Actions and consequences worksheet

Behavior to Modify	[Identify the behavior you want to change]	Additional Notes
Current Consequences
Desired Consequences

Strategies for Behavior Modification	Identify
Positive Reinforcement	Identify rewards for engaging in the desired behavior.
Negative Reinforcement	Identify ways to remove or avoid negative consequences for changing the behavior.
Punishment	Identify mild consequences for engaging in the undesired behavior.
Extinction	Identify ways to eliminate reinforcement for the undesired behavior.

Action Plan	Identify
Specific Goals	Set measurable goals for changing the behavior.
Implementation	Plan how and when to implement the behavior change strategies.
Monitoring	Keep track of progress towards goals and adjust strategies as needed.
Support System	Identify people or resources that can provide support and encouragement.

You can download more Mental Health worksheets Here

There may be a more up-to-date and editable version of this worksheet available Here which may be more suitable to present to clients if you are a therapist or to use in a classroom as a teacher or guidance counselor.

References

1. Bastian B. Changing ethically troublesome behavior: The causes, consequences, and solutions to motivated resistance. Social Issues and Policy Review. 2019 Jan;13(1):63-92.