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When to use this Form The purpose of this form is to assist staff combine self-care strategies into their daily life to reduce stress and find a work/life balance. Sample activities have been listed; however, you can look for alternatives to add as this is your individualised self-care plan. Personal Details of Staff Member First name: Family name: ☐ Employee ☐ Contractor/Volunteer ☐ Agency Casual D.O.B: Start date: Department: Name of emergency contact: Address: Contact Phone Number: Current stress levels Workplace Triggers (identify at least two) Stress Level Assessment (On a scale of 1-10) Workplace self-care activities – what helps you while at work Examples: Regular meetings with supervisors or other colleagues. Join a support group with other team members. Attend specialised training programs to understand more about client needs. My activities (it can be one or more activities): Physical self-care activities – what helps you stay fit and healthy Examples: Get regular sleep – ideally between seven and eight hours. Meal prep and aim for a healthy diet, drinking at least two litres of water a day. Take designated breaks, including lunch. Exercise regularly before or after work. My activities: Psychological self-care activities – what helps you stay clear minded and able to engage proactively at work and when personal challenges arise. Examples: Keep a reflective journal. Leave work at work, turn off emails and work phone outside of work hours. Make the time to be with friends and family. My activities: Emotional self-care activities – what helps you safely express your emotions. Examples: Supportive friendships, catch up with coffee and talk to your friends about how you are coping with work/life balance and demands. Write or think of three good things you did today. Play sport/go to gym. My activities: Spiritual self-care activities – what helps you develop a sense of perspective beyond day-to-day life. It can be religious; however, it doesn’t need to be. Examples: Mindfulness meditation. Connect with nature by taking a walk. Go to church/temple/mosque. Go to yoga classes. My activities: Relationship self-care activities – what helps you maintain healthy, supportive relationships outside of work. Examples: Prioritise close relationships in your life, for example – partners/spouse, family, children. Attend special events of your friends and family. Arrive at work and leave work on time every day. My activities: Name: Signature: Date: * Form is to be emailed to the Management team Date emailed: Task Instructions: For this part, there are two steps. 1. First read the scenario. You will continue as Jukka Sepp and complete a self-care plan. To complete the self-care plan: Identify at least two strategies for each part of the plan. Reflect on your role as Jukka in the scenarios and role plays. You can draw on your own experiences to complete the plan, if necessary. 2. Email your self-care plan to the manager, John Ford (your assessor) with a request for a debrief session and supervision. Resources and Equipment Required: Access to textbooks and other learning materials. Access to a computer, printer, Internet and email software (if required). Access to Microsoft Word (or a similar program). First Access supporting documents (accessible from the First Access website): HR3 Staff Health and Wellbeing Policy and Procedure HR T7 Self-Care Plan Template CG T1 Email Template. Jukka Sepp Having recently worked with clients going through grief and loss, Jukka monitors his stress levels and is noticing some changes in his feelings and behaviours. He has been drinking more than usual, often going home from work and having a couple of beers. His sleep patterns have been erratic, and he is finding it hard to focus at work. He missed soccer training on Wednesday night due to exhaustion. This was the first time he’d ever missed training as soccer is his passion. While a colleague is talking to him at work and asking for his advice, Jukka realises he is clenching his fists and feeling agitated. He responds abruptly to his colleague, quickly realises his reaction, takes a breath and apologises. His colleague asks Jukka if he is okay and suggests he talk to their manager. Jukka takes his colleague’s advice and reaches out to the care manager, John Ford. He mentions that he can’t seem to switch off from conversations he has recently had with clients and it appears that this is taking its toll on his stress levels. John organises a quick meeting with Jukka and discusses a self-care plan. He tells Jukka to take a mental health day to try and switch off from work entirely. John says, ‘When you return, I want you to take some time out from meeting with clients. I can get Henry and Estelle to cover you for a day. Complete your self-care plan and send it to me in an email with a request for any additional support you feel you need.’ Complete the form

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