. See how the homework workflow works.

No card required. The Free plan includes 10 worksheet uses a month. Check plan access and limits.