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Questionnaire template

Emotional Awareness Self-Reflection

A non-diagnostic self-reflection on how adults notice, understand, express and use emotions at home and at work.

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Healthcare · Personality tests. All Healthcare templates

Questions in this template

Knowing Your Own Emotions

  1. This short reflection helps you think about how you notice and handle emotions. It is not a test or a diagnosis, and there are no right or wrong answers.

  2. How often does each of the following describe you?

    • I can name the emotion I am feeling
    • I know what has caused a particular feeling
    • I notice how my feelings shape what I think
    • I notice physical sensations that go with my feelings

    For each row: choose one:

    • Never
    • Rarely
    • Sometimes
    • Often
    • Always

Understanding Others

  1. How often do you find it hard to put yourself in the shoes of someone who is struggling?

    Choose one from a list:

    • Never
    • Rarely
    • Sometimes
    • Often
    • Always

Expressing and Managing Emotions

  1. Which of these statements describe you? Select all that apply.

    Choose any that apply:

    • I can share my feelings clearly and in a helpful way
    • I usually stay composed when under pressure
    • I find it hard to put my feelings into words
    • I tend to hold my feelings back
  2. If you like, give an example of a situation where one of these showed up. (optional)

    Condition: Shown when at least one statement was selected

    Open answer

Relationships

  1. Think of a recent conversation or situation that went well because you understood your own or someone else's feelings. What happened? (optional)

    Open answer

Emotions at Work

  1. How much do you agree: paying attention to how colleagues feel makes a real difference to how my work interactions go.

    Choose one:

    • Strongly disagree
    • Disagree
    • Neither agree nor disagree
    • Agree
    • Strongly agree