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Intrapersonal Inventory
Intrapersonal Inventory
Walt Addison
2017-11-30T14:20:25+00:00
Intrapersonal Inventory Checklist
Name
Date
PLEASE RATE THE AREAS OF CONCERNS USING BELOW MEASUREMENT
None = No Concern
* = Area of Concern for Me
** = Critical Area of Concern for Me
Not being the kind of person I want to be
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Too tired to do anything
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Unhappy with my physical appearance
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Discouraged about my future
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Financial problems
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Dissatisfied or bored with everything
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Concerned about my physical health
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Feeling guilty a lot
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Concerned over my living situation
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Being ill at ease at social gatherings
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Having difficulty making decisions
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Eating problems
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Sleeping problems
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Feeling like others don’t like me
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Thoughts of suicide
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Intend to commit suicide
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Thought of hurting someone else
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Worrying excessively
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Unable to concentrate
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Feeling that no one understands me
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Nervousness
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Relationship problems
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Problems with children
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Other related family problems
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Sexual concerns
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Headaches
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Lacking love and/or affection
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Religious or Spiritual concerns
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Pressure from others
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Discrimination or oppression from others because of group affiliation
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Fearing failure or rejection
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Having difficulty trusting others
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Getting into too many arguments
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Too easily influenced by others
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Concerns about alcohol or drug use
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Concerns about recovery from alcohol or drug use
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Feeling a great sense of loss or grief related to death
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Trauma/Abuse recovery
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Work/Career/Educational problems
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
Other specific problems
None - No concern
* - Area of Concern for Me
** - Critical Area of Concern for Me
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