Self-Talk Assessment Questionnaire Form
Please answer the following questions to help assess your self-talk patterns. Your responses will remain confidential.
How often do you engage in self-talk?
*
Very often
Often
Sometimes
Rarely
Never
Please indicate how much you agree with the following statements about your self-talk.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I use self-talk to motivate myself.
1
2
3
4
5
My self-talk is mostly positive.
6
7
8
9
10
I notice negative self-talk in stressful situations.
11
12
13
14
15
I use self-talk to plan or solve problems.
16
17
18
19
20
I criticize myself through self-talk.
21
22
23
24
25
How would you rate the overall tone of your self-talk?
*
1
2
3
4
5
Which of the following best describes the content of your self-talk?
*
Mostly positive
Mostly negative
Balanced (both positive and negative)
I am not sure
When do you most often notice your self-talk?
*
When facing challenges
During daily routines
When making decisions
In social situations
Other
How helpful do you find your self-talk in managing emotions?
*
Not helpful
1
2
3
4
Very helpful
5
1 is Not helpful, 5 is Very helpful
Do you consciously try to change your self-talk?
*
Yes, regularly
Sometimes
No
Which strategies do you use to improve your self-talk?
Positive affirmations
Mindfulness or meditation
Journaling
Seeking feedback from others
Other
How would you describe the impact of your self-talk on your daily life?
*
Very positive
Somewhat positive
Neutral
Somewhat negative
Very negative
If you wish, please share any additional comments about your self-talk patterns.
Submit Assessment
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