ECHO - Student Survey: Selective Prevention

ECHO
(Education and Counseling for High School Opportunities)
Student Survey: Selective Prevention
CDAC Behavioral Healthcare, Inc.

Counselor

Name of counselor

Name

First NameLast Name

School

Name of school

Date

Date of completion

Type of Survey:

Main area in which you are experiencing difficulties:

For the statements below, select the answer that best describes your attitude and feelings at this time related to the problem selected above.

I would describe my stress level related to my problem as:

I know and use positive coping skills to handle my problem.

I have confidence that my problem(s) can be resolved.

I have reached out to positive friends/peers who can support me with my problem.

I have access to positive adults who encourage, support and help me when I need it.

I have a strong commitment to school.