Self-Worth Checklist

 Name: ________________________________________  Date: ________________


1 - Never, 2 - Rarely, 3 - Sometimes, 4 - Often, 5 - Always


 Participant  Behavior  Facilitator
Looks at others when speaking and listening to them
Interprets the messages of other people accurately
Exhibits a willingness to listen with an open mind to the ideas of others
Clean and neatly groomed for the situation
Expresses thoughts and feelings genuinely
(Uses sarcasm sparingly.)
Uses "I" messages to express opinions, expectations, and beliefs
Extends self to meet others, gets to know them by name, and identifies common interests
Voluntarily complies with the social norms of the situation
Acknowledges mistakes and shortcomings by apologizing
Smiles
Moves with purpose and urgency - without slumping
 Defends personal rights and space without violence

Participant Comments: _____________________________________________________
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Facilitator Comments: ______________________________________________________
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