REBT ASSESSMENT OF ANXIETY DEPRESSION AND ANGER EXPERIENCES [form] Name[text,r_name,30] Email [text,r_email,30] Explanation In this form you will check through and give a picture of how each of these mood AREAS sit in your life. You'll look at the things that trigger it for you, how you think when you experience that mood and how you behave when you experience that mood. Then you'll assess just what degree of impact it has on your life. After therapy or your specific learning course you'll revisit this form to re-profile and check for progress. SUMMARY of Profiling 1. Check off the triggers you experience with each emotion and if others write them in. 2. Check off the thinking processes that occur for you and write about others if present. 3. Check off behaviours that occur when you experience the triggers and thoughts accompanied by the mood/emotion. 4. Make selections in each of the three categories that measure the impact this mood/emotion has on your life. ------------------------------------------------------------------------------------------ There are 8 main areas of experiences linked with upsets in life, strong negative emotions and unhelpful behaviours that disrupt our ability to achieve and funciton. Each one will be examined as a unit. DEPRESSION related issues THINKING PROCESSES [checkbox,depression B- I only see negative aspects of a loss of failure] I only see negative aspects of a loss of failure [checkbox,depression B- I think of other losses and failures that I have experienced] I think of other losses and failures that I have experienced [checkbox,depression B- I think I am unable to help myself a sense of helplessness] I think I am unable to help myself (a sense of helplessness) [checkbox,depression B- I only see pain and blackness in the future (a sense of hopelessness)] I only see pain and blackness in the future (a sense of hopelessness) OTHER THOUGHTS similar? [textarea,Other kinds of Depression thoughts I have,2,70] BEHAVIOUR EXPRESSIONS [checkbox,depression C- I withdraw from reinforcements] I withdraw from reinforcement or encouragement [checkbox,depression C- I withdraw into myself] I withdraw into myself [checkbox,depression C- I create an environment consistent with my feelings] I create an environment consistent with my feelings I attempt to terminate feelings of depression in self-destructive ways such as [checkbox,depression C- suicide attempts] suicide attempts [checkbox,depression C- inflicting pain] inflicting pain [checkbox,depression C- damaging property] damaging property OTHER BEHAVIOURAL expressions similar? [textarea,Other kinds of behaviour when depressed,2,70] In terms of the above thinking and behaving processes... How Frequent? (low = now and again; medium = more than I can ignore; high = reasonably often) [list,depression frequency of01] [option,depression 1 low,Low] [option,depression 2 Medium,Medium] [option,depression 3 High,High] [/list] How Intense? (low = grabs my attention; med = distruptive but managing; high = more than I can manage) [list,depression intensityof01] [option,depression 1 low,Low] [option,depression 2 Medium,Medium] [option,depression 3 High,High] [/list] How long do the episodes last (low = brief; med = hangs around for up to a day or more; high = hangs arround for days at a time) [list,depression durationof01] [option,depression 1 low,Low] [option,depression 2 Medium,Medium] [option,depression 3 High,High] [/list] ============================================================================ ANXIETY related issues THINKING PROCESS [checkbox,anxiety B- I overestimate the negative features of the event] I overestimate the negative features of the (event) [checkbox,anxiety B- I underestimate my ability to cope with the threat] I underestimate my ability to cope with the threat [checkbox,anxiety B- I create an even more negative threat in my mind] I create an even more negative threat in my mind [checkbox,anxiety B- I have more task irrelevant thoughts than mere concern] I have more task irrelevant thoughts than mere concern [checkbox,anxiety B- I withdraw mentally from the event] I withdraw mentally from the (event) OTHER similar THOUGHTS? [textarea,Other kinds of anxiety thoughts I have,2,70] BEHAVIOUR EXPRESSIONS [checkbox,anxiety C- I withdraw physically from the event] I withdraw physically from the (event) [checkbox,anxiety C- I ward off the threat event with ritual superstition etc] I ward off the threat [event] with ritual, superstition etc. [checkbox,anxiety C- I tranquilise my feelings with medication or substances.] I tranquilise my feelings with medication or substances. [checkbox,anxiety C- I seek reassurance from others] I seek reassurance from others [checkbox,anxiety C- I am taking medication prescribed by a medical professional] I am taking medication prescribed by a medical professional OTHER similar BEHAVIOURS [textarea,Other kinds of anxiety behaviour,2,70] In terms of the above thinking and behaving processes... How Frequent? (low = now and again; medium = more than I can ignore; high = reasonably often) [list,anxiety frequency of01] [option,anxiety 1 low,Low] [option,anxiety 2 Medium,Medium] [option,anxiety 3 High,High] [/list] How Intense? (low = grabs my attention; med = distruptive but managing; high = more than I can manage) [list,anxiety intensityof01] [option,anxiety 1 low,Low] [option,anxiety 2 Medium,Medium] [option,anxiety 3 High,High] [/list] How long do the episodes last (low = brief; med = hangs around for up to a day or more; high = hangs arround for days at a time) [list,anxiety durationof01] [option,anxiety 1 low,Low] [option,anxiety 2 Medium,Medium] [option,anxiety 3 High,High] [/list] ==================================================================== ANGER related issues THINKING PROCESSES [checkbox,anger B- Someone else has broken my personal rule] Someone else has broken my personal rule [checkbox,anger B- My personal self-esteem is threatened] My personal self-esteem is threatened [checkbox,anger B- My personal view of self is threatened]My personal view of self is threatened [checkbox,anger B- I overestimate the extent the other person acted deliberately] I overestimate the extent the other person acted deliberately [checkbox,anger B- I see malicious intent in the motives of others] I see malicious intent in the motives of others [checkbox,anger B- I see myself as definitely right others seen as definitely wrong] I see myself as definitely right; other(s) seen as definitely wrong [checkbox,anger B- I am unable blocked from seeing the other person's point of view] I am unable, blocked from seeing the other person's point of view [checkbox,anger B- I plot to exact revenge of some kind] I plot to exact revenge of some kind OTHER similar THOUGHTS? [textarea,Other kinds of anger thoughts I have,2,70] MY BEHAVIOURAL RESPONSES [checkbox,anger C- I attack the other physically] I attack the other physically [checkbox,anger C- I attack the other verbally] I attack the other verbally [checkbox,anger C- I attack the other passive-aggressively] I attack the other passive-aggressively [checkbox,anger C- I displace the attack onto another person, animal, or object] I displace the attack onto another person, animal, or object [checkbox,anger C- I withdraw aggressively] I withdraw aggressively [checkbox,anger C- I recruit propaganda allies against the other] I recruit (propaganda) allies against the other OTHER similar BEHAVIOURS [textarea,Other kinds of anger behaviour,2,70] In terms of the above thinking and behaving processes... How Frequent? (low = now and again; medium = more than I can ignore; high = reasonably often) [list,anger frequency of01] [option,anger 1 low,Low] [option,anger 2 Medium,Medium] [option,anger 3 High,High] [/list] How Intense? (low = grabs my attention; med = distruptive but managing; high = more than I can manage) [list,anger intensityof01] [option,anger 1 low,Low] [option,anger 2 Medium,Medium] [option,anger 3 High,High] [/list] How long do the episodes last (low = brief; med = hangs around for up to a day or more; high = hangs arround for days at a time) [list,anger durationof01] [option,anger 1 low,Low] [option,anger 2 Medium,Medium] [option,anger 3 High,High] [/list] =============================================================== Okay could you please just indicate the presence of these FOUR GENERAL RESPONSE TRAITS in terms of your upsetting experiences FRUSTRATION This is about your experience of frustration with your: self, others, life in general THINK about WHERE you are mainly FOCUSED when experiencing frustration [checkbox,frustration Self] Mostly with on ME my sense of self [checkbox,frustration others] Mostly with another person or persons [checkbox,frustration life] In general,Mostly with LIFE in general and how I view it [checkbox,frustration God]Mostly with the divine or GOD's part in what's happening How Frequent? (low = now and again; medium = more than I can ignore; high = reasonably often) [list,frustration frequency of01] [option,frustration 1 low,Low] [option,frustration 2 Medium,Medium] [option,frustration 3 High,High] [/list] How Intense? (low = grabs my attention; med = distruptive but managing; high = more than I can manage) [list,frustration intensityof01] [option,frustration 1 low,Low] [option,frustration 2 Medium,Medium] [option,frustration 3 High,High] [/list] What areas of your life do you experience this frustration? [textarea,experience of frustration,2,70] ====================================================== PHYSICAL PAIN OR DISCOMFORT Feeling pain or discomfort in relation to your living or trying to overcome something... THINK about WHERE you are mainly FOCUSED when experiencing discomfort [checkbox,discomfort Self] Mostly with on ME my sense of self [checkbox,discomfort others] Mostly with another person or persons [checkbox,discomfort life] In general,Mostly with LIFE in general and how I view it [checkbox,discomfort God]Mostly with the divine or GOD's part in what's happening How Frequent? (low = now and again; medium = more than I can ignore; high = reasonably often) [list,discomfort frequency of01] [option,discomfort 1 low,Low] [option,discomfort 2 Medium,Medium] [option,discomfort 3 High,High] [/list] How Intense? (low = grabs my attention; med = distruptive but managing; high = more than I can manage) [list,discomfort intensityof01] [option,discomfort 1 low,Low] [option,discomfort 2 Medium,Medium] [option,discomfort 3 High,High] [/list] What areas of life do you experience this discomfort? [textarea,experience of discomfort,2,70] ========================================================= NEGATIVE LABELS OR VALUING OF SELF OR OTHERS.. Using negative ratings, valuings etc. in the form of labels or descriptions of your self, others or life... THINK about WHERE you are mainly FOCUSED when use these labels [checkbox,labels Self] Mostly with on ME my sense of self [checkbox,labels others] Mostly with another person or persons [checkbox,labels life] In general,Mostly with LIFE in general and how I view it [checkbox,labels God]Mostly with the divine or GOD's part in what's happening How Frequent? (low = now and again; medium = more than I can ignore; high = reasonably often) [list,labels frequency of01] [option,labels 1 low,Low] [option,labels 2 Medium,Medium] [option,labels 3 High,High] [/list] How Intense? (low = grabs my attention; med = distruptive but managing; high = more than I can manage) [list,labels intensityof01] [option,labels 1 low,Low] [option,labels 2 Medium,Medium] [option,labels 3 High,High] [/list] What areas of your life do you find yourself using labelling? [textarea,experience of labelling,2,70] =========================================================== INFLEXIBLE OR RIGID EXPECTING or DEMANDING Finding yourself demanding or expecting things without allowing for anything less than what you expect of your self, others, life etc.... THINK about WHERE you are mainly FOCUSED when you inflexibly demand [checkbox,demands Self] Mostly with ME my sense of self [checkbox,demands others] Mostly with another person or persons [checkbox,demands life] In general,Mostly with LIFE in general and how I view it [checkbox,demands God]Mostly with the divine or GOD's part in what's happening How Frequent? (low = now and again; medium = more than I can ignore; high = reasonably often) [list,demands frequency of01] [option,demands 1 low,Low] [option,demands 2 Medium,Medium] [option,demands 3 High,High] [/list] How Intense? (low = grabs my attention; med = distruptive but managing; high = more than I can manage) [list,demands intensityof01] [option,demands 1 low,Low] [option,demands 2 Medium,Medium] [option,demands 3 High,High] [/list] Where do you find yourself holding rigid expectations? [textarea,experience of demanding,2,70] ============================================================== EXAGGERATING THE DEGREE OF BADNESS This is where we can value an event or outcome in a much worse light than it really deserves... THINK about WHERE you are mainly FOCUSED when you exaggerate the badness [checkbox,exaggerating badness Self] Mostly with ME my sense of self [checkbox,exaggerating badness others] Mostly with another person or persons [checkbox,exaggerating badness life] In general,Mostly with LIFE in general and how I view it [checkbox,exaggerating badness God]Mostly with the divine or GOD's part in what's happening How Frequent? (low = now and again; medium = more than I can ignore; high = reasonably often) [list,exaggerating badness frequency of01] [option,exaggerating badness 1 low,Low] [option,exaggerating badness 2 Medium,Medium] [option,exaggerating badness 3 High,High] [/list] How Intense? (low = grabs my attention; med = distruptive but managing; high = more than I can manage) [list,exaggerating badness intensityof01] [option,exaggerating badness 1 low,Low] [option,exaggerating badness 2 Medium,Medium] [option,exaggerating badness 3 High,High] [/list] Where do you find yourself exaggerating the badness of events most? [textarea,experience of exaggerating badness,2,70] ============================================================= Congratulations you've taken the first step to helping someone else help you and for you to begin helping yourself! Please share with me anything else you feel I need to know to understand you and your experiences? [textarea,comments,3,70,Write in here...] [submit,SEND this Entry][reset,Start Over again] [/form]