Susan wrote town Possible PTSD in her notes, then handed him the questionaire. "Don't feel any pressure filling this out; it's mostly just for reference, and to help you think of why you're here today, all right?"
1.What prompted you to come here today?
2. Are you experiencing any of the following symptoms: Difficulty sleeping? Appetite problems? Changes in drug/alcohol use? Changes in sexual interest? Problems with classes/grades? Other problems?
3. How often do you exercise? How often do you use alcohol? Drugs? (please specify)
4. Are there any recent new stressors in your life? (for example):
Death of loved one Change in job Divorce (yours/parents) Marriage (yours/parents) Child (yours/parents) Move to a new place Other
5. Is there any family history of emotional/mental disorder that the therapist should be aware of?
Alcoholism/Drug abuse Depression Schizophrenia Manic-Depression Other
5. What is your main goal in seeking therapy?
6. Have you previously been in therapy?
"Fill that out, then we'll go over it, all right?"
Re: Around 4:00, NFB
1.What prompted you to come here today?
2. Are you experiencing any of the following symptoms:
Difficulty sleeping?
Appetite problems?
Changes in drug/alcohol use?
Changes in sexual interest?
Problems with classes/grades?
Other problems?
3. How often do you exercise?
How often do you use alcohol?
Drugs? (please specify)
4. Are there any recent new stressors in your life?
(for example):
Death of loved one
Change in job
Divorce (yours/parents)
Marriage (yours/parents)
Child (yours/parents)
Move to a new place
Other
5. Is there any family history of emotional/mental disorder that the therapist should be aware of?
Alcoholism/Drug abuse
Depression
Schizophrenia
Manic-Depression
Other
5. What is your main goal in seeking therapy?
6. Have you previously been in therapy?
"Fill that out, then we'll go over it, all right?"