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Appendix - Reproducible Client Worksheets

Test | Table of Contents

Identifying Supportive Others
Review CD track 2 for more information regarding this technique.

1. List five relationships that are important to you.  Next, write each name on a separate sheet of paper.
2. Write three adjectives that describe each person.   As you list adjectives, recall memories that illustrate each adjective.
3. Once you have created your list, take several minutes to write answers to each of the following questions for your supportive others.
a. Which aspects of this relationship are positive for you?  Which are not?
b. What is it about this person that causes you to trust him or her?  Are there ways in which he or she is trustworthy, and ways he or she is not?
c.  Which of your needs are met in this relationship?  What needs do you meet for him or her?
d.  How do you think the trauma of Tim’s suicide impacted your relationship with him or her?
How do feelings of shame, anger, guilt, or anxiety influence how you interact with her or him?
e. How would you like your relationship with this person to change?  Is it possible to discuss your
concerns with him or her?
4. List three people you can call in the mornings, three you can call in the afternoons, and three you can call in the evenings if you become overwhelmed with negative feelings.  Keep this list by your telephone.  On the same sheet of paper, record the number of your therapist and the number for an after-hours crisis line.

The Programmed Cry
Review CD Track 5 for more information regarding this technique

1. Choose a room in the house that has special importance to you.  You may want to consider choosing Stacy’s bedroom.  Bring a full box of tissues, a radio or CD player, a pillow, and a picture of Stacy with you.  Choose a time in the evening for your programmed cry.
2.  Turn the lights in the room low, and turn on soft music.  Select a station with few interruptions, or a tape or CD of sentimental music.  Turn the volume as loud as is comfortable.
3. Feel the impact of the mood you have created.  Allow it to touch your sadness.  Think about Stacy and look at your photographs.  Remember your most special times, and think about your loss.  Turn your feelings loose.  Say what you are feeling aloud to yourself.
4.  Put two chairs back to back.  Sit in one, and imagine Stacy sitting in the other.  Talk directly to Stacy.  Tell her what you are feeling out loud.
5.  If you have a religious orientation or a concept of a divinity, you may wish to picture God or another spiritual focus sitting in the other chair.  Tell God, or your chosen focus, your feelings about your loss without restraint.
6.  Hold your pillow in your arms and cry into it.  Rock back and forth.  Yell if you want to.  Call out your loss.  Let your feelings go for as long as they want to come out.  Know that you are being healed by the release of all the pain and sadness.  Do not try to hide any feelings.
7.  When you begin to feel better, allow that new feeling to emerge.  Concentrate your attention on the positive thoughts that you are having.  Say those positive thoughts out loud.
8.  When you are ready, turn up the lights and turn the music down low.  Change the mood of the music to something happy and bright.  Put away the symbols of your cry- the tissues, pillow, and chairs.
9.  Do breathing exercises; stretch your muscles.  Do simple calisthenics or run in place.
10.  drink a large glass or two of water.  Make some herbal tea, or have some juice.  Snack on something healthy like fruits or vegetables.
11.  Take a warm bath or shower, read a humorous book, and then go to sleep.  The next morning, journal about your experience.

The Structured Sleeping Technique
Review CD Track 7 for more information regarding this technique

Create an hour-by-hour daily calendar in order to structure your waking and sleeping time.  Use the following steps:
1. Morning.  List what you will do from the time you get up until the time you have lunch.  Schedule your lunch at a specific hour, and eat at that time whether you feel like eating or not.
2. Afternoon.  List what you will do after lunch until time for dinner.  Schedule dinner at a specific time, and eat whether or not you feel like eating.
3. Evening.  List the hours of the evening from dinner until bedtime.  Fill in what you will do each hour of the evening.  Try to follow through with each evening’s plan.  Schedule relaxing activities that focus on your own needs. 
4.  Night time.  List the time that you are waking most frequently during the night.  List each half hour from your early waking time until your normal waking time.  Each evening, write down what you will do in 30-minute increments from the time you wake up until your normal rising time.  Give yourself tasks to do that are unpleasant.  Clean your room or bathroom, fold laundry, or anything you don’t like to do.  Do not snack or lie in bed staring at the ceiling.
5. If you go back to bed following your early morning waking, use relaxation breathing, visualization exercises, or progressive muscle relaxation to help you go back to sleep.

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