Self Care Maintenance Plan Page 2

My Self-Care Maintenance Plan Worksheet

Consider what you do now for self-care and list those activities within each dimension of self-care on this worksheet (or you can add new

dimensions at the end that represent other aspects of your life). Identify new strategies that you will begin to incorporate as part of your

ongoing self-care maintenance plan — pay particular attention to domains that you have not been addressing in the past.

On the last page identify barriers that might interfere with ongoing self-care, how you will address them, and any negative coping strategies you

would like to target for change.

MIND

BODY

Current practice:

New practice:

EMOTIONS

SPIRIT

Current practice:

New practice:

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Parent category: Medical