Daily Rise Check In Worksheet
The Daily Rise
Confidence and Independence Check-In
Name:
Date:
1. Emotional Temperature
1
Overwhelmed
2
Nervous
3
Okay
4
Confident
5
Strong
My number today is: The biggest worry on my mind is:
What my body feels like:
(Tight shoulders, butterflies, heavy legs, tired...)
"One small thing that would help me move up 1 number is: _____________________________________________"
2. Thought Reset
What Happened
What I Thought
A Stronger Thought
💡 Helpful Idea: "Teasing says more about them than it does about me."
3. Morning Power Plan
Circle one tool for today:
Ignore and walk
Confident body language
Sit near a safe peer
Positive self-talk
"If teasing happens, I will __________________________________"
4. Confidence Builder
One thing I like about myself:
A strength (not about appearance):
Why I deserve to be in class today:
5. Independence Tracker (Fade Plan)
Week 1
Daily 8-10 min check-in
Week 2
3 check-ins per week
Week 3
2 check-ins per week
Week 4
1 check-in + self-check
"I handled today by myself when I __________________________________________________________________"
If My Clinician Is Not Here
IF IT IS AN EMERGENCY
(You feel unsafe or there is a medical need)
- 1 Go directly to the front office
- 2 Tell the office staff you need support
- 3 Ask for the school counselor or admin
IF NOT AN EMERGENCY
(You are feeling nervous but are safe)
- 1 Use this worksheet on my own
- 2 Try one tool from your Power Plan
- 3 Go to class and take it step by step
- 4 Ask your teacher for support if needed
"I am capable of handling hard moments."
Positive Affirmation Strips
Cut these out for your pocket or locker
I can have a good day, even if it starts hard.
I am proud of myself for showing up.
I can handle this class one step at a time.
I am stronger than teasing.
I keep going, even when I don’t feel like it.
I am learning how to overcome challenges.
I deserve to feel safe and respected at school.
I am doing better than I think I am.
My kindness is a strength.
Every day I practice being brave.
My own positive school thoughts: