Stress Indicator

1637 WordsOct 30, 20117 Pages
The Counseling Team International 1881 Business Center Drive, Suite 11 San Bernardino, CA 92408 (909) 884-0133 www.thecounselingteam.com STRESS INDICATORS QUESTIONNAIRE This questionnaire will show how stress affects different parts of your life. Circle the response which best indicates how often you experience each stress indicator during a typical week. When you have answered all the questions add the point totals for each section. 5- Almost Always (on five days a week) 4- Most of the time (on three days a week) 3- Some of the time ( on one and one-half days a week) 2- Almost never (less than two hours a week) 1- Never PHYSICAL INDICATORS: How often would you say: Most Some Almost of the of the Almost always time time never Never…show more content…
5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 Emotional Indicator Point Total __________ 6 PERSONAL HABITS: How often would you say: I spend less than three hours a week working on a hobby of mine. I spend less than one hour a week writing personal letters, writing in a diary or writing creatively. I spend less than 30 minutes a week talking casually with my neighbors. I lack time to read the daily newspaper. I watch television for entertainment more than one hour a day. I drive in a motor vehicle faster than the speed limit for the excitement and challenge of it. I spend less than 30 minutes a day working toward a life goal or ambition of mine. My day to day living is not really affected by my religious beliefs or my philosophy of life. When I feel stressed, it is difficult for me to plan time and activities to constructively release my stress. 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 Personal Habits Point Total __________ 7 No single question in this questionnaire proves you are experiencing stress,
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