Checklist of Characteristics of Family Dynamics

Name

First Name Last Name

Email

example@example.com

Phone Number

Area Code Phone Number

Please place a "Y" for Yes if you are experiencing any of the following characteristics and an "N" for No if you are not.

Tip toeing around issues, at a loss for what to say and scared of conflict.

Don't' know what to say or how to help your family member.

Frustrated with constant conflict.

Feeling hopeless, as though nothing will change or help.

Children not connecting with parent (s).

Not understanding certain behaviours of family members or yourself.

Asking "why us or why me?"

Desperate to rescue loved one from pain and hurt.

Mental Illness/Addictions and struggles are consuming the family.

Family near the brink of collapsing.

Severe Illness- period of shock and disorganization.

Desperate for information and support.

Devastated when loved one is hospitalized with a psychotic episode.

Exhausted and depleted.

Financial concerns.

Compassion but a lack of understanding.

No motivation from loved one.

Isolation- feeling alone while dealing with issues.

Absorbed in loved ones life.

No self-care.

In a cycle of fixing.

Poor decision making from loved one.

Constant drama surrounding situations.

Communication is more yelling than constructive conversations.

Boundaries are not consistent.

Other issues not listed.