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About
What is psychotherapy
Services
Individual Psychotherapy
Couples Therapy
Conditions we treat
Social Anxiety
Anxiety of abandonment
Low Self-Esteem
Depression
Toxic relationships
Anti-social tendencies
FAQ
Blog
Contact
About
What is psychotherapy
Services
Individual Psychotherapy
Couples Therapy
Conditions we treat
Social Anxiety
Anxiety of abandonment
Low Self-Esteem
Depression
Toxic relationships
Anti-social tendencies
FAQ
Blog
Contact
Schedule First Appointment
Welcome to our first psychological assessment!
Everyone decides to start psychotherapy for different reasons. Therefore, a general psychological test helps the therapist not only to arrive at some hypotheses about the person and their behavior, personality and capabilities but also to prepare the first session. Kindly note that by completing this form, you are eligible to schedule your first appointment.
Email
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Full Name
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Phone Number
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FLEXIBILITY SUBSCALES
ACCEPTANCE
IN THE LAST TWO WEEKS…
I was receptive to observing unpleasant thoughts and feelings without interfering with them.
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Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I tried to make peace with my negative thoughts and feelings rather than resisting them
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I made room to fully experience negative thoughts and emotions, breathing them in rather than pushing them away
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When I had an upsetting thought or emotion, I tried to give it space rather than ignoring it
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I opened myself to all of my feelings, the good and the bad
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Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
PRESENT MOMENT AWARENESS
IN THE LAST TWO WEEKS…
I was attentive and aware of my emotions
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Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I was in tune with my thoughts and feelings from moment to moment
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I paid close attention to what I was thinking and feeling
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I was in touch with the ebb and flow of my thoughts and feelings
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I strived to remain mindful and aware of my own thoughts and emotions
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Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
SELF AS CONTEXT
IN THE LAST TWO WEEKS…
Even when I felt hurt or upset, I tried to maintain a broader perspective
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Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I carried myself through tough moments by seeing my life from a larger viewpoint
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I tried to keep perspective even when life knocked me down
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When I was scared or afraid, I still tried to see the larger picture
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When something painful happened, I tried to take a balanced view of the situation
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
DEFUSION
IN THE LAST TWO WEEKS…
I was able to let negative feelings come and go without getting caught up in them
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Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When I was upset, I was able to let those negative feelings pass through me without clinging to them
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When I was scared or afraid, I was able to gently experience those feelings, allowing them to pass
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I was able to step back and notice negative thoughts and feelings without reacting to them
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
In tough situations, I was able to notice my thoughts and feelings without getting overwhelmed by them
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
VALUES
IN THE LAST TWO WEEKS…
I was very in-touch with what is important to me and my life
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I stuck to my deeper priorities in life
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I tried to connect with what is truly important to me on a daily basis
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Even when it meant making tough choices, I still tried to prioritize the things that were important to me
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
My deeper values consistently gave direction to my life
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
COMMITTED ACTION
IN THE LAST TWO WEEKS…
Even when I stumbled in my efforts, I didn't quit working toward what is important
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Even when times got tough, I was still able to take steps toward what I value in life
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Even when life got stressful and hectic, I still worked toward things that were important to me
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I didn't let set-backs slow me down in taking action toward what I really want in life
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I didn't let my own fears and doubts get in the way of taking action toward my goals
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
INFLEXIBILITY SUBSCALES
EXPERIENTIAL AVOIDANCE
IN THE LAST TWO WEEKS…
When I had a bad memory, I tried to distract myself to make it go away
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I tried to distract myself when I felt unpleasant emotions
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When unpleasant memories came to me, I tried to put them out of my mind
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When something upsetting came up, I tried very hard to stop thinking about it
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
If there was something I didn't want to think about, I would try many things to get it out of my mind
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
LACK OF CONTACT WITH THE PRESENT MOMENT
IN THE LAST TWO WEEKS…
I did most things on "automatic" with little awareness of what I was doing
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I did most things mindlessly without paying much attention
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I went through most days on auto-pilot without paying much attention to what I was thinking or feeling
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I floated through most days without paying much attention
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Most of the time I was just going through the motions without paying much attention
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
SELF AS CONTENT
IN THE LAST TWO WEEKS…
I thought some of my emotions were bad or inappropriate and I shouldn't feel them
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I criticized myself for having irrational or inappropriate emotions
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I believed some of my thoughts are abnormal or bad and I shouldn't think that way
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I told myself that I shouldn't be feeling the way I'm feeling
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I told myself I shouldn't be thinking the way I was thinking
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
FUSION
IN THE LAST TWO WEEKS…
Negative thoughts and feelings tended to stick with me for a long time
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Distressing thoughts tended to spin around in my mind like a broken record
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
It was very easy to get trapped into unwanted thoughts and feelings
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When I had negative thoughts or feelings it was very hard to see past them
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When something bad happened it was hard for me to stop thinking about it
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
LACK OF CONTACT WITH VALUES
IN THE LAST TWO WEEKS…
My priorities and values often fell by the wayside in my day to day life
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When life got hectic, I often lost touch with the things I value
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
The things that I value the most often fell off my priority list completely
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
I didn't usually have time to focus on the things that are really important to me
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
When times got tough, it was easy to forget about what I truly value
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
INACTION
IN THE LAST TWO WEEKS…
Negative feelings often trapped me in inaction
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Negative feelings easily stalled out my plans
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Getting upset left me stuck and inactive
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Negative experiences derailed me from what's really important
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
Unpleasant thoughts and feelings easily overwhelmed my efforts to deepen my life
*
Never TRUE
Rarely TRUE
Occasionally TRUE
Often TRUE
Very Often TRUE
Always TRUE
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