Closeness Circle Interpersonal Therapy Worksheet

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.

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.