It is important to gain insight into your daily activities, how enjoyable they are and how they affect your mood. This form will help you to register which activities you have done, when you did them, how much you enjoyed the activity, how competent you felt and what mood you were in during the activities.

How do I fill in the Activity Form?

Record every activity you do every day for at least a week (e.g. breakfast, walking, drinking coffee, shopping, showering, etc.). Then fill out the following things:

  • How enjoyable the activity was on a scale of 0-10 (0 = not at all pleasant / ‘must’, 10 = very pleasant)
  • How competent you felt on a scale of 0-10 (0 = not competent at all, 10 = extremely competent).
  • What mood you were in on a scale of 0-10 (0 = very depressed, 10 = not depressed at all)

During your next session, you will discuss the completed list with your practitioner and see how your activities and mood may influence each other.

NiceDay

You can record this on paper, but it is more convenient for your practitioner to be able to see the information through NiceDay. You can do this by creating a diary registration every day and calling it “Activity Registration”. In the notes, you can write down the information stated in the columns below. At the bottom, you will find an example of a completed activities registration in the NiceDay diary.

Activity form

Date: ________________

Time of day Activity Enjoyment

(0-10) *

Competence (0-10) ** Mood (0-10) ***

 

* Enjoyment: Take notes on how enjoyable the activity was. P-score 0-10 (0 = not at all pleasant / must, 10 = very pleasant)

** Competence: Write down how well you were able to carry out the activity. B-score 0-10 (0 = not competent at all, 10 = extremely competent).

*** Mood: 0-10 (0 = very depressed, 10 = not depressed at all)

An example of a completed activity form

Date: Monday, August 5

 

Time of Day Activity Enjoyment

(0-10) *

Competence (0-10) ** Mood (0-10) ***
Morning Get up 1 3 2
Morning Breakfast 2 5 3
Morning Yoga lesson 7 7 7
Afternoon Grocery shopping 0 3 2
Afternoon Coffee 5 7 6
Afternoon Cleaning the house 0 3 3
Evening I had dinner but wasn’t hungry. 1 3 3
Evening Watching TV. 6 6 6

* Enjoyment: Take notes on how enjoyable the activity was. P-score 0-10 (0 = not at all pleasant / must, 10 = very pleasant)

** Competence: Write down how well you were able to carry out the activity. B-score 0-10 (0 = not competent at all, 10 = extremely competent).

*** Mood: 0-10 (0 = very depressed, 10 = not depressed at all)

An example of an “Activity registration” (diary) in NiceDay

References: Keijsers, G. P. J., Van Minnen, A., Verbraak, M., Hoogduin, C. A. L. & Emmelkamp, P., (2017). Protocollaire behandelingen voor volwassenen met psychische klachten

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