Use a responsibility worksheet to divide a difficult situation into your decisions, another person's decisions, and shared constraints. The division is useful only if it leads to a specific available action rather than total self-blame.
Work through these questions: Did not send dates
Completed fictional example — SAMPLE DATA
This example shows how to fill in the form. It is not a real person’s record, a diagnosis, a validated assessment or a promised outcome. Use your own observations and appropriate professional advice for actual health concerns.
| Question or field | Your entry |
|---|---|
| My choice? | I delayed asking for the venue details |
| Other choice? | The venue contact has not replied |
| Shared constraint? | The office closes early |
| My repair? | Ask during office hours and mark the uncertainty |
| Evidence? | A dated request and the response, if received |
Blank worksheet — copy or print
Copy the form into your own private document or print this page. Replace each “Your entry” cell with your own note; leave anything uncertain clearly marked as unknown. This page does not save or submit your entries.
| Question or field | Your entry |
|---|---|
| My choice? | Your entry |
| Other choice? | Your entry |
| Shared constraint? | Your entry |
| My repair? | Your entry |
| Evidence? | Your entry |
Completed example
| Question or field | Fictional completed example |
|---|---|
| My choice? | Did not send dates |
| Other choice? | Did not check confirmation |
| Shared constraint? | A system outage |
| My repair? | Send dates and request alternatives |
| Evidence? | A confirmation or clear rejection |
A worked situation: Did not send dates
Fictional example. A pair misses a booking deadline. One partner never sent the dates; the other never checked the confirmation. Both can name a contribution without claiming responsibility for the booking system's outage.
Keep shared obligations in separate rows
Use one row for your choice and another for someone else’s choice. Shared constraints need their own entry: a delayed supplier or unavailable childcare is not erased by an ownership slogan. Then write the repair you can offer and the decision that requires agreement. The completed worksheet should show a boundary of control as clearly as a next action.