These questionnaires are all self-assessment tools. Their goal is to assist you in identifying relevant bio-psycho-socio-spiritual concerns and health-risk factors. Several were developed personally, whereas others have been scientifically and professionally validated (i.e., as being reliable, reproducible, sensitive and specific) for various mental and physical disorders, illnesses and risk factors.
Please feel free to make use of them. Upon completion of each questionnaire, the individual is given the opportunity to download the completed form and / or the option to submit an e-mail address to receive a copy for their records, together with the scoring or interpretation where applicable.
We do not interact with those who complete the forms unless we are asked specifically to do so.
As such, participating in these Questionnaires and surveys does not imply or constitute any therapist-patient relationship.
The information is confidential and no identifying information is required to complete them.
Health- & Life Orientation Questionnaire [English & Afrikaans]: Addresses life and relational challenges relevant to spiritual, mental and physical health. These were developed this for our practice. We have found them very helpful to identify themes of relational breakdown or distress.
The Mental Health Screening Questionnaire is a shortened version that excludes the faith and religious components of the previous questionnaire. If focuses on stress, anxiety and depression in particular.
Beck's Hopelessness Questionnaire: This questionnaire evaluates the individual's future expectations. When it is high (i.e., elevated hopelessness) it corresponds to poor outcomes for health - especially for cancer.
Self-Assessment of Spiritual Health Questionnaire: This questionnaire addresses phenomena associated with spiritual interference or psychic fragmentation (dissociation). We have found it very helpful to distinguish primarily physical, psychological or spiritual issues as the cause. It is not diagnostic, but it facilitates reflection, dialogue and appropriate intervention by a multidisciplinary team.
Life Event & Relational Distress Scale: This questionnaire assesses residual feelings of distress (unrelated to anxiety or fear), following an exceptional event or loss. As such, it differs from e.g., Post-Traumatic Stress assessments in that it considers the pain, frustration, offense, anger and resentments that may persist following a distressing or traumatic event, rather than the stress and anxiety.
Physical, Mental & Spiritual Health Questionnaire: This assesses markers of faith and religion as well as relevant negative beliefs regarding the individual's relationship with God. It also assesses various aspects of stress, anxiety and depression. This was the questionnaire we used for the Be in Health study.
PHYSICAL, MENTAL & SPIRITUAL HEALTH QUESTIONNAIRE
BECK'S HOPELESSNESS SCALE
DISSOCIATIVE EXPERIENCES SCALE
SELF-ASSESSMENT OF SPIRITUAL HEALTH QUESTIONNAIRE
MENTAL HEALTH SCREENING QUESTIONNAIRE
Dissociative Experiences Scale: This is a well-known screening tool for dissociative conditions. For our detailed discussion on Dissociative Disorders in Psychiatry and Medicine - [Click Here]