1. How the Journal Works Decide on a daily check-in time
Decide who you would like to check in with
Circle the “before” thermometer to identify what your arousal level was
For example, how activated, energized, or excited you were…
Write how it felt in your body
Make sure to be specific…Where did you feel it, for how long?
Talk with others about signals that both of you noticed on the outside,
( Like sweating, red cheeks, inability to concentrate) that let you know how
you were feeling on the inside. Write about it.
After you’ve used your calming tools, circle a number on the second
thermometer to indicate how you were feeling after.
Write about what you did to calm yourself
Talk with others about what they did, or should do in the future, that
helped you to regulate. Write about it.
Pat yourself on the back! You did great!

2. What I feel like inside 10 9 8 7 6 5 4 3 2 1
What it looks like to others

3. What I should do 10 9 8 7 6 5 4 3 2 1
What others should do

4. How I Felt Before How I Felt After Circle one! Circle one!
What I did
Circle one!
What I felt like inside
Circle one! 10 9 8 7 6 5 4 3 2 1 10 9 8 7 6 5 4 3 2 1
What happened?
What did the coach do?
Name_____________
Date____________

5. How I Felt Before How I Felt After Circle one! Circle one!
What I did
Circle one!
What I felt like inside
Circle one! 10 9 8 7 6 5 4 3 2 1 10 9 8 7 6 5 4 3 2 1
What I looked like outside
What others did
Name_____________
Date____________

6. How I Felt Before How I Felt After Circle one! Circle one!
What I did
Circle one!
What I felt like inside
Circle one! 10 9 8 7 6 5 4 3 2 1 10 9 8 7 6 5 4 3 2 1
What I looked like outside
What others did
Name_____________
Date____________