Question 1
Are you engaging in a behaviour you cannot seem to stop on your own?
E.g. substance use, self cutting, anger, food, online use, gambling...
NOTE: 'STOP' means ending the behaviour(s) for as long as you wish vs. Stop-Start-Stop-Start...etc... (i.e. I no longer smoke vs. I've quit smoking twenty times already)
| Yes | No |
Control Scale
On a scale of 1 (behaviour is totally in control) to 10 (behaviour is totally out of control)
| My score is |
Question 2
Does this behaviour have ANY destructive consequences?
Is it affecting your health, stress, relationships, sleep, school, work, eating, self-esteem etc… in any way?
| Yes | No |
Destructiveness Scale
On a scale of 1 (no destructive consequences) to 10 (behaviour is highly destructive i.e. to one's health, stress, relationships, sleep, school, work, eating, self-esteem etc)
| My score is |