Please note that you should print this out as entries will not be saved on the server.
Developing a Wellbeing Plan
- In my experience these are things that work for me – things that support my wellbeing.
- These are things that inspire me – they remind me of my values in life.
- These are some things that I would like to try to see if they support my wellbeing:
My baselines:
What am I like when I am well? When I feel well, this is how I think, feel and behave:
What am I like when I am unwell? When I am becoming unwell, this is how I think, feel and behave:
How do I and others know that I definitely need help? This is how I think, feel and behave when I am feeling unsafe:
Maintaining My Wellbeing
These are the things I need to do for myself to keep myself feeling as well as possible. State how often they need to be done (eg daily, weekly, monthly)
Dealing with Triggers:
These are the things that cause me stress and trigger symptoms:
(For each trigger identify (1) can it be helpfully avoided? Or (2) what is a helpful coping strategy for that trigger?)
| Can it be helpfully avoided? | What is a helpful coping strategy for that trigger? |
|---|---|
Add another row?
Early Warning Signs:
These are the first things that change when I’m becoming unwell: (do I notice them first or does someone else?)
PERSONAL CRISIS PLAN
These are the people whom I’d like to be listened to and kept informed when I’m obviously experiencing the above symptoms: (give name & contact details and their relationship to you)
| Name? | Relationship? | Contact Details? |
|---|---|---|
Add another row?
These are people whom I do not want to be involved in my care (give reasons if you wish):
| Name | Reason |
|---|---|
Add another row?
Treatment and Medication
My Current medication is:
These are the treatments and types of help that I would like: (list all types of help eg psychological, practical, social, medication, non-medical)
These are the treatments and types of help (including medication) that have not helped in the past and/or that I do not wish to receive (giving reasons/previous experiences may be useful):
| Treatment | Reason |
|---|---|
Add another row?
This is where I prefer to be when unwell (home/hospital/elsewhere)
Please add any other information that may be useful:
Name:
Date:
Please note that you should print this out as entries will not be saved on the server. You can download the form in Microsoft Word format here if the viewer below does not work for you.