Therapist’s Overview

CHILDHOOD DEPRESSION SURVEY

GOALS OF THE EXERCISE

1.Specify the factors in the past or present that contribute to depression.

2.Identify unmet needs that contribute to the emergence of depressed mood.

3.Begin to express feelings of sadness about painful or stressful event(s) in the context of a supportive therapeutic relationship.

4.Develop effective coping strategies to help reduce feelings of depression.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE MOST USEFUL

•Anger Management

•Divorce Reaction

•Grief/Loss Unresolved

•Low Self-Esteem

•Suicidal Ideation

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT

The therapist is encouraged to use this assignment in the initial stages of treatment to identify the core issues or stressful events that contribute to the emergence of the client’s depression. The client’s responses to the survey will help the therapist identify the factors or stressors that need to be explored more fully in future therapy sessions. Identification of the core issues or factors will allow the client to begin to express his/her feelings of sadness more openly. After providing the client with the opportunity to express his/her feelings, the therapist can then begin to teach the client effective coping strategies to reduce his/her depression and meet his/her needs. The survey is not all-inclusive. At the end of the survey, space is provided for the client to identify other factors that may be contributing to his/her depression. The survey can also be very useful when conducting psychological evaluations.

EXERCISE XI.A

CHILDHOOD DEPRESSION SURVEY

Please check the appropriate box to help your therapist understand what you may be feeling sad about in your present or past. Complete the survey and remember to bring it to your next therapy session so you can review it with your therapist.

Statement / True / False / Sometimes / Not True at Present, but True in Past
I feel sad about the death of an important person (e.g., parent, sibling, grandparent, friend).
I feel sad about the death of a family pet.
I feel sad about my parents getting a divorce.
I feel sad about hardly ever seeing my father or mother.
I feel unhappy about not spending more time with mom.
I feel unhappy about not spending more time with dad.
I’m upset about my mother or father not sticking with his or her promise(s) to do something special with me.
I often feel that mom or dad pay more attention to my brother(s)or sister(s).
I feel guilty about my bad behavior at home or school.
I feel upset about receiving poor grades at school.
I feel down about losing or failing in sports.
I am unhappy with my looks.
I often feel lonely because I have no friends or very few friends.
I often feel ignored or “left out” by the other kids at school or in the neighborhood.
I often feel “let down” by my family members or friends.
I feel sad about bad things that have happened to my friends.
I often feel sad about . . . (please list other things that often make you feel sad).