In a typical month, how often has the following been true for you? For each question, write the number that best fits your experience.
0 - almost never
1 - seldom
2 - sometimes
3 - often
4 - almost always
1. I have at least one full day off work each week.
2. I take some time for myself to be quiet, think, meditate, write and/or pray.
3. I work no more than 8 hours a day when not on deployment.
4. I exercise for at least 25 minutes, 5 days a week.
5. I do something I find fun.
6. I practice muscle relaxation, yoga, stretching, meditation or slow-breathing.
7. I share how I am feeling with at least one friend or my partner.
8. I get 7 to 8 hours of sleep a night.
9. I am careful to eat a balanced diet.
10. I drink more than 1 to 2 alcoholic drinks (0 most days, 1 several times a week, 2 once a week, 3 once a month, 4 never).
11. On balance I have more positive emotional experiences than negative.
12. At the end of the day I can leave the pressures of work behind.
13. I slow down when I am becoming tired, run-down and vulnerable to illness.
14. There are people who care about me that I trust, to whom I can talk if I want.
15. I do something I find creative or expressive.
16. I feel I have the training and skills I need to do my job well.
17. I stand up for myself, saying "NO" when I need to.
18. At work, I take a brief break every two hours and switch tasks regularly.
19. I spend time with trusted others who are part of a community of meaning and purpose (church/ community volunteers/ work colleagues/ book group).
20. I feel good about my ability to communicate with others.
21. I spend my time and energy doing what is really important to me in life.
22. I believe in my ability to accomplish goals, even when I encounter difficulties.
23. I set realistic goals for my life and work towards them.
24. I take good vacations.
25. I am able to let go of mistakes I have made.
26. I am able to manage conflict constructively.
27. I am able to let go of grudges.
28. I smoke or use other recreational drugs (0 most days, 1 several times a week, 2 once a week, 3 once a month, 4 never).
Scoring
0 - 29
This range suggest that your self care skills and lifestyle balance strategies may be POOR and that you could probably benefit from developing a plan to change your lifestyle and improve your self-care.
30 - 59
This range suggests that your self care sills and lifestyle balance strategies may be AVERAGE and that you could probably benefit from developing a plan to change your lifestyle and improve your self-care, especially if you have more stress than is typical for an adult.
60 - 84
This range suggests that you may have good self-care skills and lifestyle balance strategies in place, but could benefit from preparing for times of high stress by adding some additional practices.
> 85
This range suggests that you may have good self-care skills and lifestyle balance strategies in place for building resilience.
source: Headington Institute
www.headington-institute.org
