Rating of Self, Family, and Child in Ten Areas of Focus

It may be helpful to engage in evaluation of yourself, your family, and your child. By doing this self-evaluation, you will be better able to know where to focus your efforts.

Listed below are a variety of descriptors, thoughts, and behaviors that may describe yourself, your family, and/or your child.  Read each sentence or question, and indicate how well that sentence or question describes you and/or your child. Try to keep in mind what is developmentally appropriate for your child.  For example, you shouldn’t expect younger elementary school age children to be good at problem solving.  It would be good for both parents to fill out a form, then to meet with your counselor to discuss the answers.  Keep in mind that there are no right or wrong answers to these questions. Rate each question using the 5 point scale at the top of the questionnaire and add up your score for each section.