Monarch Therapeutic Services, LLC Transforms Distress Into Hope
  • Home
  • Services
    • Addiction Recovery Counseling
    • Brief Therapy Curricula
    • Mood and Anxiety Counseling
    • Traumatic Stress Counseling
    • Coaching
  • Appointments
  • Contact
  • DCF Referrals
  • Non-DCF Referrals
  • Brief Counseling & Coaching Referrals
  • Client Resources & Service Forms
    • New Client Clinical Intake
    • Adult Assessment/Evaluation
    • Adolescent (11-17yo) Assessment/Evaluation
    • Youth (5-10yo) Assessment/Evaluation
    • Client Demographic Update
    • Client Satisfaction Survey
    • Client Transportation Request
  • Rates and Payments
    • Sliding Fee Program
    • Sliding Fee Discount Application
    • MTS Administrative >
      • Employee Admin Documents >
        • Employee Personnel Pages >
          • Chevalier B.
          • Outlaw R.
          • Agosto-Polnett, S.
          • Williams S
  • Who We Are
  • Home
  • Services
    • Addiction Recovery Counseling
    • Brief Therapy Curricula
    • Mood and Anxiety Counseling
    • Traumatic Stress Counseling
    • Coaching
  • Appointments
  • Contact
  • DCF Referrals
  • Non-DCF Referrals
  • Brief Counseling & Coaching Referrals
  • Client Resources & Service Forms
    • New Client Clinical Intake
    • Adult Assessment/Evaluation
    • Adolescent (11-17yo) Assessment/Evaluation
    • Youth (5-10yo) Assessment/Evaluation
    • Client Demographic Update
    • Client Satisfaction Survey
    • Client Transportation Request
  • Rates and Payments
    • Sliding Fee Program
    • Sliding Fee Discount Application
    • MTS Administrative >
      • Employee Admin Documents >
        • Employee Personnel Pages >
          • Chevalier B.
          • Outlaw R.
          • Agosto-Polnett, S.
          • Williams S
  • Who We Are
Search by typing & pressing enter

YOUR CART

Life Events Checklist (LEC-5)

    LEC-5

     Listed below are a number of difficult or stressful things that sometimes happen to people. For each event check one or more answer to indicate that: (a) it happened to you personally;  (b) you witnessed it happen to someone else;  (c) you learned about it happening to a close family member or close friend; (d) you were exposed to it as part of your job (ex: paramedic, police, military, or other first responder; (e) you're not sure if it fits; or (f) it doesn't apply to you. 
    BE SURE TO CONSIDER YOUR ENTIRE LIFE (GROWING UP AS WELL AS ADULTHOOD) AS YOU GO THROW THE LIST OF EVENTS.
    [object Object]
    1. Natural disaster (ex: flood, hurricane, tornado, earthquake)
    2. Fire or explosion
    3. Transportation accident (ex: car accident, boat accident, train wreck, plane crash)
    4. Serious accident at work, home, or during recreational activity
    5. Exposure to toxic substance (ex: dangerous chemicals, radiation)
    6. Physical assault (ex: being attacked, hit, slapped, kicked, beaten up)
    7. Assault with a weapon (ex: being shot, stabbed, threatened with a knife, gun, bomb)
    8. Sexual assault (ex: rape, attempted rate, made to perform any type of sexual act through force or threat of harm)
    9. Other unwanted or uncomfortable sexual experience
    10. Combat or exposure to a war-zone (in the military or as a civilian)
    11. Captivity (ex: being kidnapped, abducted, held hostage, prisoner or war)
    12. Life-threatening illness or injury
    13. Severe human suffering
    14. Sudden violent death (ex: homicide, suicide)
    15. Sudden accidental death
    16. Serious injury, harm, or death you caused to someone else
    17. Any other very stressful event or experience
Submit
Copyright © 2016