Questionnaire>Mental Wellness – migrated oct 3. Current Concerns & Difficulties
Below is a list of common difficult emotions that you may have experienced, please check any that concern you:
Emotion Impact Please indicate on a scale of 1 – 10 how much these feelings negatively impact your life (where 1 = the feelings have no real impact on the way l live my life and 10 = the feelings dominate how l live my life)
Below is a list of common behaviors that can be influenced by our emotions and mental state, please check any that apply to you?
Behaviour Impact Please indicate on a scale of 1 – 10 how much control you feel you have over this behaviour currently (where 1 =l have full control and can act or avoid acting this way l choose and 10 = l can’t help but act this way)
What are the main goals that you hope to achieve through your stay at the retreat (retreat guests only)?
What are the main goals that you hope to achieve through your stay at the retreat (retreat guests only)?
DASS21 Please read each statement and select a number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past week. The rating scale is as follows: 0 = Did not apply to me at all 1 = Applied to me to some degree, or some of the time 2 = Applied to me to a considerable degree, or good part of the time 3 = Applied to me very much, or most of the time
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