Assessment Questionnaires for Adolescent / Adult Children 青少年 / 成人孩子的評估 - Toronto

(to be completed at registration, beginning and end of the course and at follow up

請在報名時,課程開始,課程結束和跟進時完成)

Personal Information / 个人資料

Personal information in this section will be encrypted when stored on server, but it is recommended that you submit this form over a private (e.g. home) network.
這部分的個人資料會被加密存儲在我們的服務器,但建議你通過專用網絡(例如家裡的網絡)提交此表格。

Research Questionnaire for HMT®/LMG Workshops 緊繫我心 讓我飛翔 的研究問卷

Developed by Nancy T. Aikin, PhD, & Paul A. Aikin, PhD

The following questions are to be answered for your mother / caregiver (in case you are not living with your parent). 給青少年/成人孩子的問卷: 請針對你的母親 / 看護人(如果你不和你的父母住在一起)來回答這些問題。
From your viewpoint, (relationship to caregiver: mother / grandmother / other: )
從你的角度, (跟看護人的關係: 母親/繼母/代母/祖母/婆婆/其他: )

Please answer the following questions about your mother or a mother-like figure. Respond to each statement by circling a number to indicate how much you agree or disagree with the statement. 請針對你的母親或代替母親的看護人(如果你不和你的父母同住)來回答這些問題. 請根據你對每一個陳述同意的程度作答,並圈選適當的數字代表.

The following questions are to be answered for your father / caregiver (in case you are not living with your parent).  請針對你的父親 / 看護人(如果你不和你的父親住在一起)回答這些問題。
From your viewpoint, (relationship to caregiver: father / grandfather / other:  從你的角度, (跟看護人的關係: 父親/繼父/代父/祖父/公公/其他:)

Please answer the following questions about your father or father-like figure. Respond to each statement by circling a number to indicate how much you agree or disagree with the statement. 請針對你的父親或代替父親的看護人(如果你不和你的父母同住)來回答這些問題. 請根據你對每一個陳述同意的程度作答,並圈選適當的數字來代表.

Family Assessment Instrument 家庭評估量表

C-FAI; created and validated by Andrew Siu and Daniel Shek

For each of the items describing your view of your current family, please circle the response that best represents how you feel.  Please answer every question.

在以下的題目中,請按著你對你現時家庭的看法,圈出一個你認為最能夠代表你的感覺的答案. 請回答每一條題目. 

Example: My family members are selfish.

If this is very similar to your family situation, please circle 1.  If this is somewhat similar to your family situation, please circle 2. If this is similar and dissimilar to your family situation, please circle 3.  If this is somewhat dissimilar to your family situation, please circle 4. If this is very dissimilar to your family situation, please circle 5.

例子: 我的家人是自私自利的.  

如果你覺得這句子是與你的家庭情況 十分相似, 請选 1。如果你覺得這句子是與你的家庭情況 有點相似, 請选 2。如果你覺得這句子是與你的家庭情況 介乎有點相似與有點不相似之間, 請选 3。如果你覺得這句子是與你的家庭情況 有點不相似, 請选 4。 如果你覺得這句子是與你的家庭情況 十分不相似, 請选 5。