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Child Parent Psychotherapy Application

Please answer the following questions. Your answers will remain confidential. These questions help me determine where you feel your strengths and challenges are so I can best provide for your needs.

1. I share an affectionate, warm relationship with my child
2. It is easy to be in tune with what my child is feeling
3, My child and I seem to always be struggling with each other
4. My child sees me as a source of punishment and criticism
5. If upset, my child will seek comfort from me
7. My child is uncomfortable with physical affection or touch from me
9. My child values their relationship with me
6. My child expresses hurt or jealousy when I spend time with other children
8. My child remains angry or is resistant after being disciplined
10. When my child is misbehaving they respond to my look or tone of voice
11. My child appears hurt/embarrassed when I correct them
12. Dealing with my child drains my energy
13. My child does not want to accept help.
14. I've noticed my child copying my behavior or ways of doing things
15. When I praise my child they beam with pride
17. My child reacts strongly to separation from me
19. My child spontaneously shares information about themselves
21. My child is overly dependent on me
16. When my child is in a bad mood I know we're in for a long and difficult day
18. My child's feelings toward me can be unpredictable or can change suddenly
20. Despite my best efforts, I'm uncomfortable with how my child and I get along
22. I often think about my child when at work (or away from them).
23 My child easily becomes angry with me
27. My child tries to please me
29. My child feels that I treat them unfairly
31. My child asks for my help when they really do not need my help.
24. My child whines or cries when they want something from me.
28. My child is sneaky or manipulative with me.
30. My child openly shares their experiences with me.
32. My interactions with my child make me feel effective and confident as a parent

Thanks for submitting!

© 2024 by Caitlin Joyce LCSW LLC

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