Resilience

RESILIENCE Questionnaire

Please circle the most accurate answer under each statement:


1.  I believe that my mother loved me when I was little.

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

2.  I believe that my father loved me when I was little. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

3.  When I was little, other people helped my mother and father take care of me and they seemed to love me. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

4.   I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I enjoyed it, too. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

5.  When I was a child, there were relatives in my family who made me feel better if I was sad or worried. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

6.   When I was a child, neighbors or my friends’ parents seemed to like me.

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

7.  When I was a child, teachers, coaches, youth leaders or ministers were there to help me. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

8.  Someone in my family cared about how I was doing in school. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

9.  My family, neighbors and friends talked often about making our lives better. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

10.  We had rules in our house and were expected to keep them. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

11. When I felt really bad, I could almost always find someone I trusted to talk to. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

12.  As a youth, people noticed that I was capable and could get things done. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

13.  I was independent and a go-getter. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True 

14.  I believed that life is what you make it. 

Definitely true         Probably true         Not sure         Probably Not True        Definitely Not True

How many of these 14 protective factors did I have as a child and youth? (How many of the 14 were circled “Definitely True” or “Probably True”?)   _______ 

Of these circled, how many are still true for me? _______