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  • Student Pre-Group Chill Survey Upper

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    This document contains a pre-assessment survey for a small counseling group for grades 4 and 5. The survey asks students to rate how often they experience various feelings and behaviors related to confidence, stress, communication, and coping skills on a scale from "almost always" to "almost never". It also asks students to rate their agreement with statements about mindfulness and managing emotions, and to write what they would like to learn in the counseling group.

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    Student Pre-group Chill Survey Upper

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    This document contains a pre-assessment survey for a small counseling group for grades 4 and 5. The survey asks students to rate how often they experience various feelings and behaviors related to confidence, stress, communication, and coping skills on a scale from "almost always" to "almost never". It also asks students to rate their agreement with statements about mindfulness and managing emotions, and to write what they would like to learn in the counseling group.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    16K views1 page

    Student Pre-Group Chill Survey Upper

    Uploaded by

    mbmcc
    This document contains a pre-assessment survey for a small counseling group for grades 4 and 5. The survey asks students to rate how often they experience various feelings and behaviors related to confidence, stress, communication, and coping skills on a scale from "almost always" to "almost never". It also asks students to rate their agreement with statements about mindfulness and managing emotions, and to write what they would like to learn in the counseling group.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 1

    Name

    Date
    Small Counseling Group Grade 4/5 Pre-assessment

    Check one choice for each statement.


    Almost
    Always

    Often

    Sometimes

    1. I feel confident when I am dropped off at school


    2. I have trouble sleeping in my own bed alone
    3. I have stomachaches or headaches
    4. I worry about school (doing well)
    5. I worry about performing in front of others
    6. I know how to relax
    7. I tell my parent(s) about my fears
    8. I try to avoid school or new situations (say I dont
    want to go )
    9. I tell my teacher when I am upset
    10. I tell my friends about my feelings
    11. I like to talk in front of the class
    12. I get angry over small things
    13. I feel confident before tests
    14. I am brave and like to try new things
    15. I feel comfortable at drop-off before school
    16. I feel comfortable in the lunchroom
    17. I feel stressed out

    18. I understand what mindfulness is and how it can help me.


    Strongly Agree
    Agree
    Unsure
    Disagree

    Strongly Disagree

    19. I have skills to manage my emotions in a positive manner.


    Strongly Agree
    Agree
    Unsure
    Disagree

    Strongly Disagree

    20. In this group I would like to learn:

    Almost
    Never

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