Written by
Patricia Buenaventura
Patricia Buenaventura
Reviewed by
Patricia Buenaventura

Closeness Circle Interpersonal Therapy Worksheet

Help your client identify the essential people in their life and how to work on their relationship using our Closeness Circle Interpersonal Therapy Worksheet.

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What is a Closeness Circle Interpersonal Therapy Worksheet?

A closeness circle interpersonal therapy worksheet is a diagram that aids clients in identifying the people who are important to them, understanding their relationship with these people, and how to maintain or strengthen their bond. Through this exercise, clients can also develop and sharpen their interpersonal skills. Often used during interpersonal therapy sessions, the closeness circle worksheet can be given to anyone regardless of age, given that therapists will guide their young clients.

The layout and content of the closeness circle interpersonal therapy worksheet may vary depending on the therapist. However, generally, the worksheet may have a dot or circle in the middle representing the client, and 3 to 4 outer circles surrounding the inner circle.

You can easily find closeness circle interpersonal therapy worksheets online. However, if you need one now for your practice you’re in luck. We have a template just for you.

If you're interested in accessing other worksheets, check out our video below:

Printable Closeness Circle Interpersonal Therapy Worksheet

Download this Closeness Circle Interpersonal Therapy Worksheet so your clients can reflect on their relationships.

How does this Closeness Circle Interpersonal Therapy Worksheet work?

Step One. Access the Template

To access and download a copy of our printable closeness circle interpersonal therapy worksheet template, you have to either:

  • Click the “Use Template” or “Download Template” button above
  • Search “Closeness Circle Interpersonal Therapy Worksheet” in Carepatron’s template library in our app or website

Step Two. Fill out the Worksheet

Give your client a copy of the worksheet. You may also give them prompts or instructions on filling it out and the appropriate people to place in which circle. To help you out, we’ll also include a guide below. 

Note that our worksheet doesn’t have a dot in the middle, and the client is assumed to be in the center. 

Instructions:

  • Center or First Circle (Intimacy): The patient will write the names of the people who are most important to them, like their partner, friends, and family. These people are the ones they trust the most and are the closest to in life. 
  • Second Circle (Friendship): The patient will write the names of the people they want to get close to but have difficulties with due to circumstances or their personality differences.
  • Third Circle (Participation or Connections): The patient will write the names of the people or groups they often talk to due to a shared interest but aren’t close to. 
  • Fourth Circle (Acquaintances): These are friendly people you either recently met or talk to only during certain circumstances. 

Step Three. Discuss with the Client

Once the worksheet is completed, you may ask the client questions to learn more about them and their relationships. Here are some questions you may use:

  • Who are you closest with, and why?
  • Who was the last person you saw, and why?
  • Who do you want to see/know more about, and why aren’t you both able to get to know each other better?
  • Who supports you the most?
  • How would you describe your relationship with (name)?
  • Do you want to change anything about your relationship with (name)?

You may also have your client write down their notes in the space at the bottom of the template. 

Step Four. Store Securely 

Remember to store them in a secure physical location or a HIPAA-compliant EHR like Carepatron as the worksheet contains sensitive information.

Closeness Circle Interpersonal Therapy Worksheet Example

Here’s our example of a filled-out Closeness Circle Interpersonal Therapy Worksheet PDF template featuring a fictional client. You can use our sample for educational purposes or as a reference. 

Grab a copy of our template for offline use by clicking the sample below or the “Download Example PDF” button above. 

Download this Closeness Circle Interpersonal Therapy Worksheet Example:

Closeness Circle Interpersonal Therapy Worksheet Example

When would you use this Closeness Circle Interpersonal Therapy Worksheet template?

You can use this closeness circle interpersonal therapy worksheet template while conducting interpersonal therapy sessions. More specifically, it’s best that you provide your client with a copy of our template if they:

  • Are feeling stressed by any relationship conflicts
  • Are affected by a change in a person’s role or relationship in their life
  • Are having difficulties with maintaining or starting a relationship 
  • Are experiencing grief or loss
  • Are concerned with any interpersonal skills they’re lacking in

Those diagnosed with particular mental illnesses may also benefit from answering this worksheet. Some of them are patients diagnosed with the following:

  • Depression
  • Substance/alcohol abuse disorder
  • Social Anxiety disorder
  • Eating disorders
  • Borderline Personality disorder
  • Bipolar disorder
  • Anxiety

What are the benefits of using this Closeness Circle Interpersonal Therapy Worksheet?

Simple to Use

With the exception of the guidelines for selecting individuals to include in the circles, the worksheet is uncomplicated and clear-cut as it requires the entry of names and responses to questions within the designated note section at the bottom.

Customizable and Versatile

Our template is extremely easy to modify. You can add other instructions, such as asking the client to write their name in the center circle and utilize it in various situations or types of clients. 

Improved Self-Awareness

If the patient aims to improve their interpersonal skills, they'll know more about how they handle relationships by answering this worksheet and the therapist’s questions. As a result, they’ll be more self-aware and likely find ways to improve themselves to strengthen or build better relationships. 

Improved Relationships

In addition to identifying their support network and understanding whom they can reciprocally assist, individuals can enhance their relationships by focusing on comprehending others and reinforcing their connections using this worksheet.

How long does it usually take to accomplish the Closeness Circle Interpersonal Therapy Worksheet?
How long does it usually take to accomplish the Closeness Circle Interpersonal Therapy Worksheet?

Commonly asked questions

How long does it usually take to accomplish the Closeness Circle Interpersonal Therapy Worksheet?

It depends on the client and the therapist. However, it shouldn’t take the client longer than an hour to fill out the worksheet, especially the section with the circle.

When is the Closeness Circle Interpersonal Therapy Worksheet used?

It’s used during an interpersonal therapy session to learn more about the client and help them with their relationship concerns or individual difficulties with interpersonal skills. For more specific situations or circumstances, refer to the “When would you use this closeness circle interpersonal therapy worksheet?” section above.

How is the Closeness Circle Interpersonal Therapy Worksheet helpful?

By giving the clients the chance to identify the people in their life, reflecting on their relationship with these individuals/groups, and seeing their relationship status, they learn more about themselves and their interpersonal skills. Moreover, especially for patients who are dealing with a mental illness, this worksheet will allow them to identify who their support system is during challenging times.

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