Trauma Symptom and Coping Strategies Questionnaire Form
Reflect on your recent experiences and coping strategies. Your responses help identify patterns in symptoms and approaches to self-care. Please answer honestly and comfortably.
In the past two weeks, how often have you experienced intrusive thoughts or memories related to a distressing event?
*
Never
1
2
3
4
Very Often
5
1 is Never, 5 is Very Often
How often have you felt anxious or on edge?
*
Never
1
2
3
4
Very Often
5
1 is Never, 5 is Very Often
How frequently have you had trouble sleeping (difficulty falling or staying asleep)?
*
Never
1
2
3
4
Very Often
5
1 is Never, 5 is Very Often
How often have you experienced mood swings or feelings of sadness?
*
Never
1
2
3
4
Very Often
5
1 is Never, 5 is Very Often
Which coping strategies have you used recently? (Select all that apply)
Talking to friends or family
Physical activity or exercise
Mindfulness or relaxation techniques
Creative activities (art, music, writing)
Seeking professional support
Other
How effective have your coping strategies felt?
Not at all effective
1
2
3
4
Very effective
5
1 is Not at all effective, 5 is Very effective
What activities or habits help you feel safe or grounded?
Is there anything you would like to share about your current challenges or needs?
Submit
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