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Hope Checklist
Oct 3, 2016
•
Mark Morgan
categories:
Psychiatry & Psychology
Hope Checklist
QUOTE: Just as despair can come to one only from other human beings, hope, too, can be given to one only by other human beings. -Elie Wiesel
INSTRUCTIONS: Respect the tragedy of lost hope and work to rebuild it. Use this checklist to help the patient find their sources of hope, comfort, and peace.
-Choose-
No
Yes
<-- Do you have spiritual or cultural beliefs that help you?
-Choose-
No
Yes
<-- Do you have children?
-Choose-
No
Yes
<-- Do you have other family members that you support?
-Choose-
No
Yes
<-- Do you have family members that support you?
-Choose-
No
Yes
<-- Do you have pets?
-Choose-
No
Yes
<-- Do you have a supportive friend or group of friends?
-Choose-
No
Yes
<-- Do you have a job or vocation that is fulfilling?
-Choose-
No
Yes
<-- Do you have a hobby or other activities that you enjoy?
-Choose-
No
Yes
<-- Are there any activities that want to do in the future?
-Choose-
No
Yes
<-- Are there any places you want to see in the future?
-Choose-
No
Yes
<-- Are there any experiences you want to have in the future? (sites you'd like to see, tastes you'd like to taste, music you'd like to hear)
-Choose-
No
Yes
<-- Do you have any positive memories that give you comfort?
-Choose-
No
Yes
<-- Are there other things that give you hope, strength, comfort, or peace?
display/hide references
reference:
#1
Saguil, A., & Phelps, K. (2012). The spiritual assessment. American family physician, 86(6).
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