Name: _____________________________ Date:________________________

Everyone is talking about last night’s football game at lunch, but no one is talking to you.

Feel:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_

Do:___________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

You best friend tells you to steal a bag of Skittles from the grocery store.

Feel:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_

Do:___________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

A few of your friends are going to a movie tonight. They invite you but say, “Don’t tell (your other friend). We don’t
like him.”

Feel:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_

Do:___________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Some people at the grocery store are yelling insults at a Muslim woman in hijab.

Feel:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_
Do:___________________________________________________________________________________________
_____________________________________________________________________________________________
____________________________________________________________________________________________
You are walking at the mall with your friend. She bends down and rips her pants along the top, exposing her
underpants underneath.

Feel:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_

Do:___________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

You got a new jacket at the thrift store and on the first day you wear it, someone at the gas station points, laughs,
and says “Nice jacket loser.”

Feel:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_

Do:___________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

You see a few friends at McDonalds sitting around a table. You want to join, but there’s no open chairs.

Feel:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_

Do:___________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Your SLP is carrying a big bag. She slips and falls, and everything spills out onto the ground. She sighs and looks
frustrated.
Feel:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_

Do:___________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________