Emotional Regulation Self-Assessment Form
Evaluate your emotional regulation skills and strategies to gain insight into your emotional well-being.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Age
*
Please rate how often each statement applies to you:
*
Rows
Never
Rarely
Sometimes
Often
Always
I am aware of my emotions as they arise.
1
2
3
4
5
I can express my emotions appropriately.
6
7
8
9
10
I have strategies to calm myself when upset.
11
12
13
14
15
I am able to pause before reacting impulsively.
16
17
18
19
20
I can adapt my emotional responses to different situations.
21
22
23
24
25
I find it easy to talk about my feelings with others.
26
27
28
29
30
How would you rate your overall ability to regulate your emotions?
*
1
2
3
4
5
When you experience strong emotions, which coping strategy do you use most often?
*
Deep breathing or relaxation techniques
Talking to someone you trust
Physical activity or exercise
Distracting yourself with activities
Bottling up or suppressing emotions
Other
How confident are you in your ability to manage stress?
*
Not at all confident
1
2
3
4
5
6
7
8
9
Extremely confident
10
1 is Not at all confident, 10 is Extremely confident
In the past week, how often have you felt overwhelmed by your emotions?
*
Please Select
Never
Once or twice
Several times
Almost every day
Every day
Which of the following best describes your current emotional state?
*
Calm and stable
Generally positive but sometimes anxious
Frequently stressed or irritable
Often sad or withdrawn
Other
What is one area of emotional regulation you would like to improve? (Optional)
Submit Self-Assessment
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