Family Satisfaction Questionnaire
This is the SMILKSTEIN'S FAMILY SYSTEM APGAR ITEMS (original and revised version) and is only suitable for completion by people ages 8 and older.
Name
First Name
Last Name
Rate your satisfaction with each statement about your family using the following options: Almost Always, Some of the Time, Hardly Ever. The first version of each statement is for people ages 11 and older. The second version of each statement is for children ages 8 to 10. This assessment is not suitable for children under the age of 8.
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Rows
Almost Always (2pts.)
Some of the Time (1pt.)
Hardly Ever (0pts.)
I am satisfied that I can turn to my family for help when something is troubling me.
OR
When something is bothering me, I can ask my family for help.
I am satisfied with the way my family talks over things with me and shares problems with me.
OR
I like the way my family talks over things and shares problems with me.
I am satisfied that my family accepts and supports my wishes to take on new activities or directions.
OR
I like how my family lets me try new things I want to do.
I am satisfied with the way my family expresses affection and responds to my emotions, such as anger, sorrow, and love.
OR
I like what my family does when I feel mad, happy, or loving.
I am satisfied with the way my family and I share time together.
OR
I like how my family and I share time together.
Evaluation:
8–10 = Highly Functional
4–7 = Moderately Functional
0–3 = Severely dysfunctional
Submit
Should be Empty: