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Spiritual Assessment
Please answer the following questions honestly. This assessment is designed to help both you and your counselor understand your current spiritual state and areas where you may seek growth or guidance.
Name
First Name
Last Name
Part 1: Personal Reflection
1. What does spirituality mean to you? ( Is it faith-based, connected to nature, focused on mindfulness, or something else?)
2. How connected do you feel to a higher power, purpose, or inner self on a daily basis? ( Rate on a scale of 1-10, where 1=disconnected, 10=deeply connected.)
3. What activities or practices bring you peace, fulfillment, and connection to your spiritual self? ( Examples: Prayer, meditation, journaling, volunteering, worship, nature walks, etc.)
4. When was the last time you felt truly aligned or at peace spiritually? What were you doing?
5. Do you feel like you have a purpose in life? If so, how clear is that purpose to you?
Part 2: Current Practices
6. How often do you engage in spiritual practices (prayer, meditation, worship, etc.)?
Daily
Weekly
Occasionally
Rarely
Never
7. What obstacles (time, mindset, fear, etc.) prevent you from connecting with your spirituality more deeply?
8. Do you have a community (faith group, mentor, or friends) that supports your spiritual growth? If not, would you like to find or build one?
9. What role do gratitude, forgiveness, and self-compassion play in your spiritual life?
10. How often do you reflect on your values, beliefs, and life purpose?
Part 3: Spiritual Wellness Goals
11. What areas of your spiritual life do you feel need growth or attention? (Example: Finding purpose, developing consistency, deepening trust in a higher power, learning mindfulness techniques, etc.)
12. What are 2-3 spiritual goals you want to achieve over the next 3–6 months? (Examples: Meditate for 10 minutes daily, read scripture weekly, practice gratitude journaling, attend a spiritual group, etc.)
12. When someone's talking to me, I think about what I'm going to say next to make sure I get my point across correctly.
Not at all
Rarely
Sometimes
Often
Very Often
13. What daily or weekly practices can you implement to foster spiritual wellness?
14. What impact would achieving these goals have on your life and overall well-being?
15. Who or what can support you on your spiritual journey (mentors, coaches, accountability partners, books, etc.)?
Spiritual Wellness Score (optional)
Assign a score for how you feel in each area:
1. Connection to a higher power or purpose (1–10)
2. Spiritual practices (1–10)
3. Sense of life purposes (1-10)
4. Peace and inner fulfillment (1-10)
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