• ABMBH Women's Group Therapy Screening Questionnaire

    Finding Her: The Journey Back to Yourself Format: Virtual | 8 Weeks
  • Format: (000) 000-0000.

  • Interest and Personal Goals

  • Are you interested in improving your self-esteem and confidence?*
  • Do you sometimes struggle to recognize your own needs outside of your responsibilities to others?*
  • Do you have difficulty setting boundaries or saying no?*
  • Do you frequently put other people's needs before your own?*
  • Do you struggle with people-pleasing, perfectionism, or self-doubt?*
  • Are you interested in learning healthier ways to prioritize your emotional well-being?*
  • Are you willing to explore your personal growth and identity in a therapeutic setting?*

  • Emotional Wellness

  • Do you currently experience stress, anxiety, or emotional overwhelm?*
  • Do emotional challenges currently interfere with your daily responsibilities or relationships?*
  • Are you currently experiencing a significant life transition or relationship difficulty?*
  • Do you feel that additional emotional support would be beneficial at this time?*
  • Are you currently receiving individual therapy or other mental health treatment?*
  • Do you have at least one person or resource you can turn to for emotional support?*

  • Clinical Safety and Support Needs

  • Have you experienced a mental health crisis within the past 30 days?*
  • Within the past month, have you had thoughts of suicide or harming yourself?*
  • Are you currently having thoughts of harming someone else?*
  • Are you currently having thoughts of harming another person?*
  • Have you recently experienced symptoms that make it difficult to maintain your personal safety?*
  • Are you currently experiencing substance use concerns that interfere with your daily functioning?*
  • Are you currently in a situation where participating in group therapy could place your safety or privacy at risk?*

  • Group Readiness

  • Are you comfortable participating in discussions with other women?*
  • Are you willing to listen respectfully to perspectives and experiences different from your own?*
  • Are you willing to maintain the confidentiality of information shared by other group members?*
  • Are you willing to maintain the confidentiality of information shared by other group members?*
  • Are you open to self-reflection and participating in therapeutic activities?*
  • Are you willing to work toward personal goals throughout the eight-week program?*

  • Virtual Participation and Commitment

  • Will you be physically located in Texas during each virtual group session?*
  • Do you have reliable internet access and a device that supports video sessions?*
  • Do you have a private space where others cannot hear your group sessions?*
  • Are you able to commit to attending the scheduled sessions for eight weeks?*

  • Expectations and Next Steps

  • Do you believe this group aligns with your current personal goals?*
  • Would you like to move forward with the group enrollment process?*
  • Are you willing to complete the required intake and consent documents before participating?*

  • Thank You for Taking the First Step Toward Finding Her!

     

    Thank you for your interest in Becoming Her: The Journey Back to Yourself, presented by A Beautiful Mind Behavioral Health.

    Taking time to focus on yourself, your emotional wellness, and your personal growth is an important step toward creating meaningful change.

    What Happens Next?

    Our clinical team will carefully review your screening responses to determine whether this group is an appropriate fit for your current needs. Please understand that completing this questionnaire does not guarantee enrollment.

    If additional information is needed, a member of our team may contact you to schedule a brief follow-up screening. If the group is a good fit, you will receive information about the next steps, including registration, required consent forms, and group participation details.

    Important Information About Your Participation

    This group is designed to provide a supportive therapeutic environment; however, it is not intended to replace crisis intervention, emergency mental health services, or a higher level of care when needed.

    Your responses will be handled in accordance with our privacy practices and applicable confidentiality requirements.

    If you are experiencing an immediate mental health emergency, call 911 or visit your nearest emergency department. If you are experiencing a suicidal or emotional crisis, call or text 988 for immediate support.

    We look forward to supporting you on your journey toward greater confidence, self-discovery, and emotional well-being.

    A Beautiful Mind Behavioral Health, PLLC

    Your Journey Back to Yourself Starts Here.

  • Should be Empty: