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  • WORTH, ESTEEM, & SIGNIFICANCE (WES) ASSESSMENT

    Research Consent Form
  • Introduction:
       You are participating in a self-assessment study exploring worth, esteem, and significance in personal and relational contexts. Your participation is voluntary, and you may withdraw at any time without penalty. Please review the following information carefully before proceeding. 

       NOTE: The WES Assessment is an exploratory framework intended to support personal insight and relational understanding. It is not a diagnostic tool, nor is it currently validated through clinical research. This instrument is part of an evolving body of work that may change as future research, theory development, and practitioner feedback emerge. Users are encouraged to engage with the material using their own sound judgment, critical thinking, and in consultation with a qualified professional when appropriate. Interpretations and suggestions provided within this report should be considered informational and reflective; not definitive or prescriptive. Use of this tool is voluntary and undertaken at your own discretion and risk.


    1. Purpose of the Assessment
    The WES Assessment helps individuals reflect on how they perceive self-worth, esteem, significance, and relational experiences. This tool is for self-reflection and insight and is not a diagnostic instrument. This report generated by your responses is intended for self-reflection and personal growth, should not be used as, or considered to be, a diagnostic tool, and should be used in conjunction with therapy, mentoring, or coaching.


    2. What to Expect
    You will complete a 48-question survey measuring different aspects of self-worth and relationships.
    Responses will be rated on a 5-point scale (Strongly Agree to Strongly Disagree).
    The assessment will take approximately 5 to 10 minutes to complete.
    Upon completion, you may receive a summary of your results for self-reflection.

    3. Confidentiality & Data Protection
    Your responses will be kept confidential and stored securely.

    No personally identifying information is required unless you choose to share it.
    Data may be used for research or educational purposes, but only in aggregated and anonymized form.
    Individual results will not be shared with third parties without your consent.
    If you have concerns about data security, you may contact Nathan D. Croy at info@ex-ft.com.


    4. Potential Risks & Benefits
    Risks:
    Some questions may prompt emotional reflection on self-worth or relationships.
    If you feel uncomfortable, you may skip questions or exit the assessment at any time.
    If you experience distress while completing this assessment and would like to seek professional support, the following resources may be helpful:

    📞 Immediate Support (Crisis Hotlines)

    • 988 Suicide & Crisis Lifeline (U.S.) – Call or text 988 for 24/7 support.
    • Crisis Text Line (U.S. & International) – Text HOME to 741741 to connect with a trained crisis counselor.
    • SAMHSA National Helpline (Substance & Mental Health Support) – Call 1-800-662-HELP (4357) for free, confidential treatment referrals.


    🌍 Find a Therapist

    • Psychology Today Therapist Directory: www.psychologytoday.com
    • Open Path Collective (Low-Cost Therapy): www.openpathcollective.org
    • Mental Health America (MHA) Resources: www.mhanational.org

    🏥 Insurance & Community Mental Health

    Contact your insurance provider for in-network mental health services.
    Search for a Community Mental Health Center (CMHC) in your area via FindTreatment.gov.
    If you are in immediate danger or need urgent help, please call 911 or go to the nearest emergency room.

    Benefits:
    Increased self-awareness of personal strengths and growth areas.
    A structured framework for reflecting on self-worth and relationships.
    Opportunity to identify patterns and make intentional changes.


    5. Voluntary Participation & Right to Withdraw
    You are not required to participate.
    You may stop the assessment at any time without penalty.
    If you withdraw, your responses will not be saved or analyzed.

    6. Contact Information
    If you have questions, concerns, or wish to withdraw your data, please contact:

    Nathan D. Croy
    Licensed Clinical Marriage & Family Therapist (LCMFT)
    Member, American Association for Marriage and Family Therapy (AAMFT)
    Info@ex-ft.com 888.631.3938

    For concerns about research ethics, you may contact AAMFT Ethics Committee at ethics@aamft.org.

     

  • WES Assessment

    This assessment is designed to be used with a therapist who can facilitate meaningful interpretations of the results in order to increase insight and awareness. This process is for self-exploration and should not be taken as a diagnosis. If you have concerns about your mental health or relationships, please consult a qualified professional. You will not be able to see your results as they rely on an interpretation from a mental health professional who has been adequately trained on interpreting the WES.
  • Instructions

    Please select the option that best represents how much you agree or disagree with each statement. Your first reaction is what you should choose.
  • CWES Instructions

    Please select the option that best represents how much you agree or disagree with each statement as it relates to your work. Your first reaction is what you should choose.
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