FAP pre-questionnaire
HOW I TYPICALLY ACT TOWARDS MYSELF IN DIFFICULT TIMES
Please read each statement carefully before answering. To the left of each item, indicate how often you behave in the stated manner, using the following scale:
1. I’m disapproving and judgmental about my own flaws and inadequacies. *
Almost Never
Almost Always
2. When I’m feeling down I tend to obsess and fixate on everything that’s wrong. *
Almost Never
Almost Always
3. When things are going badly for me, I see the difficulties as part of life that everyone goes through. *
Almost Never
Almost Always
4. When I think about my inadequacies, it tends to make me feel more separate and cut off from the rest of the world. *
Almost Never
Almost Always
5. I try to be loving towards myself when I’m feeling emotional pain. *
Almost Never
Almost Always
6. When I fail at something important to me I become consumed by feelings of inadequacy. *
Almost Never
Almost Always
7. When I’m down, I remind myself that there are lots of other people in the world feeling like I am. *
Almost Never
Almost Always
8. When times are really difficult, I tend to be tough on myself. *
Almost Never
Almost Always
9. When something upsets me I try to keep my emotions in balance. *
Almost Never
Almost Always
10. When I feel inadequate in some way, I try to remind myself that feelings of inadequacy are shared by most people. *
Almost Never
Almost Always
11. I’m intolerant and impatient towards those aspects of my personality I don’t like. *
Almost Never
Almost Always
12. When I’m going through a very hard time, I give myself the caring and tenderness I need. *
Almost Never
Almost Always
13. When I’m feeling down, I tend to feel like most other people are probably happier than I am. *
Almost Never
Almost Always
14. When something painful happens I try to take a balanced view of the situation. *
Almost Never
Almost Always
15. I try to see my failings as part of the human condition *
Almost Never
Almost Always
16. When I see aspects of myself that I don’t like, I get down on myself. *
Almost Never
Almost Always
17. When I fail at something important to me I try to keep things in perspective. *
Almost Never
Almost Always
18. When I’m really struggling, I tend to feel like other people must be having an easier time of it. *
Almost Never
Almost Always
19. I’m kind to myself when I’m experiencing suffering. *
Almost Never
Almost Always
20. When something upsets me I get carried away with my feelings. *
Almost Never
Almost Always
21. I can be a bit cold-hearted towards myself when I’m experiencing suffering. *
Almost Never
Almost Always
22. When I’m feeling down I try to approach my feelings with curiosity and openness. *
Almost Never
Almost Always
23. I’m tolerant of my own flaws and inadequacies. *
Almost Never
Almost Always
24. When something painful happens I tend to blow the incident out of proportion. *
Almost Never
Almost Always
25. When I fail at something that’s important to me, I tend to feel alone in my failure. *
Almost Never
Almost Always
26. I try to be understanding and patient towards those aspects of my personality I don’t like. *
Almost Never
Almost Always
DERS
Please indicate how often the following statements apply to you by writing the appropriate number from the scale below on the line beside each item:
1. I am clear about my feelings. *
Almost Never
Almost Always
2. I pay attention to how I feel. *
Almost Never
Almost Always
3. I experience my emotions as overwhelming and out of control. *
Almost Never
Almost Always
4. I have no idea how I am feeling. *
Almost Never
Almost Always
5. I have difficulty making sense out of my feelings. *
Almost Never
Almost Always
6. I am attentive to my feelings. *
Almost Never
Almost Always
7. I know exactly how I am feeling. *
Almost Never
Almost Always
8. I care about what I am feeling. *
Almost Never
Almost Always
9. I am confused about how I feel. *
Almost Never
Almost Always
10. When I’m upset, I acknowledge my emotions. *
Almost Never
Almost Always
11. When I’m upset, I become angry with myself for feeling that way. *
Almost Never
Almost Always
12. When I’m upset, I become embarrassed for feeling that way. *
Almost Never
Almost Always
13. When I’m upset, I have difficulty getting work done. *
Almost Never
Almost Always
14. When I’m upset, I become out of control. *
Almost Never
Almost Always
15. When I’m upset, I believe that I will remain that way for a long time. *
Almost Never
Almost Always
16. When I’m upset, I believe that I’ll end up feeling very depressed. *
Almost Never
Almost Always
17. When I’m upset, I believe that my feelings are valid and important. *
Almost Never
Almost Always
18. When I’m upset, I have difficulty focusing on other things. *
Almost Never
Almost Always
19. When I’m upset, I feel out of control. *
Almost Never
Almost Always
20. When I’m upset, I can still get things done. *
Almost Never
Almost Always
21. When I’m upset, I feel ashamed with myself for feeling that way. *
Almost Never
Almost Always
22. When I’m upset, I know that I can find a way to eventually feel better. *
Almost Never
Almost Always
23. When I’m upset, I feel like I am weak. *
Almost Never
Almost Always
24. When I’m upset, I feel like I can remain in control of my behaviors. *
Almost Never
Almost Always
25. When I’m upset, I feel guilty for feeling that way. *
Almost Never
Almost Always
26. When I’m upset, I have difficulty concentrating. *
Almost Never
Almost Always
27. When I’m upset, I have difficulty controlling my behaviors. *
Almost Never
Almost Always
28. When I’m upset, I believe that there is nothing I can do to make myself feel better. *
Almost Never
Almost Always
29. When I’m upset, I become irritated with myself for feeling that way. *
Almost Never
Almost Always
30. When I’m upset, I start to feel very bad about myself. *
Almost Never
Almost Always
31. When I’m upset, I believe that wallowing in it is all I can do. *
Almost Never
Almost Always
32. When I’m upset, I lose control over my behaviors. *
Almost Never
Almost Always
33. When I’m upset, I have difficulty thinking about anything else. *
Almost Never
Almost Always
34. When I’m upset, I take time to figure out what I’m really feeling. *
Almost Never
Almost Always
35. When I’m upset, it takes me a long time to feel better. *
Almost Never
Almost Always
36. When I’m upset, my emotions feel overwhelming. *
Almost Never
Almost Always
MBI - General Survey
Below are 16 statements of job-related feelings. Please read each statement carefully and decide if you ever feel this way about your job. If you have never had this feeling, circle the "0" (zero) to the right of the statement. If you have had this feeling, indicate how often you feel it by circling the number (from 1 to 6) that best describes how frequently you feel that way.

0 = Never, 1 = A few times a year or less, 2 = Once a month or less, 3 = A few times a month, 4 = Once a week, 5 = A few times a week, 6 = Everyday

1. I feel emotionally drained from my work. *
Never
Everyday
2. I feel used up at the end of the workday. *
Never
Everyday
3. I feel tired when I get up in the morning and have to face another day on the job. *
Never
Everyday
4. Working all day is really a strain for me. *
Never
Everyday
5. I can effectively solve the problems that arise in my work. *
Never
Everyday
6. I feel burned out from my work. *
Never
Everyday
7. I feel I am making an effective contribution to what this organization does. *
Never
Everyday
8. I have become less interested in my work since I started this job. *
Never
Everyday
9. I have become less enthusiastic about my work. *
Never
Everyday
10. In my opinion, I am good at my job. *
Never
Everyday
11. I feel exhilarated when I accomplish something at work. *
Never
Everyday
12. I have accomplished many worthwhile things in this job. *
Never
Everyday
0 = Never, 1 = A few times a year or less, 2 = Once a month or less, 3 = A few times a month, 4 = Once a week, 5 = A few times a week, 6 = Everyday
13. I just want to do my job and not be bothered. *
Never
Everyday
14. I have become more cynical about whether my work contributes anything. *
Never
Everyday
15. I doubt the significance of my work. *
Never
Everyday
16. At my work, I feel confident that I am effective at getting things done. *
Never
Everyday
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