To be filled out separately by Offender and Safe guard 2 copies

1. Think of three situations in which the following disagreement/anger circumstance occurred. Write about one in each of the following categories.

a. A situation with a significant other or wife/husband.

b. A situation regarding the purchase of an item or service.

c. A situation regarding a friend or relative.

2. Name the last time you were particularly angry, giving the circumstances surrounding the occurrence, how the offender/safe guard responded to you and how you responded to the offender/safe guard.

3. What was the outcome of this exchange? Who "won"? Did both of you walk away feeling that the exchange was helpful and productive, or unhelpful and unproductive

4.What would you have done differently if you could repeat the exchange?

5.Now in each of the situations above, rewrite what you have written only replacing your name with theirs and their name with yours. (number and use additional paper if necessary)

6. What would you do differently now?

Signature____________________________ Date: ______________________