Healthy Boundaries Worksheet
A boundaries worksheet listing nine boundary areas, a table for situations, needed boundaries and scripts, and plans for pushback and guilt.
1-page fillable PDF · US Letter (prints on A4) · Boundaries · Interpersonal
- Approach / concern
- Universal
- Technique
- Boundaries · Interpersonal
- Format
- Fillable PDF, 1 page (US Letter / A4)
- Access
- Pro and Advanced plans (3-day free trial)
- For
- Licensed clinicians to use with clients
- Updated
- October 2026
Key facts
What is the Healthy Boundaries Worksheet?
Personal boundaries define what a person is and isn’t comfortable with regarding time, energy, space, emotions, money and values. Setting boundaries involves clearly communicating limits and following through.
Why it works
Boundary-setting draws on assertiveness skills, which are an evidence-based intervention for interpersonal and emotional difficulties (Speed et al., 2018). DBT interpersonal effectiveness skills also emphasize maintaining self-respect (Linehan, 2015).
When to use it
- People-pleasing and burnout
- Codependency and enmeshed families
- Caregivers and helping professionals
- Workplace stress
How to use it in session
- Explore signs that boundaries are needed.
- Identify areas and specific situations.
- Script short, clear boundary statements.
- Plan for pushback and follow-through.
- Address guilt and old beliefs.
Clinician tips
- Boundaries are about your own actions, not controlling others.
- Expect guilt at first; it often fades with practice.
- Safety first in abusive situations.
Worked example
Sharing with clients
Members can download the PDF to print or email, or copy a private client link from the download box. Your client opens the link and downloads the worksheet on any device. No client account is needed, and nothing your client writes is stored on TherapyAid.
Frequently asked questions
Are boundaries selfish?
No. Healthy boundaries protect relationships by preventing resentment and burnout.
What if someone gets angry at my boundary?
Their reaction is theirs to manage. Stay calm, restate the boundary and follow through.
References
Speed, B. C., Goldstein, B. L., & Goldfried, M. R. (2018). Assertiveness training: A forgotten evidence-based treatment. Clinical Psychology: Science and Practice, 25(1), e12216.
Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.
This worksheet is an educational tool for use by, or under the guidance of, a licensed or registered mental-health professional. It is not a diagnostic instrument or a substitute for clinical judgement. If a client is in crisis in Canada, call or text 9-8-8 or call 9-1-1.
