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Six Month Progress Survey

 

Circle the option which you feel describes you. Please answer each question as honestly as possible.

 

 

I find it easy to relax.


Never — Rarely —  Occasionally — Frequently — Always


 

I am open-minded.


Never — Rarely —  Occasionally — Frequently — Always


 

I find it easy to visualize things.


Never — Rarely —  Occasionally — Frequently — Always

 

I find it easy to visualize things that other people describe to me (e.g. a springtime meadow).


Never — Rarely —  Occasionally — Frequently — Always


 

I am happy with myself.


Never — Rarely —  Occasionally — Frequently — Always

 

Other people’s perception of me defines who I am.


True — False


 

It’s easier to work when given clear directions from an authority.


Never — Rarely —  Occasionally — Frequently — Always

 

I’m able to make decisions for myself.


Never — Rarely —  Occasionally — Frequently — Always

 

I need to be protected and guided.


Never — Rarely —  Occasionally — Frequently — Always




Service is it’s own reward.

True - False




I experience compulsions or desires without being able to explain their cause.


Never — Rarely —  Occasionally — Frequently — Always

 

I act on these compulsions or desires.


Never — Rarely —  Occasionally — Frequently — Always


 

I have difficulty remembering important things (e.g. current date and location).


Never — Rarely —  Occasionally — Frequently — Always

 

It is __________ difficult to remember.


Not at All — Somewhat — Very — Extremely — Impossibly

 

I can usually remember with concentration.


True — False


 

I feel in control of myself.


Never — Rarely —  Occasionally — Frequently — Always


 

My long-term habits and behaviors have changed recently.


True — False

 

I can explain these changes.


True — False

 

These changes are related to sex.


True — False

 

In my opinion, these changes are __________.


Positive — Negative

 

In the space below, please describe these changes, if any.


 

 

 

 

[Read the following quotation aloud.]



“I will do as I am told.”



I read the quotation aloud.


True — False


 

I want someone else to have control of my life.


True — False

 

I enjoy being forced to do things that I strongly dislike. 


Never — Rarely —  Occasionally — Frequently — Always