psychological questionnaire to assess the

psychological fitness of a parent to raise

a child:
Section 1: Background Information

1. Personal Details:

- Name, age, gender, contact information.

- How would you describe your current marital/relationship status?

- Are you the biological parent of the child? If not, what is your relationship to the child?

2. Family History:

- What was your relationship like with your own parents or guardians when you were growing
up?

- Are there any significant family dynamics or conflicts that have influenced your upbringing or
shaped your parenting approach?

Section 2: Parenting Experience

1. Parenting Practices:

- How do you typically discipline your child when they misbehave? Provide specific examples.

- How do you encourage and reinforce positive behavior in your child?

- How do you handle conflicts or disagreements with your child? How do you promote effective
communication?

2. Parent-Child Relationship:

- Describe the nature of your relationship with your child. How would you characterize your level
of emotional closeness and attachment?

- How involved are you in your child's daily life, including their school activities, hobbies, and
social interactions?
 - How do you support your child's emotional needs? Give examples of how you help them
navigate difficult emotions.

3. Coping Skills:

- How do you typically manage stress or frustration related to parenting challenges?

- Do you engage in any self-care practices or activities to maintain your emotional well-being? If
yes, please describe them.

- How do you ensure a healthy work-life balance and prioritize your child's needs alongside your
own?

Section 3: Emotional Well-being

1. Mental Health History:

- Have you ever been diagnosed with a mental health condition? If so, please provide details,
including the diagnosis, treatment received, and current status.

- Are you currently taking any medications or receiving therapy/counseling? If yes, please
describe.

2. Emotional Resilience:

- How would you describe your emotional resilience? How do you cope with personal setbacks or
challenges in your life?

- How do you respond to your child's emotional needs and help them develop their emotional
intelligence?

- Are you able to recognize and regulate your own emotions effectively? Can you provide
examples?

3. Self-Care:

- How do you prioritize your own mental and physical well-being while fulfilling your parenting
responsibilities?

- What activities or practices do you engage in to relax, recharge, or maintain a healthy lifestyle?

- Are you comfortable seeking support or assistance from others when you feel overwhelmed or
stressed?
Section 4: Parenting Attitudes and Beliefs

1. Parenting Values:

- What are your core beliefs and values when it comes to parenting? How do these beliefs
influence your parenting decisions?

- How do you balance setting rules and boundaries for your child with promoting their autonomy
and independence?

- How do you support your child's educational and intellectual development?

2. Attitudes towards Children:

- How would you describe your attitude towards children in general? How do you perceive their
needs, emotions, and capabilities?

- How do you demonstrate empathy towards your child and promote their empathy towards
others?

- How do you encourage your child to express their opinions and make decisions appropriate to
their age and development?

3. Parenting Support:

- Who are the individuals or resources you rely on for parenting support? Are you involved in any
parenting communities or groups?

- How open are you to seeking assistance or guidance from professionals (e.g., pediatricians,
therapists) when faced with parenting challenges?

- How do you manage your parenting responsibilities when you need to juggle