Resilience Survey for Resilience Reminders parents

Please help us evaluate the effectiveness of the resilience conversations by answering these questions. Your answers will only be used by program evaluators, will be kept completely confidential, and will not be made available to parents or school personnel.

If you do not feel comfortable completing this survey for any reason, you may stop at any time.

First Name *

Last Intial *

School/Program *

Grade *

Date * +

This survey has three sections that should take less than five minutes each.

PART 1

Here is a list of things that happen to people and that people think, feel or do. Read each sentence carefully, and choose the one answer (Never, Rarely, Sometimes, Often, or Almost Always) that tells about you best.
THERE ARE NO RIGHT OR WRONG ANSWERS. *

	Never	Rarely	Sometimes	Often	Almost Always
Life is fair.	Never	Rarely	Sometimes	Often	Almost Always
I can make good things happen.	Never	Rarely	Sometimes	Often	Almost Always
I can get the things I need.	Never	Rarely	Sometimes	Often	Almost Always
I can control what happens to me.	Never	Rarely	Sometimes	Often	Almost Always
I do things well.	Never	Rarely	Sometimes	Often	Almost Always
I am good at fixing things.	Never	Rarely	Sometimes	Often	Almost Always
I am good at figuring things out.	Never	Rarely	Sometimes	Often	Almost Always
I make good decisions.	Never	Rarely	Sometimes	Often	Almost Always
I can adjust when plans change.	Never	Rarely	Sometimes	Often	Almost Always
I can get past problems in my way.	Never	Rarely	Sometimes	Often	Almost Always
If I have a problem, I can solve it.	Never	Rarely	Sometimes	Often	Almost Always
If I try hard, it makes a difference.	Never	Rarely	Sometimes	Often	Almost Always
If at first I don't succeed, I will keep on trying.	Never	Rarely	Sometimes	Often	Almost Always
I can think of more than one way to solve a problem.	Never	Rarely	Sometimes	Often	Almost Always
I can learn from my mistakes.	Never	Rarely	Sometimes	Often	Almost Always
I can ask for help when I need it.	Never	Rarely	Sometimes	Often	Almost Always
I can let others help me when I need to.	Never	Rarely	Sometimes	Often	Almost Always
Good things will happen to me.	Never	Rarely	Sometimes	Often	Almost Always
My life will be happy.	Never	Rarely	Sometimes	Often	Almost Always
No matter what happens, things will be alright.	Never	Rarely	Sometimes	Often	Almost Always

PART 2

Here is a list of things that happen to people and that people think, feel or do. Read each sentence carefully, and choose the one answer (Never, Rarely, Sometimes, Often, or Almost Always) that tells about you best.
THERE ARE NO RIGHT OR WRONG ANSWERS. *

	Never	Rarely	Sometimes	Often	Almost Always
I can meet new people easily.	Never	Rarely	Sometimes	Often	Almost Always
I can make friends easily.	Never	Rarely	Sometimes	Often	Almost Always
People like me.	Never	Rarely	Sometimes	Often	Almost Always
I feel calm with people.	Never	Rarely	Sometimes	Often	Almost Always
I have a good friend.	Never	Rarely	Sometimes	Often	Almost Always
I like people.	Never	Rarely	Sometimes	Often	Almost Always
I spend time with my friends.	Never	Rarely	Sometimes	Often	Almost Always
Other people treat me well.	Never	Rarely	Sometimes	Often	Almost Always
I can trust others.	Never	Rarely	Sometimes	Often	Almost Always
I can let others see my feelings.	Never	Rarely	Sometimes	Often	Almost Always
I can calmly tell others that I don't agree with them.	Never	Rarely	Sometimes	Often	Almost Always
I can make up with friends after a fight.	Never	Rarely	Sometimes	Often	Almost Always
I can forgive my parent(s) if they upset me.	Never	Rarely	Sometimes	Often	Almost Always
If people let me down, I can forgive them.	Never	Rarely	Sometimes	Often	Almost Always
I can depend on people to treat me fairly.	Never	Rarely	Sometimes	Often	Almost Always
I can depend on those closest to me to do the right thing.	Never	Rarely	Sometimes	Often	Almost Always
I can calmly tell a friend if he or she does something that hurts me.	Never	Rarely	Sometimes	Often	Almost Always
If something bad happens, I can ask my friends for help.	Never	Rarely	Sometimes	Often	Almost Always
If something bad happens, I can ask my parent(s) for help.	Never	Rarely	Sometimes	Often	Almost Always
There are people who will help me if something bad happens.	Never	Rarely	Sometimes	Often	Almost Always
If I get upset or angry, there is someone I can talk to.	Never	Rarely	Sometimes	Often	Almost Always
There are people who love and care for me.	Never	Rarely	Sometimes	Often	Almost Always
People know who I really am.	Never	Rarely	Sometimes	Often	Almost Always
People accept me for who I really am.	Never	Rarely	Sometimes	Often	Almost Always

PART 3

Here is a list of things that happen to people and that people think, feel or do. Read each sentence carefully, and choose the one answer (Never, Rarely, Sometimes, Often, or Almost Always) that tells about you best.
THERE ARE NO RIGHT OR WRONG ANSWERS. *

	Never	Rarely	Sometimes	Often	Almost Always
It is easy for me to get upset.	Never	Rarely	Sometimes	Often	Almost Always
People say that I am easy to upset.	Never	Rarely	Sometimes	Often	Almost Always
I strike back when someone upsets me.	Never	Rarely	Sometimes	Often	Almost Always
I get very upset when things don't go my way.	Never	Rarely	Sometimes	Often	Almost Always
I get very upset when people don't like me.	Never	Rarely	Sometimes	Often	Almost Always
I can get so upset that I can't stand how I feel.	Never	Rarely	Sometimes	Often	Almost Always
I get so upset that I lose control.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I don't think clearly.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I react without thinking.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I stay upset for about an hour.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I stay upset for several hours.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I stay upset for the whole day.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I stay upset for several days.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I make mistakes.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I do the wrong thing.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I get into trouble.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I do things that I later feel bad about.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I hurt myself.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I hurt someone.	Never	Rarely	Sometimes	Often	Almost Always
When I get upset, I get mixed-up.	Never	Rarely	Sometimes	Often	Almost Always