Tanja Lepcheska 
CBT activity sheets
What CBT activity sheets are and how they work CBT activity sheets are structure...
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Last Updated: Nov 4, 2026
Mental Health & Therapy
Choices and consequences worksheet: A free printable decision-making tool
Free PDF 2 pages, print-ready Clinician-reviewed
A choices and consequences worksheet slows a quick decision down long enough to look at it. The free two-page form sets out five short situations. For each one, the person decides whether the choice was good or bad, explains why, and predicts what happens next.
Therapists, school counselors and teachers use it to build a pause between impulse and action. What follows is a five-step walkthrough, a filled-in example with model answers, and a prep checklist. You’ll also see how the worksheet changes between the therapy room and the classroom.
Template details
- Template type
- Worksheet
- Format
- Printable PDF, 2 pages
- Sections
- 5 sections
- Fields to complete
- 28 fields
- Best for
- Mental Health & Therapy
Free download
Download your free Choices and consequences worksheet
A two-page printable form with name, date of birth and age fields, plus five blank situation boxes. Each situation asks whether the choice was good or bad and why, and the first four ask what the consequence will be.
What’s inside
- Name, date of birth and age fields for the person completing it
- A one-line instruction to read each situation and the choice made
- Five blank situation boxes for scenarios you write before the session
- A good-or-bad prompt under every situation, asking the person to explain why
- A consequence prompt under situations one to four asking what happens next
- Two print-ready pages with space for handwritten answers
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Key takeaways
A choices and consequences worksheet presents five situations and asks whether each choice was good or bad, why, and what happens next.
You write the situations yourself, so one form works for a teen in counseling, a classroom, or an adult in recovery.
The consequence question does the most work when you split each answer into short-term and long-term outcomes.
Asking what the person in the story felt before they chose links emotions to decisions.
The filled-in example on this page doubles as an answer key for three common situations.
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What the choices and consequences worksheet asks, box by box
The form runs to two pages and stays deliberately simple. You supply the situations, so it bends to almost any age or setting. Here is what each part holds:
- Header: name, date of birth and age. The age guides how concrete your situations need to be.
- Instruction line: “Read the situation and the choice made. Then, answer the given questions.”
- Five situation boxes: blank spaces where you write a short scenario that ends on a choice someone made.
- Two questions per situation: “Is the choice they made a good or bad one? Why?” and “What do you think will be the consequence of the choice made?”
Notice that both questions ask about “they”, not “you”. The person judges someone else’s choice first. That distance makes honest answers easier, especially for a teen who gets defensive about their own behavior.
One quirk to know before you print: situation five carries only the good-or-bad question. Ask the consequence question out loud, or have the person answer it in the margin.
Run the worksheet in five steps, from blank boxes to debrief
Each step below maps to a part of the form. Plan the first one before the session, and run the rest together.
- Write the situations in advance. Keep each one to two or three sentences that end on a clear choice. Start far from the person’s own life, then move closer by situation four or five.
- Read the first situation together. Check that the person can name the choice in their own words before they judge it.
- Ask for the verdict, then the why. A bare “bad” tells you little. Push gently for the reasoning, because that is where beliefs show up.
- Predict the consequence, then split it. Ask what happens in the next day, then what happens in six months. Write both answers down.
- Debrief and bridge. Ask which situation felt most familiar. That answer often opens the conversation you wanted to have.
Leave plenty of room for step five. The debrief is where the worksheet stops being an exercise and becomes a conversation about the person’s own choices. If that conversation lands on a decision they still face, a decisional balance worksheet helps them weigh it before they act.
Connecting emotions to choices makes the consequences land
Emotions usually come before choices, so one extra question makes the worksheet far more revealing. Many people don’t notice a feeling drove a decision until they see it written down.
In step three, before the verdict, ask: “What was the person in this story feeling right before they chose?” Common answers include frustration, loneliness, pressure, excitement, or boredom. If the person can’t find the word, a primary emotions list gives them a short set to start from.
In step four, add a second question for each consequence: “How would that outcome make them feel?” The answer shows whether the choice dealt with the feeling or only covered it for a while.
Then turn it around in the debrief. A counselor working with a 15-year-old might hear: “I felt left out, so I started rumors to feel in control. It felt good for a day, then I felt guilty and more isolated.” That link between feeling, choice and fallout is the insight the worksheet is built to surface.
Put together, one situation runs through two printed questions and three you ask out loud. The chart below lays them out in session order.
Three model answers show how the consequence split works
Below are three sample situations with model answers. They suit a teen, a school student and an adult in recovery. The two consequence columns show the split from step four.
Look closely at Sam’s row. Some choices are neither fully good nor fully bad, and the form’s “Why?” leaves room for that nuance. For patients in recovery, a stages of relapse worksheet then tracks the early warning signs that come before a lapse.
Use these answers as a guide, not a script. If a patient’s answer differs but the reasoning holds, accept it. The habit of predicting outcomes matters more than matching the model.
Four prompts that sharpen a vague consequence
When a consequence answer stays vague, these follow-up prompts help split it into short term and long term:
- What happens in the next hour or the next day?
- Who else feels the effect, and how?
- What would this look like in six months if it happened every week?
- Would you make the same choice knowing the long-term outcome?
How the worksheet changes between therapy and the classroom
The same worksheet works in both settings. What you change is the source of the situations, the depth of reflection, and how you handle privacy. The matrix below maps the practical differences, so you can adapt it without redesigning the tool.
In therapy and counseling sessions: Frame the worksheet as a shared exploration. Say, “Let’s look at what happened here and see if a pattern shows up.” Allow silence, and don’t rush the steps. Over a few sessions, answers often reveal recurring patterns such as avoidance or people-pleasing.
In classrooms and school counseling: Run it as a whole-class SEL activity, often after discussing a character’s decision in a story. Adapt the language to the grade level, and treat a wrong answer as learning rather than failure.
Anonymous responses help you spot class-wide trends, such as impulse-control or peer-pressure issues, without singling anyone out. When one student’s answers keep showing the same pattern, a positive behavior support plan gives the school team a structured way to respond.
In either room: Use the worksheet for reflection, never interrogation. A person who feels accused will disengage, and a patient may stop showing up.
A few setup mistakes can undo the worksheet
Most problems with this worksheet start before the session does. Three come up again and again:
- Starting too close to home. If situation one mirrors last week’s incident, the person feels accused and shuts down.
- Accepting a one-word verdict. A bare “bad” without a “why” shows you nothing about how the person reasons.
- Grading the answers. Treat a surprising answer as information worth exploring, and ask what led there.
Check these five things before you print
Run through this list once the five situations are written:
- Each situation is two or three sentences long and ends on a clear choice.
- The situations move from distant to familiar by situation four or five.
- The wording suits the age written on the form’s header.
- You have a note to ask the consequence question aloud for situation five.
- You know where the finished sheet goes, whether that’s the patient record or an anonymous class pile.
That last point matters more than it looks. A completed worksheet only helps if you can find it again next session.
How Pabau keeps worksheet answers with the patient record
On paper, a completed worksheet tends to land in a folder, away from the session notes that explain it. By the next appointment, the answers are hard to find and harder to compare.
Pabau, the practice software we build for healthcare teams, lets you rebuild the worksheet as one of your digital forms. You can send it before a session, and the answers file into the patient’s Client record beside your treatment notes.
In session, you can then open last month’s worksheet and ask what has changed. That continuity is what therapy practice management is built for across a full caseload.
Keep worksheet answers in the patient record
Pabau sends the choices and consequences worksheet as a digital form and files each answer in the patient’s record, ready for your next session.
Conclusion
The worksheet’s strength is its blank boxes. Write situations just far enough from the person’s own life to discuss openly, then close that distance one situation at a time.
Spend the most time on the consequence question, and always split it into short term and long term. That split is where an impulsive choice loses its appeal.
Keep the completed sheets, too. Compared over weeks, they show whether someone is pausing longer before they act. Book a demo to see how Pabau keeps each worksheet in the patient record, ready for your next session.
Continue your research
Want a printable tool for mapping feelings before a decision happens? Body map emotions worksheet pairs with the emotion questions on this page, helping patients name what they felt right before they acted.
Helping someone separate what they can and can’t influence? Circle of control worksheet sorts worries into what a person controls and what they don’t, a natural next step after a consequences debrief.
Working with younger patients on behavior change? Behavior rewards chart reinforces the choices-and-consequences work with positive reinforcement at school and at home.
Need a next step once a patient can name the feeling? Regulating emotions worksheet teaches the skills that keep a strong feeling from turning into a rushed choice.
Supporting an adult patient with impulse control? ADHD strategies for adults covers practical techniques that complement the long-term consequence prompts in this worksheet.
Frequently asked questions
Is the choices and consequences worksheet a CBT tool?
It draws on cognitive behavioral ideas, because it links a feeling and a choice to an outcome. It isn’t a validated assessment, though, and it produces no score. Treat it as a structured reflection exercise.
Is there a choices and consequences worksheet with answers?
The model answers table on this page works as an answer key for three situations. Accept a different answer when the reasoning holds, because the habit of predicting outcomes matters more than a match.
What age is the worksheet suitable for?
The form has an age field but no set age range. Younger children can work through it with an adult reading each situation aloud. Teens and adults can usually complete it alone.
Can you use it in a group session?
Yes. Give everyone the same situations, let each person answer alone, then compare verdicts as a group. Different answers to the same choice often start the most useful discussion.
Can patients complete it as homework between sessions?
Yes, once they have done one in session with you. Send it with the situations already written, then review the answers together at the next appointment.
How is it different from a decisional balance worksheet?
A choices and consequences worksheet looks back at a choice someone already made. A decisional balance worksheet weighs the pros and cons of a choice still ahead, so the two work well in sequence.
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