"Progress Monitoring Schedule Template - Centre for Clinical Interventions"

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Monitoring Your Relaxation Level
It is important to practice relaxation to achieve the best results, as this is a new skill that you are learning. You can monitor you own progress
by keeping a relaxation diary that records the when, where and how of your practice. This will help you to identify particular situations and / or
times of the day when you are most tense. Use the scale to indicate your level of relaxation before and after you complete your relaxation.
The most relaxed and
The most tense or anxious
0
10
1
2
3
4
5
6
7
8
9
Relaxation
Relaxation
Comments /
level before
level after
Date & Time
Comments / Reactions
Reactions:
What parts of your
body relaxed easily?
What sensations
were you aware of
in your body?
Was your mind
relaxed?
What sorts of
images were most
relaxing for you?
C
entre for
C I
linical
nterventions
• Psychotherapy • Research • Training
This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the
information from this website before making use of such information.
Monitoring Your Relaxation Level
It is important to practice relaxation to achieve the best results, as this is a new skill that you are learning. You can monitor you own progress
by keeping a relaxation diary that records the when, where and how of your practice. This will help you to identify particular situations and / or
times of the day when you are most tense. Use the scale to indicate your level of relaxation before and after you complete your relaxation.
The most relaxed and
The most tense or anxious
0
10
1
2
3
4
5
6
7
8
9
Relaxation
Relaxation
Comments /
level before
level after
Date & Time
Comments / Reactions
Reactions:
What parts of your
body relaxed easily?
What sensations
were you aware of
in your body?
Was your mind
relaxed?
What sorts of
images were most
relaxing for you?
C
entre for
C I
linical
nterventions
• Psychotherapy • Research • Training
This document is for information purposes only. Please refer to the full disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the
information from this website before making use of such information.