Written Debrief Form

 

 

 

Debrief: Please write an answer for each question below. The answer you give for these questions should be honest and help you work toward a solution that will help you resolve the problem that got you in the isolation area and will prevent this behavior from happening again.

 

1. What did I do to earn this consequence?

 

                                                                                                                                         

 

                                                                                                                                         

 

2. What was I feeling at the time?

 

                                                                                                                                         

 

                                                                                                                                         

 

3. Why did I make this choice?

 

                                                                                                                                         

 

                                                                                                                                         

 

4. What other choices did I have?

 

                                                                                                                                         

 

                                                                                                                                         

 

5. Is there some personal issue in or out of the classroom that may be increasing my stress level today? If yes, what is it and what can I do to relieve this added stress?

 

                                                                                                                                         

 

                                                                                                                                         

 

6. What would I like to say about what happened that may help explain the problem?

 

                                                                                                                                         

 

                                                                                                                                         

 

7. What can I change to keep this from happening again?

 

                                                                                                                                         

 

                                                                                                                                         

 

8. What will I agree to do or try if this situation happens again?

 

                                                                                                                                         

 

                                                                                                                                         

 

9. How am I feeling now?