Written Debrief Form
Quiet Room

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 time-out?

    2.  

  2. What was I feeling at the time?

    3.  

  3. Why did I make this choice that led to a time-out?

    4.  

  4. What better choice could I have made?

    5.  

  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.  

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

    7.  

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

    8.  

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

    9.  

  9. How am I feeling now?

    10.  

  10. What consequence do I believe would be fair for my behavior?

    11.  

  11. Should an apology or restitution be given? If yes, what should this be?