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Templates
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Michael Williams - Templates
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Template - Relationship Journal
Relationship Journal
Date:
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Step 1 - They Said
Step 1a – S/he said: Write down exactly what the other person said.
Be brief:
Step 1b – His/her feelings: Check the emotion words s/he might have been feeling if you aren’t sure, just put your best guesses (underline).
1) Angry
i. Upset
ii. Annoyed
iii. Irritated
iv. Mad
v. Ticked Off
vi. Resentful
vii. Bitter
viii. Incensed
ix. Irate
x. Furious
xi. Enraged
2) Anxious
i. Apprehensive
ii. Nervous
iii. Concerned
iv. Worried
v. Uptight
vi. Panicky
vii. Afraid
viii. Fearful
...
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Step 2 - You Said
Step 2a – I said: Write down exactly what you said next.
Be brief:
Step 2b – My feelings: Check the emotion words below to show how you felt when she/he said that. If you aren’t sure, just put your best guesses (underline).
1) Angry
i. Upset
ii. Annoyed
iii. Irritated
iv. Mad
v. Ticked Off
vi. Resentful
vii. Bitter
viii. Incensed
ix. Irate
x. Furious
xi. Enraged
2) Anxious
i. Apprehensive
ii. Nervous
iii. Concerned
iv. Worried
v. Uptight
vi. Panicky
vii. Afraid
viii. Fearf...
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Step 3a - EAR Checklist
EAR Checklist (Empathy Assertiveness Respect)
Instructions. Review what you wrote down in Step 2a. Was your statement an example of Good Communication or Bad Communication?
Good Communication
1. Empathy:
⁃ Good: You acknowledge the other person's feelings.
⁃ Bad: You ignore the other person's feelings.
2. Assertiveness:
⁃ Good: You express your feelings openly and directly.
⁃ Bad: You failed to express your feelings openly.
3. Respect:
⁃ Good: Your attitude is respectful and car...
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Step 3b - The Bad Communication Checklist
The Bad Communication Checklist
Instructions. Review what you wrote down in Step 2a of the Relationship Journal. How many of the following communication errors can you spot?
Communication Error (underline errors you made)
1. Truth – You insist you're "right" and the other person is "wrong."
2. Blame – You imply the problem is the other person's fault.
3. Defensiveness – You argue and refuse to admit any imperfection.
4. Martyrdom – You imply that you're an innocent victim.
5. Put...
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Step 4 - Consequences
Step 4 – Consequences: Did your response make the problem: better worse?
Why?
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Step 5 - Revised Version
Step 5 – Revised Version: Revise what you wrote down in Step 2 (use the “Five Secrets of Effective Communication.” If your revised response is ineffective, try again).
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Template - Daily Mood Journal
Daily Mood Journal
Date:
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Step 1 - Event
Upsetting Event:
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Step 2 & 4 - My Emotions
Upsetting Event:
My Emotions
1) Angry - % Now ; % Goal ; % After ;
i. Upset
ii. Annoyed
iii. Irritated
iv. Mad
v. Ticked Off
vi. Resentful
vii. Bitter
viii. Incensed
ix. Irate
x. Furious
xi. Enraged
2) Anxious - % Now ; % Goal ; % After ;
i. Apprehensive
ii. Nervous
iii. Concerned
iv. Worried
v. Uptight
vi. Panicky
vii. Afraid
viii. Fearful
3) Bored - % Now ; % Goal ; % After ;
i. Uninterested
ii. Unmotivated
4) Criticized - % Now ; % Goal ; % After ;
i. Picked On
ii....
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Step 3 - Negative Thoughts & Distortion
Negative Thoughts & Distortions
1) Negative Thoughts & Distortions
i. Negative Thought:
a. % Now:
b. % After:
ii. Distortion:
a. % Belief:
iii. Positive Thought:
2) Negative Thoughts & Distortions
i. Negative Thought:
a. % Now:
b. % After:
ii. Distortion:
a. % Belief:
iii. Positive Thought:
3) Negative Thoughts & Distortions
i. Negative Thought:
a. % Now:
b. % After:
ii. Distortion:
a. % Belief:
iii. Positive Thought:
4) Negative Thoughts & Distortions
i...
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Template - Daily Communication Scripting
1) The Disarming Technique (DT)
2) Thoughts Empathy (TE)
3) Feeling Empathy (FE)
4) Inquiry (IN)
5) I-Feel Statements (IF)
6) Conveying Respect (CR)
E = Empathy
1. The Disarming Technique (DT): Find some truth in what the patient is saying, even if it seems unreasonable or unfair.
2. Empathy: Put yourself in the patient’s shoes; try to see the world through his or her eyes.
• Thought empathy (TE): Paraphrase the patient’s words.
• Feeling empathy (FE): Acknowledge how the patien...
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Template - Possible Responses
Monday, March 11, 2024, 5:55 PM
Possible Responses
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What Was Said
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What I Said
What I Said
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What They Said
What They Said
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Thoughts
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My Thoughts & Feelings to Their Reply
My Thoughts & Feelings to Their Reply
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Why They Might Have Replied The Way They Did
Why They Might Have Replied The Way They Did
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Possible Replies
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Possible Reply 1
Possible Reply 1
Reply:
Reason for Saying This:
How This Might Make Them Feel:
Possible Response From Other Person:
1 - 5 Stars on Maintaining the Relationship:
1 - 5 Stars On Helping Them Become a Better Person (not my responsibility):
1 - 5 Stars on "I Thou" Relationship:
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Possible Reply 2
Possible Reply 2
Reply:
Reason for Saying This:
How This Might Make Them Feel:
Possible Response From Other Person:
1 - 5 Stars on Maintaining the Relationship:
1 - 5 Stars On Helping Them Become a Better Person (not my responsibility):
1 - 5 Stars on "I Thou" Relationship:
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Possible Reply 3
Possible Reply 3
Reply:
Reason for Saying This:
How This Might Make Them Feel:
Possible Response From Other Person:
1 - 5 Stars on Maintaining the Relationship:
1 - 5 Stars On Helping Them Become a Better Person (not my responsibility):
1 - 5 Stars on "I Thou" Relationship:
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Possible Reply 4
Possible Reply 4
Reply:
Reason for Saying This:
How This Might Make Them Feel:
Possible Response From Other Person:
1 - 5 Stars on Maintaining the Relationship:
1 - 5 Stars On Helping Them Become a Better Person (not my responsibility):
1 - 5 Stars on "I Thou" Relationship:
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Possible Reply 5
Possible Reply 5
Reply:
Reason for Saying This:
How This Might Make Them Feel:
Possible Response From Other Person:
1 - 5 Stars on Maintaining the Relationship:
1 - 5 Stars On Helping Them Become a Better Person (not my responsibility):
1 - 5 Stars on "I Thou" Relationship:
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What I Actually Replied
What I Actually Replied
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