Surviving Bullies Workbook

Excerpt: Completing the Incident Report

imageMany individuals who are being bullied describe their experiences as similar to getting lost in a dense fog—a fog where one’s emotions
become confused, where one can no longer tell a friend from a foe, and even bystanders seem to have turned hostile.

Suddenly, buildings that were once safe have morphed into menacing corridors where bullies may lurk. School buses have now become confined spaces with no escape. The formerly innocent comments of classmates now seem to take on malicious double meanings.

The purpose of the Incident Report is to help you cut through the fog of confusion caused by you being bullied.

The process of recording the facts will allow you to think clearly and objectively about what is happening to you.

Specifically, the Incident Report has been designed to help you work out:
—Who is bullying you
—Where they are bullying you
—How they are bullying you
—How severely they are bullying you

Most importantly, this section will help you accurately record the complex feelings you have about being bullied. Please fill out the Incident Report based on your most typical experience with bullying. If you are being bullied in a number of ways, please make note of this in the comments sections.

Remember, your goal is to accurately report how you are being bullied. By doing so, you will be able to move forward and solve your bullying problem based on real facts, not on confusion. Once again, this workbook is confidential. So please answer the questions as openly and honestly as you can. Lets begin!

Basic Facts

Date of Incident:   Day / Month /Year
Time of Incident:  
How many bullies were involved? 1   2   3   4   5   More? ____
Names of Bullies:
  Nickname First Name Last Name

Do you think the bullying was:
  Verbal Yes    No  
  Physical Yes    No  
  Sexual Yes    No  
  Racial Yes     o  
  Other (describe below) Yes    No  

Where exactly did the bullying take place?
  Home or near home? Yes    No  
  Traveling to school? Yes    No  
  On a school bus? Yes    No  
  At school? Yes    No  
  Place an “X” on the map below to show where the incident(s) took place:
If this map does not look like your school, add a page and draw a map of your school. Or if the incident(s) took place outside of your school, add a page and draw a map showing where you were bullied. Then mark an “X” on the spot(s) where your bullying incident(s) took place.
  Bullying Incident Mao

Type of Bullying

  What is Verbal?    
  Was the bullying incident(s) verbal in nature? Yes    No
  If YES, circle the descriptions of the incident(s) that most closely describes what you experienced. On the next page, carefully describe exactly what happened to you.
  Veral Bullying Continuum
  Please circle the words that most describe how you felt immediately after the incident(s), then circle a number from 1 to 5 to describe the intensity of your feelings. For example, if you felt a little ashamed, circle the number 1. If you felt very ashamed, circle the number 5.
  Anger     1      2      3      4      5
  Fear     1      2      3      4      5
  Rage     1      2      3      4      5
  Shame     1      2      3      4      5
  Humiliation     1      2      3      4      5
  Lonliness     1      2      3      4      5
  Self-hatred     1      2      3      4      5
  Pathetic     1      2      3      4      5
  Hopeless     1      2      3      4      5
  Desire for Revenge     1      2      3      4      5
  Now, look over your scores. If you find that you’re scoring high on this exercise, don't worry. You're entitled to strong feelings because being bullied is a difficult experience. It's very important for you to be mindful of your future actions because strong emotions can lead to impulsive and destructive behavior.
Please write down exactly what happened to you in the space provided below.
  Be sure to answer: How many times a month are you being verbally humiliated? Is it the same sort of verbal humiliation each time or does it vary? Is it just one bully who is doing this or is it a group of bullies? Does the group have a leader or does the group leader often change?
The incident report continues to cover all the types of bullying. You will use this information, along with all of the other information you gather as a result of completing Missions in the Surviving Bullies Workbook, to come up with your personal anti-bullying plan. Just remember: it's up to YOU to complete these Missions; nobody can do it for you.

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