This reflection questionnaire is a tool to help people reflect on a difficult relationship, challenging situation or traumatic event.
As an adaptable template, it can be used in a variety of circumstances. It is designed to help someone acknowledge the effect a situation has had on them, including physically, emotionally, relationally and spiritually.
An individual can use their answers to then talk about how they have been affected and what moving forward looks like for them.
It can be used by an individual for personal reflection.
It can also be used as part of a community reflection or debrief process.
By hearing multiple reflections, an organisation can gain an overview of the impact of a big event, look for trends or discover common themes.
How to use these questions:
First, identify the difficult situation. This can be a person (my father), a single word (pandemic), a phrase (my parent’s divorce), or a few sentences describing an event (the time the youth group got lost on a tramp in a storm).
Questions 1-9 involve looking at how the event/situation has affected you.
Questions 10 - 15 ask you to consider what moving forward looks like to you.

1 John 4: 16-21
God is love, and those who abide in love abide in God, and God abides in them. Love has been perfected among us in this: that we may have boldness on the day of judgment, because as he is, so are we in this world. There is no fear in love, but perfect love casts out fear; for fear has to do with punishment, and whoever fears has not reached perfection in love. We love because he first loved us. Those who say, “I love God,” and hate their brothers or sisters, are liars; for those who do not love a brother or sister whom they have seen, cannot love God whom they have not seen. The commandment we have from him is this: those who love God must love their brothers and sisters also.

Romans 12: 3-5
For by the grace given to me I say to everyone among you not to think of yourself more highly than you ought to think, but to think with sober judgment, each according to the measure of faith that God has assigned. For as in one body we have many members, and not all the members have the same function, so we, who are many, are one body in Christ, and individually we are members one of another.

Colossians 3: 12-17
As God’s chosen ones, holy and beloved, clothe yourselves with compassion, kindness, humility, meekness, and patience. Bear with one another and, if anyone has a complaint against another, forgive each other; just as the Lord has forgiven you, so you also must forgive.
Above all, clothe yourselves with love, which binds everything together in perfect harmony. And let the peace of Christ rule in your hearts, to which indeed you were called in the one body. And be thankful.

Ephesians 4: 22-32
.. be renewed in the spirit of your minds, and to clothe yourselves with the new self, created according to the likeness of God in true righteousness and holiness.
So then, putting away falsehood, let all of us speak the truth to our neighbours, for we are members of one another. Be angry but do not sin; do not let the sun go down on your anger, and do not make room for the devil. Put away from you all bitterness and wrath and anger and wrangling and slander, together with all malice, and be kind to one another, tenderhearted, forgiving one another, as God in Christ has forgiven you.

Mark 11: 20-25
Jesus answered them, “Have faith in God. Truly I tell you, if you say to this mountain, ‘Be taken up and thrown into the sea,’ and if you do not doubt in your heart, but believe that what you say will come to pass, it will be done for you. So I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours. “Whenever you stand praying, forgive, if you have anything against anyone; so that your Father in heaven may also forgive you your trespasses.”

Taken from Jesus' parable in Matthew 18: 23-35 v28: But that same slave, as he went out, came upon one of his fellow slaves who owed him a hundred denarii; and seizing him by the throat, he said, ‘Pay what you owe.’ Then his fellow slave fell down and pleaded with him, ‘Have patience with me, and I will pay you.’ But he refused; then he went and threw him into prison until he would pay the debt. When his fellow slaves saw what had happened, they were greatly distressed, and they went and reported to their lord all that had taken place. Then his lord summoned him and said to him, ‘You wicked slave! I forgave you all that debt because you pleaded with me. Should you not have had mercy on your fellow slave, as I had mercy on you?

2 Corinthians 5:16-21
From now on, therefore, we regard no one from a human point of view; even though we once knew Christ from a human point of view, we know him no longer in that way. So, if anyone is in Christ, there is a new creation: everything old has passed away; see, everything has become new! All this is from God, who reconciled us to himself through Christ, and has given us the ministry of reconciliation; that is, in Christ God was reconciling the world to himself, not counting their trespasses against them, and entrusting the message of reconciliation to us.
So, we are ambassadors for Christ, since God is making his appeal through us; we entreat you on behalf of Christ, be reconciled to God.

John Stott suggests the illustration Jesus uses in Matthew 5:23-24 can be modernised to read

‘If you are in church, in the middle of a service of worship, and you suddenly remember that your brother has a grievance against you, leave church at once and put it right. Do not wait till the service has ended.
Seek out your brother and ask his forgiveness. First, go, then come. First, go and be reconciled to your brother, then come and offer your worship to God.’

1 Peter 3: 8-11
Finally, all of you, have unity of spirit, sympathy, love for one another, a tender heart, and a humble mind. Do not repay evil for evil or abuse for abuse; but, on the contrary, repay with a blessing. It is for this that you were called—that you might inherit a blessing. For “Those who desire life and desire to see good days, let them keep their tongues from evil and their lips from speaking deceit; let them turn away from evil and do good; let them seek peace and pursue it.