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Best Friends
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Goals:
Diet:
Tell us about your exercise habits:
Are you currently experiencing anxiety, panics attacks or have any phobias:
Do you drink alcohol or engage in recreational drug use?
What significant life changes, traumas or stressful events have you experienced?
Narcissistic Abuse Assessment
Are you safe?
*
Yes
No
Are/Were you the victim of narcissistic abuse?
*
Yes (more than three months ago)
Yes (less than 3 months ago)
No
Are you sttruggling to get over the narcissist?
*
Yes
No
Do you have an intense pull to go back to the narcissist?
*
Yes
No
Do you feel sorry for the narcissist in your life
*
Yes
No
Are you eager to understand what happened to you and how to avoid this from happening again?
*
Yes
No
Would you like to learn how to become stronger and set healthy boundaries?
*
Yes
No
Are you interested in changing your critical inner voice to a positive one?
*
Yes
No
Do you want to have a fulfilling relationship and trust again?
*
Yes
No
Do you have nightmares, flashbacks or do you startle easily?
*
Yes
No
Tell us your story:
*
Tell us about your sleep habits:
*
Tell us about your relationship with your parents.
*
How did you come to know the narcissist?
*
Tell us about your relationship with your parents.
*
How did you hear about us?
*
Are you willing to make an investment into your future?
*
GOALS
What do you want to take away from this life-coaching program?
*
Have you done life-coaching programs before?
Yes
No
What are some things you specifically need to work on in your life?
*
I can read people pretty well...
*
Not at all
A little
Very Well
I feel I can trust people pretty easily...
Not at all
With a lot of help
With a little practice
Easily
Briefly describe your competence level and experience with cognitive behavioral therapy:
*
Where do you see yourself in 5 years?
*
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