Looking for Bears // Emotional Wellbeing Assessment

Introduction
Demographics
Questionnaire
Feedback

Introduction

Thank you for considering participation in this research assessment. This draft assessment is based on my Neuro-Social Model of Emotional Wellbeing and is intended to provide a qualitative analysis of your emotional wellbeing. I am conducting this study to evaluate the completeness and effectiveness of the assessment design. Your participation is valuable in helping me develop and validate this assessment. This assessment is being conducted by Looking for Bears and your responses will remain confidential and anonymous.

Instructions: Please read each question carefully and provide your most honest and accurate responses. If a question does not apply to you, please select the Neutral option.

Time Estimate: The estimated time to complete this assessment is approximately 10-15 minutes. The questionnaire portion contains 100 questions. I appreciate your time and thoughtful responses.

Contact Information: If you have any questions or concerns about this assessment, please feel free to contact me. I am available to address any inquiries you may have.

Data Privacy: I am committed to protecting your privacy and ensuring the security of your responses. All data collected is anonymous and will be treated confidentially and stored securely in accordance with applicable data protection laws.

DISCLAIMER:
The survey presented here is intended to be qualitative, not quantitative, and aims to help identify different aspects of a respondent's wellbeing. It is important to note that the survey is currently being provided for research purposes and has not undergone psychometric validation, so its results should be interpreted with caution. Future administration of a published survey should involve a qualified professional who can ensure its proper use, interpret results in context, and provide necessary support or resources based on each individual's unique circumstances.

Questionnaire

Please read each statement carefully and provide your most honest and accurate responses. All statements are required.

		Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
1	I am comfortable and accepting of myself as I am.
2	I am shown grace and understanding when I make mistakes.
3	My living space is comfortable and suitable for my needs.
4	I am free from being bullied or insulted by others.
5	My environment is clean and well-maintained.
6	I receive constructive feedback and recognition for my contributions.
7	I am able to set and enforce personal boundaries in my relationships.
8	I believe in my ability to carry out tasks and overcome challenges.
9	My actions, choices, and work are aligned with my values.
10	I have access to a healthy and balanced diet and enough food.
11	I feel fulfilled by the work or activities I engage in.
12	I have opportunities for meaningful social interactions and connections.
13	I have people in my life who provide emotional and practical support.
14	I am treated with unconditional positive regard by others.
15	The surrounding environment is peaceful and conducive to concentration.
16	I have connections with individuals who share similar values and beliefs.
17	My school or work environment is conducive to my needs.
18	I have a safe and adequate place to live.
19	I have a clear sense of purpose and direction in life.
20	I feel a sense of belonging and acceptance in my social groups.
21	I have clear thinking and focus.
22	I have access to safe and affordable housing.
23	I have access to enough food and water.
24	I am able to communicate effectively with those around me.
25	My environment inspires and promotes a sense of wellbeing.
26	I excel and have extensive knowledge in specific areas.
27	I embrace challenges and obstacles with a creative mindset.
28	I feel safe in my physical environment.
29	I feel like I'm making a meaningful contribution to my community.
30	I feel empowered to take control of my life.
31	I am committed to lifelong learning and personal development.
32	I actively reflect on my strengths and areas for growth.
33	I have tools and strategies to effectively regulate my feelings.
34	I get enough restful sleep to rejuvenate my body and mind.
35	I receive validation and affirmation for my authentic self.
36	I regularly have opportunities to utilize my strengths.
37	I have opportunities to express my true self.
38	I have sufficient energy to engage in daily activities.
39	I am a priority to another person.
40	I am able to make informed decisions based on my own judgment.
41	I am free from disease or injury that affects my wellbeing.
42	I believe I am worthy of the same love and affection I shown others.
43	I set up and maintain boundaries that align with my identity.
44	I am safely able to discuss my emotions with those close to me.
45	I have positive qualities and attributes.
46	I believe I have a unique purpose.
47	I am kind and forgiving to myself when I make mistakes or face challenges.
48	I feel healthy and energetic.
49	My actions are aligned with my core values.
50	I can access necessary medical care and services.
51	I do not experience discrimination on a regular basis.
52	I can easily get around my community whenever I desire.
53	I feel safe and secure in my community.
54	I feel authentic and true to myself in various aspects of life.
55	I have goals that give me a sense of purpose.
56	I often experience joy through living my purpose.
57	I experience physical comfort and absence of pain or discomfort.
58	I have suitable clothing for different weather conditions.
59	I receive support to bounce back from setbacks and stay committed to my mission.
60	I feel safe and respected in my social interactions and relationships.
61	I have clarity of thought and mental agility.
62	I can choose my own path and set goals for myself.
63	I feel secure and protected from physical harm.
64	I have people around me who support and care for me.
65	I am attuned to the sensations and needs of my body.
66	I am more curious than judgmental with other people and myself.
67	I receive love and acceptance without conditions.
68	I am valued and appreciated for who I am.
69	I possess specific intelligences and gifts.
70	I feel secure in getting my needs met.
71	I am able to maintain personal hygiene and cleanliness.
72	I have specific skills that are useful.
73	I can easily access medical care in an emergency.
74	I take ownership of my actions and choices.
75	I have adequate opportunities for sleep and rest.
76	Others talk to me before making decisions about me.
77	The natural envioronment where I live is pleasing to me.
78	I can access quality and affordable education.
79	I have a clear understanding of my strengths, weaknesses, and values.
80	I am able to share my feelings and vulnerabilities with others.
81	I trust the people I interact with, and they trust me.
82	I continually work to hone and improve my gifts.
83	I regularly engage in exercising my body.
84	I feel secure in my employment options.
85	I feel included and accepted in my social circles.
86	I am actively working on personal growth and self-improvement.
87	I celebrate my progress and achievements.
88	I find joy and satisfaction when engaging in activities that align with my strengths.
89	My physical environment is accessible to me.
90	I am driven by internal motivation to pursue my goals and aspirations.
91	I have the freedom to make my own decisions.
92	I am aware of why I think, behave, and feel the ways I do.
93	I have stability in terms of income and financial resources.
94	I am treated with kindness and respect by others.
95	I receive recognition and appreciation for my contributions.
96	I have access to legal rights and protections.
97	I have access to natural light in my environment.
98	I receive comfort when I am having a difficult time.
99	I have the privacy I need in my living and personal spaces.
100	I am empowered to actively participate in decision-making

DISCLAIMER:
The survey presented here is intended to be qualitative, not quantitative, and aims to help identify different aspects of a respondent's wellbeing. It is important to note that the survey is currently being provided for research purposes and has not undergone psychometric validation, so its results should be interpreted with caution. Future administration of a published survey should involve a qualified professional who can ensure its proper use, interpret results in context, and provide necessary support or resources based on each individual's unique circumstances.

Feedback

Thank You!

Thank you for your time and contribution to this research endeavor. I appreciate your willingness to participate in this assessment. Your feedback is invaluable in helping me gain insights and make informed decisions. All fields in this section are optional, but I would greatly appreciate your feedback on this assessment:

Overall Experience

What are your general thoughts about the assessment? Did you find it engaging, easy to navigate, and understand? Why or why not?

Clarity of Instructions

Were the instructions provided clear and easy to follow? Did you encounter any difficulties or confusion while completing the assessment? If yes, please explain.

Relevance of Questions

Did you feel that the assessment questions were relevant to the assessment's stated objectives? Were there any questions that you found unnecessary or unrelated? Are there areas in your life that you do not feel were covered by this assessment? Which questions felt unclear or ambiguous? Please provide specific examples, if applicable.

Assessment Length

How would you rate the length of the assessment? Was it too short, too long, or just right? Did you feel any questions could be eliminated or condensed without losing important information?

Technical Issues

Did you encounter any technical problems while taking the assessment (e.g., page loading issues, error messages, formatting errors)? If yes, please describe the problem and provide details.

Suggestions for Improvement

Based on your experience with this assessment, do you have any suggestions for how it could be improved? Are there any additional features, question types, or changes you would recommend to enhance the assessment experience?

DISCLAIMER:
The survey presented here is intended to be qualitative, not quantitative, and aims to help identify different aspects of a respondent's wellbeing. It is important to note that the survey is currently being provided for research purposes and has not undergone psychometric validation, so its results should be interpreted with caution. Future administration of a published survey should involve a qualified professional who can ensure its proper use, interpret results in context, and provide necessary support or resources based on each individual's unique circumstances.

Your Result: / 100

Learn More

To learn more and dive deeper into your results, please check out my coaching and consulting services.

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DISCLAIMER:
The survey presented here is intended to be qualitative, not quantitative, and aims to help identify different aspects of a respondent's wellbeing. It is important to note that the survey is currently being provided for research purposes and has not undergone psychometric validation, so its results should be interpreted with caution. Future administration of a published survey should involve a qualified professional who can ensure its proper use, interpret results in context, and provide necessary support or resources based on each individual's unique circumstances.

Assessments // Emotional Wellbeing Assessment

Emotional Wellbeing

Introduction

Demographics

Questionnaire

Feedback

Your Result: / 100

Learn More

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