The purpose of this activity is to help you in identifying a sense of your spirituality. There are no “right” or “wrong” answers. It is provided to guide you as you think through what brings you a sense of meaning and comfort.

1. What are the most important relationships in your life?
 

  My family of origin (parents, siblings, etc)

  A significant other or spouse

  Children

  Friends

  God or a Higher Power

  People I work with

  Other ______________________

2. Who or what helps you find meaning and a sense of purpose?
 

  Family relationships

  Friendships

  Work

  Relationships with the earth/environment

  God/Higher Power

  Other _____________________

3. What helps you cope in difficult times?
 

  Support of family/friends

  Belief in the basic goodness of life

  Faith in God/Higher Power

  Music/poetry/literature

  Prayer or meditation

  Other _____________________

4. How do you take care of yourself?
 

  Time alone

  Talking with others

  Physical exercise, diet

  Prayer, meditation, or other ritual

  Nothing

  Other _____________________

5. Do you believe in God/a Higher Power?
 

  Yes

  Somewhat

  No

6. If yes, how would you describe God/your Higher Power?
 

  Angry

  In control of all events

  Judging

  All-knowing

  Kind

  Able to do anything

  Loving

  Other ______________________

7. If no, what are your beliefs about life?
 

  Random events

  Meaning comes from ________________

  Hopelessness

  Other _______________________

8. Are there any spiritual practices that are important to you?
 

  Attending religious services

  Prayer

  Reading Scripture

  Meditation

  Rituals

  Yoga

  Other _______________________

 

If you'd like to discuss any of these questions, you can Chat with a Counselor.

This scale is designed to help you to examine what spiritual strengths you have as well as potential areas of distress. There are no “right” or “wrong” answers, however it will help you in identifying areas in which you may want to seek further resources or support.

  I feel . . . 3
Strongly
2
Not as Much as I Would Like
1
Not at All
1 God/a Higher Power’s presence amidst my/my loved one’s illness.      
2 At ease about my disease/loved one’s disease.      
3 Confident in my/my loved one’s treatment process.      
4 At peace about my/my loved one’s future.      
5 Strength in my sense of spirituality or religious beliefs.      
6 Supported by others who will listen to my fears and hopes.      
7 Meaning in religious or spiritual rituals.      
8 Comforted by my religious or spiritual beliefs.      
9 That my/my loved one’s treatment team knows and understands our religious and spiritual beliefs.      
10 Reassured that my support system hears and respects my religious or spiritual beliefs and questions.      
Total      

 

If you find that there is one or more areas where you marked a 2 or a 1, you may want to focus on the resources available on this site to help you with questions or find support. Or you may want to connect with a counselor through our free service, Chat with a Counselor.