1 – Not at all
2 – A little
3 – Somewhat
4 – Quite a bit
5 – A lot
¹
1
2
3
4
5
1
I cooperate with people around me.
2
Getting and improving qualifications or skills is important to me.
3
I know how to behave in different social situations.
4
My family have usually supported me through life.
5
My family knows a lot about me.
6
If I am hungry, I can get food to eat.
7
People like to spend time with me.
8
I talk to my family/partner about how I feel.
9
I feel supported by my friends.
10
I feel that I belong in my community.
11
My family/partner stands by me during difficult times.
12
My friends stand by me during difficult times.
13
I am treated fairly in my community.
14
I have opportunities to show others that I can act responsibly.
15
I feel secure when I am with my family/partner.
16
I have opportunities to apply my abilities in life (like skills, a job, caring for others).
17
I enjoy my family's/partner's cultural and family traditions.
The presented answer sheet is not an original form and is not intended for printing or use as a handout.
The answer numbers are used only to label response columns. They are NOT scores and should not be used for calculating results.