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Do You Need Counselling?
This self-assessment questionnaire is designed to help you reflect on your emotional and mental well-being over the past week. Your responses may help you determine whether counselling could benefit you. There are no right or wrong answers—this is simply a tool to help you gain insight into your own experiences.
Self-Assessment Questionnaire
This questionnaire is not a diagnosis, but a self-awareness tool.
Everyone deserves to feel supported in their mental health journey. Whether you seek professional counselling or explore self-care techniques, the most important step is acknowledging your emotions and taking action towards well-being.
Section 1: Emotional and Mental Well-being
In the past week, have you...
1) Felt nervous or anxious without a clear reason?
2) Found yourself worrying excessively about different things?
3) Felt easily annoyed or irritated?
4) Had little interest or pleasure in doing things?
5) Felt constantly down, hopeless, or unmotivated?
6) Had trouble concentrating on work or studies?
Section 2: Behavioral and Coping Patterns
In the past week, have you...
7) Had thoughts of self-harm or engaged in self-harming behaviors?
8) Found it difficult to trust people?
9) Worried excessively about being abandoned by others?
10) Relied on substances (alcohol, gambling, pornography, etc.) to cope?
By submitting, I consent to the collection, use, and disclosure of my personal data for the purpose of receiving offers, services, and marketing communications from Restoring Peace Counselling & Consultancy Pte. Ltd. , in accordance with the Personal Data Protection Act (PDPA). I understand that my information and quiz results will be kept confidential and will not be shared with third parties without my consent. I may withdraw my consent at any time.
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Understanding Your Results & Next Steps
* Results will appear here once questionnaire is submitted
Your results will appear here upon
completion of the questionnaire.