Solution-Focused Recovery Scale for Abuse Survivors


Copyright © 1988, 1993 by Yvonne Dolan, M.A.; Revision © 1995 by Yvonne Dolan & Lynn Johnson. All rights reserved. For duplication, see below.

Name_______________________________________________ Date: __________________________

Circle the number that applies to you today: 0 = Not at all, 1 = Just a little, 2 = Occasionally, 3 = Some of the time; a fair amount of the time; 4 = Frequently or most of the time.

| 0 | 1 | 2 | 3 | 4 | A. I am able to think/talk about the abuse or the sexual abuse when it is appropriate.
| 0 | 1 | 2 | 3 | 4 | B. I am able to think/talk about things other than the abuse or sexual abuse.
| 0 | 1 | 2 | 3 | 4 | C. I sleep adequately; I don't feel unusually sleepy in the daytime.
| 0 | 1 | 2 | 3 | 4 | D. I feel part of a supportive family.
| 0 | 1 | 2 | 3 | 4 | E. I stand up for my self (I am reasonably assertive).
| 0 | 1 | 2 | 3 | 4 | F. I maintain physical appearance (weight, hair, nails etc.)
| 0 | 1 | 2 | 3 | 4 | G. I go to work; I am on time, I am reasonably productive.
| 0 | 1 | 2 | 3 | 4 | H. I am satisfied with my work.
| 0 | 1 | 2 | 3 | 4 | I. I engage in social activities outside the home.
| 0 | 1 | 2 | 3 | 4 | J. I have a healthy appetite.
| 0 | 1 | 2 | 3 | 4 | K. I care for child, loved ones, pets. (I can take care of others.)
| 0 | 1 | 2 | 3 | 4 | L. I adapt to new situations.
| 0 | 1 | 2 | 3 | 4 | M. I initiate contact with friends, loved ones.
| 0 | 1 | 2 | 3 | 4 | N. I show a sense of humor.
| 0 | 1 | 2 | 3 | 4 | O. I am interested in future goals.
| 0 | 1 | 2 | 3 | 4 | P. I pursue leisure activities.
| 0 | 1 | 2 | 3 | 4 | Q. I exercise regularly.
| 0 | 1 | 2 | 3 | 4 | R. I take sensible protective measures inside and outside house.
| 0 | 1 | 2 | 3 | 4 | S. I choose supportive relationships over non-supportive ones.
| 0 | 1 | 2 | 3 | 4 | T. I am able to relax without drugs or alcohol.
| 0 | 1 | 2 | 3 | 4 | U. I seem to tolerate constructive criticism well.
| 0 | 1 | 2 | 3 | 4 | V. I seem to accept praise well. I thank the person giving the praise.
| 0 | 1 | 2 | 3 | 4 | W. I enjoy a healthy sexual relationship. I can give and accept intimacy.
| 0 | 1 | 2 | 3 | 4 | X. I have long term friendships.
| 0 | 1 | 2 | 3 | 4 | Y. I am satisfied with relationship with spouse or partner.
| 0 | 1 | 2 | 3 | 4 | Z. My partner or spouse would say that relationship is healthy and satisfying.

OTHER SIGNS OF RECOVERY (Please list any which are important to you):
| 0 | 1 | 2 | 3 | 4 | AA. My dreams are usually tolerable and not very upsetting.
| 0 | 1 | 2 | 3 | 4 | BB. My attention span is fairly good and I can concentrate well.
| 0 | 1 | 2 | 3 | 4 | CC. I experience a wide range of emotions, both pleasant and unpleasant.
| 0 | 1 | 2 | 3 | 4 | DD. People would say I am more calm than jumpy

List any others below:
| 0 | 1 | 2 | 3 | 4 | ______________________________________________________________________________
| 0 | 1 | 2 | 3 | 4 | ______________________________________________________________________________
| 0 | 1 | 2 | 3 | 4 | ______________________________________________________________________________
| 0 | 1 | 2 | 3 | 4 | ______________________________________________________________________________
| 0 | 1 | 2 | 3 | 4 | ______________________________________________________________________________
This form may be duplicated if the copyright notice is attached and if the individual or organization duplicating this form does not charge patients or colleagues for copying costs. It is expressly  forbidden  to  charge for distribution or copying. For more information, contact Yvonne Dolan M.A. This form is based on Resolving Sexual Abuse, by Y. Dolan, published by Norton Books.