Therapy Reflection Form

 

Important Privacy Notice: For your privacy and confidentiality, please do not include your full name anywhere on this form. Your initials and Date of Birth will be used for identification with your therapist.

 

Reflect on the kind of life you would like to live. 

What truly matters to you deep down? What kind of person do you aspire to be? Consider your values in areas like relationships (family, friends, romantic), personal growth/learning, career/contribution, community involvement, spirituality, and health/well-being.
Examples: "I want to live a life where I am more present with my loved ones, courageous in pursuing my passions, kind and compassionate (to myself and others), continuously learning and growing, contributing meaningfully to my community, or feeling more connected and authentic."

What thinking patterns (e.g., recurrent thoughts, beliefs, worries, self-judgments) tend to show up and move you *away* from living this desired life?

These are often automatic and can feel very true or demanding in the moment. They might be critical, fearful, or hopeless.
Examples: "I'm not good enough," "I'll probably fail anyway, so why bother trying?", "It's too difficult/overwhelming," "I'm too anxious/tired/depressed to do that," "What if... (a negative outcome happens)?", "I shouldn't feel this way," "Things have to be perfect or it's not worth it," "I'm unlovable."

What behaviors or actions do you find yourself doing that move you *away* from your desired life, especially when those difficult thoughts or feelings (from question 2) show up?

These actions might provide temporary relief from discomfort but often keep you stuck or take you further from your values in the long run.
Examples: Procrastinating on important tasks, avoiding social situations or challenging conversations, excessive worrying or ruminating (getting lost in thought), giving up easily when things get hard, withdrawing from loved ones, using substances (alcohol, drugs, food) to cope with feelings, overworking to avoid personal issues, snapping at others, excessive screen time.

What thoughts, perspectives, or self-talk could help you acknowledge difficult experiences and *still* move *towards* your desired life?

This isn't about suppressing negative thoughts, but about changing your relationship with them, or cultivating thoughts that are more flexible, compassionate, and aligned with your values.
Examples: "This is important to me, so I'm willing to feel some discomfort," "I can take one small step, even if I don't feel ready," "My thoughts are just thoughts, not commands or facts," "I am capable of handling this feeling while doing what matters," "It's okay to feel this way and still choose to act on my values," "What would the [valued quality, e.g., courageous, kind] part of me do here?", "I can be a work in progress."

What behaviors or actions, no matter how small, can you take (or are you already taking) that help you move *towards* your desired life and align with your values?

These are actions that embody what's important to you, even if they feel challenging or you don't feel motivated at first.
Examples: Practicing mindfulness for a few minutes each day, doing something I value even when I don't feel like it (e.g., going for a walk, calling a friend), breaking overwhelming tasks into smaller, manageable steps, speaking kindly and compassionately to myself, reaching out for support from trusted people, setting healthy boundaries, engaging in hobbies or activities that bring joy or meaning, exercising regularly, spending quality, present time with loved ones.