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Lifestyle Balance Worksheet

Lifestyle Balance WorksheetInstructions:Answer the following questions to help you determine how balanced your life is currently. Then reviewyour answers. Identify two out-of- Balance areas that you want to change. Write a plan for change in each Physical:Are you in good health?YesNoDo you exercise regularly?YesNoDo you follow a reasonable diet?YesNoDo you take good care of your appearance?YesNoDo you get sufficient rest and sleep?YesNoDo you get regular medical and dental checkups?YesNoDo you have strategies to handle cravings to use substances?YesNo2. Mental/emotional:Are you experiencing excessive stress?YesNoDo you worry too much?YesNoDo you have strategies to reduce mental stress?

Lifestyle Balance Worksheet Instructions: Answer the following questions to help you determine how balanced your life is currently. Then review your answers. Identify two out-of-balance areas that you want to change. Write a plan for change in each area.

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Transcription of Lifestyle Balance Worksheet

1 Lifestyle Balance WorksheetInstructions:Answer the following questions to help you determine how balanced your life is currently. Then reviewyour answers. Identify two out-of- Balance areas that you want to change. Write a plan for change in each Physical:Are you in good health?YesNoDo you exercise regularly?YesNoDo you follow a reasonable diet?YesNoDo you take good care of your appearance?YesNoDo you get sufficient rest and sleep?YesNoDo you get regular medical and dental checkups?YesNoDo you have strategies to handle cravings to use substances?YesNo2. Mental/emotional:Are you experiencing excessive stress?YesNoDo you worry too much?YesNoDo you have strategies to reduce mental stress?

2 YesNoAre you able to express your feelings to others?YesNoDo you suffer from serious depression or anxiety?YesNo3. Intellectual:Are you able to satisfy your intellectual needs?YesNoDo you have enough interests to satisfy your intellectual curiosity?YesNo4. Creative/artistic:Do you regularly participate in creative or artistic endeavors?YesNoDo you have talents or abilities that you think are not being used as much as you YesNowould like?5. Family:Are you generally satisfied with your family relationships?YesNoDo you spend enough time with your family (especially your children, if you have any)?YesNoCan you rely on your family for help and support?YesNo6. Personal relationships:Are you generally satisfied with the quantity and quality of your personal relationships?

3 YesNoDo you have friends you can depend on for help and support?YesNoAre you able to express your ideas, needs, and feelings to others?YesNoAre there any specific relationships in which you have serious problems?YesNo7. Spiritual:Is there enough love in your life ?YesNoDo you pay enough attention to your inner spiritual life ?YesNoDo you feel a sense of inner peace?YesNoDennis C. Daley, G. Alan Marlatt Overcoming Your Alcohol or Drug Problem: Strategies for Balanced Living. Copyright 2006 by Oxford University Press Oxford Clinical Psychology | Oxford University Press8. Work or schoolAre you usually satisfied with your work or school situation?YesNoDo you spend too much time or effort working?

4 YesNoDo you spend too little time or effort working?YesNo9. Financial:Do you have sufficient income to meet your expenses?YesNoAre you having any serious financial problems ( , too much debt, no savings, etc.)?YesNoDo you handle your money responsibilities with an eye to the future?YesNoDoes money play too big a role in your life ?YesNoOut-of- Balance area:My change plan:Out-of- Balance area:My change plan:Dennis C. Daley, G. Alan Marlatt Overcoming Your Alcohol or Drug Problem: Strategies for Balanced Living. Copyright 2006 by Oxford University Press Oxford Clinical Psychology | Oxford University Press


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