Healthcare Training Institute - Quality Education since 1979CE for Psychologist, Social Worker, Counselor, & MFT!!
Appendix
C - Controlling Behavior Weekly Logs
Reproducible
Client Worksheet
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Instructions: Complete each
section. Be specific. Topic:_____________________________Date:______________Name:________________________________ 1.
Briefly describe the situation and the action you used to control (statements,
gestures, tone of voice, physical contact, facial expressions). _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 2.
Intent: What did you want to happen in this situation? _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 3.
What feelings were you having? _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 4.
In what way did you minimize or deny your actions or blame her? _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 5.
Effects: what was the result of your action? Include results of blaming or minimizing. (on
you)__________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ (on
her)___________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 6.
It would have been better if I... _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ 7.
How did your past use of violence affect this situation? _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Caesar,
P. Lynn, Treating Men Who Batter, Springer Publishing Company, NY, NY,
1989.
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