Your Every Girl Wellness Planning Questionnaire
What's your #1 challenge? (current concern?)
Briefly list the challenges that have resulted in you seeking help at this time.
Why is this a problem for you?
Include any symptoms or impairments, for example: sleep disturbance, panic attacks, lack of focus etc.
If you could narrow things down to two sub-problems you want to focus on in your sessions, what would they be?
(What problems do you want to focus on in your sessions?)
What obstacles are getting in the way of you solving your problems on your own?
(like no social support, poor coping skills, history of trauma, limited income, etc.)
What things have helped you in your life this far?
(for example, family support, faith in God, good friends, etc.)
What do you hope to get out of working with Every Girl Living?
(What do you think or hope the solution to your problems will look like?)
What are 2 goals you'd like to accomplish?
(What would you like to learn, develop, or resolve?)
Check the interventions you are interested in incorporating into your treatment.
Psychotherapy or Life Coaching
Coping Skills Training
How often do you want to meet individually?
Are there any other things you think are important to focus on?
Should be Empty: