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* 1. How did you hear about this survey?

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* 2. Check off any and/or all of the roles that follow that apply to you related to offering or seeking help

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* 3. If you are a help provider, what is your role? (If you do not see your role listed below, please add it in the "other" space.)

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* 4. Please share about what motivated you to offer help in your current capacity.

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* 5. If you are a recipient of help, please share about the help that you received.

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* 6. If you are affiliated with an organization or an association, please share in greater detail about your membership checking off anything that applies and adding more information in the "other" comment box.

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* 7. From the perspective of someone OFFERING help, what do you see as the challenges facing those who need help? Check off all that apply. (Please note: There is a "glitch" that you can't check off more than one so please put in the OTHER COMMENT BOX -- any additional answers you want to share.)

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* 8. From the perspective of someone SEEKING help, what do you see as the challenges facing those who need help? Check off all that apply. (Please note: There is a "glitch" that you can't check off more than one so please put in the OTHER COMMENT BOX -- any additional answers you want to share.)

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* 9. My new book is called HELP YOURSELF. Are there any additional questions related to offering, or seeking, help that I should be asking in this survey?

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* 10. If you answered "yes" to the previous question, please share your comments, and any suggested questions, in this space.

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* 11. It used to be called "bibliotherapy" and later it would just be called a "self-help" book." Please look over the list below and check off any of these books that you have read and that you found personally or professioally useful related to just about any health or mental health issue. Even business or relationship books are welcome. If there are any additional books you want to recommend that are missing from this list, please add those titles in the "Other" section. Also, if you wish to annotate why a book was so useful, those comments will be appreciated.

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* 12. Please share any other comments you have below:

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* 13. Thank you for sharing your contact information in case I want to do follow-up by phone or e-mail.

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* 14. You are more than 13 years of age and you grant permission to the use your completed survey for statistical purposes. (In the next question I will ask about guidelines for quoting from your survey.)

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* 15. If I do wish to quote from your survey, you grant permission to me to do that as long as the following criteria are met

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* 16. If you, or a family member or friend, need help, what kind of help would you like to receive? What do you think that help should be like, especially if it is different from the help you are currently (or previously) have been offered?

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* 17. If you are someone GIVING help, what do you do to make sure you also get help and/or prevent burning out from providing help?

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* 18. If you are someone providing help, check off the key area you give help in. If you provide help in more than one area, you could list those additional areas in the "Other" comment box.

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* 19. Are there are any associations, organizations, agencies, or individuals that you suggest I consider contacting and/or including in my new book, HELP YOURSELF? If so, please add that in the comment box and/or provide as much contact information as possible, e.g. website address, e-mail, phone number, etc.

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* 20. For those who are receiving help, is there anything additional you want help providers to know about you and/or your situation to improve the experience?

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* 21. If you are someone WHO HAS RECEIVED help, check off the key area you received help in. If you received help in more than one area, you could list those additional areas in the "Other" comment box.

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* 22. What is your age?

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* 23. Please describe your race/ethnicity.

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* 24. What is your current religion, if any?

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* 25. If you are affiliated with an organization, association, company, or agency that OFFERS help, what year were you founded or started?

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* 26. If there is ONE COMMENT or INSIGHT about OFFERING help you would like to share, what would that be? Please list that comment/insight below.

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* 27. If there is ONE COMMENT or INSIGHT about RECEIVING help you would like to share, what would that be? Please list that comment/insight below.

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