Student Questionnaire

Please answer the following Yes or No questions:

1. Recently, have you become worried about your behavior?
   Yes    No
2. Have you been isolating yourself, staying away from peers and activities you used to enjoy?
   Yes    No
3. Has your performance in school or work changed? Have your grades, attendance or behaviors changed at school/work?
   Yes    No
4. Are you now involved with a different set of peers or have a peer group that is getting into trouble or struggling with life difficulties?
   Yes    No
5. Are you demonstrating self-harming behavior such as cutting, impulsive actions, or talk of suicide?
   Yes    No
6. Have you become more anxious in recent weeks or months?
   Yes    No
7. Do you get along with or enjoy being with your parents?
   Yes    No
8. Do you become easily overwhelmed?
   Yes    No
9. Have you noticed that you are more irritable or argumentative at what seem to be insignificant situations?
   Yes    No
10. Do you find it difficult to take directions from your parents and other authority figures like teachers or employers?
    Yes    No
11. Have you become more aggressive at home/school/work or with peers?
    Yes    No
12. Do you talk less to the people closest to you about your life like your parents, friends, boy/girlfriend?
    Yes    No
13. Have you been running away from home, staying out really late, or wasting most of the daytime recovering from the night before?
    Yes    No
14. Are you using drugs and alcohol frequently?
    Yes    No
15. Have you had several sexual partners in the last few months?
    Yes    No
16. Have your sleep patterns or eating habits changed recently?
    Yes    No
17. Have you experienced a trauma or significant event within the last 6 months?
    Yes    No

Short Answer Questions

1. How have you changed over the last 3-6 months?
2. What skills or talents do you pride yourself in?
3. What brings you joy?
4. How do you make friends/keep friends?
5. What non-school activities do your excel at?
6. What have you done in the past to help yourself get through difficult times?
7. How would you describe your relationship with your parents now?
8. How do you normally deal with stress?
9. When was the last time you felt like you were truly enjoying life?
10. What do you like to do for fun?
11. Who have been the role models in your life?
12. What one thing would you like to get out of being at Open Sky?

More About You

How did you find out about Open Sky?