Pastoral Counselling Center- Brief Adolescent Outcome Behaviour

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Pastoral Counselling Center- Brief Adolescent Outcome Behaviour

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The Pastoral Counselling Center- Brief Adolescent Outcome Behaviour questionnaire is a brief self-assessment form intended for adolescents. The form uses a 5 point scale and looks at different lifestyle choices, mental health problems and physical health problems that could affect adolescents.

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Causes :

Children & Youth, Education, Health

Sub Causes :

drugs, mental health, right to education

Identity Ratio Sets :

Age , Gender (3 options), Gender (3 options), Gender (3 options)

Sub Ratios :

Female, Under 18, Male, Other

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*Q1. What’s been happening? Share a relaxed anecdote, case study or recent success.

*Q2. Date the activity actually happened

Q3. Location (Text)

*Q4. Add attachments

*Q5. Change update's privacy

Q6. Use drugs for non-medical purposes? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q7. Feel threatened or bullied by others? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q8. Feel worthless? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q9. Drink alcohol (beer, wine, hard liquor), or use drugs or illegal substances? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q10. Have a hard time having fun? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q11. Sleep a lot more than you normally do? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q12. Eat a lot more or less than usual? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q13. Feel nervous and/or shy around other people? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q14. Get into fights with family members and/or friends? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q15. Have a hard time sleeping because you were worried? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q16. Feel unhappy or sad? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q17. Think that you don't have any friends? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q18. Get into trouble? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q19. Have little or no friends? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q20. Avoid Going to School? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q21. Think about hurting yourself? (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

Q22. Disobey adults? (Not do what adults told you to do) (single choice)

Question Settings ▼

The Ask(s): how this will appear in the survey

Strongly Agree	Agree	Undecided	Disagree	Strongly Disagree

Dropdown List used: Likert Scale

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