Self-Doubt Assessment Form
Assess your self-doubt patterns and triggers. All responses are confidential and help you reflect on your experiences.
How often do you experience self-doubt?
*
Rarely
Sometimes
Often
Almost always
In which areas of your life do you most often feel self-doubt?
*
Work or career
Relationships
Academic or learning
Personal decisions
Social situations
Other
How strongly do you agree with the following statements about self-doubt?
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I often question my abilities.
1
2
3
4
5
I compare myself to others frequently.
6
7
8
9
10
Self-doubt prevents me from taking action.
11
12
13
14
15
I find it hard to accept compliments.
16
17
18
19
20
I worry about making mistakes.
21
22
23
24
25
How much does self-doubt impact your decision making?
*
Not at all
1
2
3
4
A great deal
5
1 is Not at all, 5 is A great deal
When you feel self-doubt, how do you usually respond?
*
Overthink or procrastinate
Seek reassurance from others
Avoid taking action
Push through despite doubts
Other
How would you rate your overall self-confidence?
*
1
2
3
4
5
What typically triggers your self-doubt?
*
Negative feedback
Comparison to others
Unfamiliar situations
Past failures
High expectations
Other
How comfortable are you seeking support when experiencing self-doubt?
*
Very uncomfortable
Somewhat uncomfortable
Neutral
Somewhat comfortable
Very comfortable
How often do you recognize positive qualities in yourself?
*
Never
Rarely
Sometimes
Often
Always
Briefly describe a recent situation where you felt self-doubt and how you handled it.
*
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