Pain / Fatigue Diary

Pain and/or Fatigue Diary

When

Date / Time

0% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Pain Management to learn more about Pain Management and to get in touch with one of iTherapy's counselors.

Situation

What was I doing, where, who with, how long for?

16% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Pain Management to learn more about Pain Management and to get in touch with one of iTherapy's counselors.

Pain / Fatigue

Describe and Rate
0 (none) - 10 (max)

33% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Pain Management to learn more about Pain Management and to get in touch with one of iTherapy's counselors.

Emotion/s

Frustrated, anxious, angry, depressed, sad, scared etc.

50% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Pain Management to learn more about Pain Management and to get in touch with one of iTherapy's counselors.

Thoughts

What went through my mind at that time?
What did that mean to me or say about me?
What really upset me about that?

66% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Pain Management to learn more about Pain Management and to get in touch with one of iTherapy's counselors.

Alternative, more helpful Thought & Response

Is there another way of looking at this?
What would be more helpful - for me and for the situation?

84% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Pain Management to learn more about Pain Management and to get in touch with one of iTherapy's counselors.

When Situation Pain / Fatigue Emotion/s Thoughts Alternative, more helpful
Thought & Response

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

Answer Question to Complete Worksheet

When

Answer Question to Complete Worksheet

Situation

Answer Question to Complete Worksheet

Pain / Fatigue

Answer Question to Complete Worksheet

Emotion/s

Answer Question to Complete Worksheet

Thoughts

Answer Question to Complete Worksheet

Alternative, more helpful
Thought & Response

Answer Question to Complete Worksheet


© Carol Vivyan 2009, permission to use for therapy purposes.

100% Complete

Your responses are private. They are not viewed by a clinician. If you feel like you need help, contact one of our therapists. Visit Education and Resources Page for Pain Management to learn more about Pain Management and to get in touch with one of iTherapy's counselors.
Thanks to www.getselfhelp.co.uk for this template.