::Life Status Questionnaire::
This questionnaire is given to clients about once a month. It is scored and placed with the rest of the clients file. The goal is to see a slow pattern which shows the clients progress.
Instructions: Looking back over the last week, including today, help us undersand how you have been feeling. Read each item carefully and pick the answer with best describes your current situation. For this questionnaire, work is defined as employment, school, volunteer work, housework, and so forth.
Pleas answer using the key below.
0 = Never
1 = Rarely
2 = Sometimes
3 = Frequently
4 = Always Always
1. I have trouble falling asleep or staying asleep.
2. I feel no interest in things.
3. I feel stressed at work, school, or other daily activities.
4. I blame myself for things.
5. I am satisfied with my life.
6. I feel irritated.
7. I have thoughts of ending my life.
8. I feel weak
9. I find my work/school or other daily activities satisfying.
10. I feel fearful
11. I use alcohol or drugs to get going in the morning.
12. I feel worthless.
13. I am concerned about my family troubles.
14. I feel lonely.
15. I have frequent arguments.
16. I have difficulty concentrating.
17. I feel hopeless about the future.
18. I am a happy person.
19. Disturbing thoughts come into my mind that I cannot get rid of.
20. People critize my drinking (or drug) use.
21. I have an upset stomach.
22. I am not working/studying as well as I used to.
23. I have trouble getting along with friends and close acquaintances.
24. I have trouble at work/school or other daily activities because of drinking or drug use.
25. I feel that something bad is going to happen.
26. I feel nervous.
27. I feel that I am not doing well at work/school or in other daily activities.
28. I feel something is wrong with my mind.
29. I feel blue.
30. I am satisfied with my relationships with others.
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