Self- Assessment

If you are wondering whether therapy could be beneficial to you, completing the following Problem Orientation Checklist will be useful in helping you make this decision. Although this tool cannot be used to diagnose any specific problem, this checklist can nonetheless be used as a guide to help you evaluate the degree to which a problem may be interfering with your life, and consequently whether you should obtain the expertise of a healthcare professional. An evaluation from a professional is required in order to evaluate whether one or more of the items below reaches clinical significance and warrants a therapeutic intervention.


There are two ways in which this questionnaire can be scored. The first way is to sum up all the values you have circled for each item in order to obtain an overall score. Then look up the Interference Index based on the score and my recommendations.
Interference Index
Mild Interference
Try my Self-Help Toolkits . If you do not experience an improvement after a few weeks,
Contact Me for a consultation.
Moderate Interference
Although you can try the Self-Help Toolkits , it is recommended that you speak to a healthcare professional for further advice.
Contact Me for a brief consultation.
Significant Interference
There are likely problems that reach clinical significance and warrant the help of a healthcare professional. Contact Me for a brief consultation.

Sometimes an overall score is not indicative of the severity of a specific problem. For example, one could rate a 1 on all the items on the Problem Orientation Checklist but score a 5 on item 6 which deals with sleep problems. A rating of five suggests that poor sleep quality is interfering daily with functioning. Specifically, a person who scores this high may not feel rested, become easily fatigued and fall asleep on the job or while driving. Although the overall score is not high, the rating on the individual item strongly suggests that some intervention is needed. If you scored a 5 or more one or more of the above items, I would recommend that you Contact Me for additional advice.

Montreal Psychologist 1310 Greene Avenue Suite 760 Montreal QC H3Z 2B2 (514) 605-7610







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