Do you say yes before checking your time or energy? Do you keep explaining a limit after you have already stated it? Noticing the pattern can help you choose a manageable place to practice.
The People-Pleasing & Boundary Self-Check is a 12-page fillable and printable PDF for adults, developed with AI assistance and reviewed and approved by Raymond Navarro, MS, LMHC. It combines a 30-item reflection with a personal Boundary Profile and a seven-day experiment.
$4.99 · One PDF · 12 pages · 78 fillable fields
This is an educational reflection tool, not a validated psychological test or diagnostic assessment. Scores are prompts for reflection and do not establish a diagnosis, severity level or treatment need.
What does the Self-Check cover?
- Difficulty saying no
- Guilt and fear of disapproval
- Overexplaining and justifying
- Overcommitment and self-neglect
- Boundary follow-through
Reflect on the past four weeks and add the six item scores in each area yourself. The PDF does not calculate scores automatically. Use your reflections to identify a situation that feels manageable, rather than treating a number as a label.
Move from noticing to one small experiment
The Boundary Profile helps you identify recurring contexts. The cost check invites you to consider time, energy, resentment, sleep, money and relationships. Then the seven-day experiment provides space to plan a small boundary, choose your words and record what you notice.
A starting question: What would I like to pause before agreeing to this week? You might practice checking your calendar before accepting a request. Choose a situation that fits your capacity and safety.
The boundary ladder offers prompts from pausing through disengaging. You do not have to use the firmest response or have a difficult conversation before you are ready.
Choose the resource that fits your next step
Notice a pattern and plan one experiment: this Self-Check can be used on its own.
Find words for a specific situation: 50 Boundary Scripts for People Pleasers offers wording to adapt for everyday boundaries.
Explore the topic more broadly: the People-Pleasing & Boundaries Reset Workbook provides a broader guided resource. The Scripts and Reset Workbook are sold separately and are not included with this Self-Check.
How will I receive and use the PDF?
After payment is confirmed, download the file from Etsy in a web browser under Purchases and reviews. Guest buyers receive a download link in the Etsy receipt email. Etsy’s app does not support digital-file downloads. No physical item is shipped.
Type into the fields with a compatible PDF reader, or print the US Letter pages (8.5 × 11 inches) and write by hand. Save a small test entry before completing the whole workbook; compatibility can vary by device or app.
You can also compare all Navarro Therapy workbooks and resources.
Use and safety: for adults 18+ and personal educational use. This resource is not therapy, diagnosis, treatment, crisis care, or medical or legal advice. Purchase does not create a therapist-client relationship. If a relationship involves threats, coercion or abuse, prioritize safety and individualized support rather than confronting someone. References and safety resources are included in the PDF.
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