Please complete after any incidents in which you felt guilty:

1. Describe the situation which occurred.


What was the issue?



2. How did I respond?

Did I talk harshly___, loudly___, disrespectfully___, critically___, in a threatening___ or judgmental way___?

Did I make character assassinations?___

Did I make wrongful or exaggerated accusations?



3. Was my response measured,___ respectful___, tactful___?

Did I keep to the issue described in question one? ___
I listened___
I paraphrased what was said to me___
I demonstrated empathy (put myself in the other person’s shoes)___
I stated my feelings in a calm manner along with the facts___



4. What could I have done differently?




5. How could I have responded in a healthier manner?

Used more tact___
Been more respectful___
Kept the tone of my voice down___
Listened more___
Summarized what was said to me___
Showed more empathy___
Stated my feelings firmly but calmly___


*Measuring whether your guilt is true or false:
In order to determine whether you did something right or wrong - score your questionnaire this way:
1. If you checked any items in questions 2 or 5 or answered question #4 - your guilt is probably right-on.  You most likely should apologize.

2. If you didn’t check any items or complete questions 2, 4 or 5 but, checked items in question 3 - your guilt is most likely false.

Order: What's So Amazing About Grace? by Phillip Yancey

©copyright 2007 by Lynette J. Hoy, NCC, LCPC