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Leeds Mental Wellbeing Service

Sleep Well Session - 1st July

Event starts: 1st Jul 2021 1:00pm

Event ends: 1st Jul 2021 3:00pm

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By signing up to online classes you will automatically give text consent as this is how we contact you to register for each class.

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Below are a few short questionnaires to help us understand your current symptoms. You will be asked to complete these for every session with our service, to help us your progress.

PHQ-9*

Over the last 2 weeks, how often have you been bothered by any of the following problems?Not at allSeveral daysMore than half the daysNearly every day
1Little interest or pleasure in doing things
2Feeling down, depressed, or hopeless
3Trouble falling or staying asleep, or sleeping too much
4Feeling tired or having little energy
5Poor appetite or overeating
6Feeling bad about yourself - or that you are a failure or have let yourself or your family down
7Trouble concentrating on things, such as reading the newspaper or watching television
8Moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual
9Thoughts that you would be better off dead or of hurting yourself in some way

GAD-7*

Over the last 2 weeks, how often have you been bothered by any of the following problems?Not at allSeveral daysMore than half the daysNearly every day
1Feeling nervous, anxious or on edge
2Not being able to stop or control worrying
3Worrying too much about different things
4Trouble relaxing
5Being so restless that it is hard to sit still
6Becoming easily annoyed or irritable
7Feeling afraid as if something awful might happen

Phobia scales*

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • Would not avoid
  • Slightly avoid
  • Definitely avoid
  • Markedly avoid
  • Always avoid
Choose a number from the scale above to show how much you would avoid each of the situations or objects listed below.
1Social situations due to a fear of being embarrassed or making a fool of myself
2Certain situations because of a fear of having a panic attack or other distressing symptoms (such as loss of bladder control, vomiting or dizziness)
3Certain situations because of a fear of particular objects or activities (such as animals, heights, seeing blood, being in confined spaces, driving or flying)

Work and social adjustment scales*

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • Not at all
  • Slightly
  • Definitely
  • Markedly
  • Very severely, I cannot work
People's problems sometimes affect their ability to do certain day-to-day tasks in their lives. To rate your problems look at each section and determine on the scale above how much your problem impairs your ability to carry out the activity
1WORK - If you are retired or choose not to have a job for reasons unrelated to your problem, please tick N/A (not applicable)
2HOME MANAGEMENT - Cleaning, tidying, shopping, cooking, looking after home/children, paying bills etc.
3SOCIAL LEISURE ACTIVITIES - With other people, e.g. parties, pubs, outings, entertaining etc.
4PRIVATE LEISURE ACTIVITIES - Done alone, e.g. reading, gardening, sewing, hobbies, walking etc.
5FAMILY AND RELATIONSHIPS - Form and maintain close relationships with others including the people that I live with

Medications

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Employment status questions

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Employment advisors in IAPT pilot questions

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If yes, please tick the benefits you currently receiveYesNoPrefer not to say
Jobseekers Allowance (JSA)
Employment Support Allowance (ESA)
Universal Credit (UC)
Personal Independence Payment (PIP)
Other
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