My Safe Plan Worksheet

1. My Big Feeling Signals

Circle the ones that happen in your body:

• My heart beats fast

• My tummy feels tight

• My hands feel wiggly

• My face feels hot

• My thoughts feel loud

• Something else: ___________

2. What Helps Me Feel Safe

Circle or write the things that help your body calm:

• Deep breaths

• Hug from someone I trust

• Holding my stuffed animal

• Sitting in my cozy spot

• Quiet music

• Talking to a grown‑up

• A warm blanket

• A prayer

• Something else: ___________

3. My Safe People

Write or draw three people you can go to when you need help:

4. My Safe Words

Sometimes it’s hard to explain what you feel.

Here are some words you can use:

• “I need help.”

• “My feelings are too big.”

• “Can you sit with me?”

• “I need a break.”

Write your own safe words here:

5. My Safe Place

Draw or describe a place where your body feels calm and protected.

6. A Prayer for Safety

A simple prayer you can use anytime:

“God, please help my heart feel safe again.”

Write or draw what helps you feel God close:

7. My Safe Plan

When my feelings get big, I can:

8. How I Feel Now

Circle one:

🙂 Calm

😐 A little better

😕 Still working on it

😢 I need more help