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Client Self-Assessment Questionnaire:
Do You Need Therapy?

Thank you for considering therapy as a potential resource for your well-being. Please take a moment to reflect on the following questions. Your responses are confidential and will help you gauge whether therapy might be beneficial for you.

Emotional Well-being:


Are you experiencing difficulties in your relationships (family, friends, romantic)?
Do you find it challenging to communicate effectively with others?

Coping Strategies:

Life Changes:

Have you recently experienced significant life changes (e.g., loss, job change, relocation)?
How have these changes affected your daily life and overall well-being?

Self-Esteem and Confidence:

How would you rate your self-esteem and confidence levels?
Do you struggle with self-doubt or negative self-talk?

Sleep and Energy:

How is your sleep quality and duration?
Do you often feel fatigued or lack energy during the day?

Physical Health:

Have you noticed any physical symptoms (e.g., headaches, digestive issues) related to stress or emotional challenges?
Do you have any chronic health conditions that impact your daily life?

Goal Setting:

Are you having difficulty setting and achieving personal or professional goals?
Do you feel a sense of direction and purpose in your life?


Do you find it challenging to make decisions, big or small?
Have you noticed a pattern of indecision or second-guessing?

Personal Insight:

Are you open to self-reflection and personal growth?
Do you feel there are aspects of your life that you would like to explore further with a professional?

Thank you for your submission. Someone from out staff will be in touch.!

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