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Confidential help survey posted in
Help Yourself Now
or at the drjanyager.com website by Jan Yager, Ph.D. (Copyright 2020, 2019, 2018, All rights reserved)
1.
How did you hear about this survey?
Link posted in HELP YOURSELF NOW by Dr. Jan Yager
Link posted in RESOURCES section of www.drjanyager.com website
HARO (Help a Reporter Out)
Colleague sent me a link
Friend sent me a link
Relative sent me a link
Read about it in the media
Author sent a link
Other (please specify)
2.
Check off any and/or all of the roles that follow that apply to you related to offering or seeking help
I professionally or through my association, organization, or agency offer help
I have sought help, on one or more occasions
I am a researcher or journalist who writes about help
Other (please specify)
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.)
Counselor
Administrator
Physician
Social worker
Researcher
Trainer
Blogger
Author
Intervention specialist
volunteer
CEO
software provider
marketing specialist
coping advocate
Other (please specify)
4.
Please share about what motivated you to offer help in your current capacity.
5.
If you are a recipient of help, please share about the help that you received.
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.
national
international
regional
statewide
local
online only
Other (please specify)
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.)
stigma
pride
not yet self-aware that help is needed
depression
cost
old habits are hard to break
too busy with work or family obligations
pride
Other (please specify)
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.)
stigma
pride
not yet self-aware that help is needed
depression
cost
old habits are hard to break
too busy with work or family obligations
pride
Other (please specify)
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?
Yes
No
10.
If you answered "yes" to the previous question, please share your comments, and any suggested questions, in this space.
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.
Psycho-cybernetics by Maxwell Maltz, M.D.
The 7 Habits of Highly Effective People by Stephen Covey, Ph.D.
On Death and Dying by Elisabeth Kubler-Ross
Man's Search for Meaning by Viktor E. Frankl
Beyond Feast Or Famine: Daily Affirmations for Compulsive Eaters by Susan K. Ward
What Life Should Mean to You by Alfred Adler
The Procrastinator's Handbook by Rita Emmett
When Friendship Hurts by Jan Yager, Ph.D.
One Day My Soul Just Opened Up by Iyanla Vanzant
How to Win Friends and Influence People by Dale Carnegie
Self-Therapy by Muriel Schiffman
Intimate Relations by Murray S. Davis
Other (please specify)
12.
Please share any other comments you have below:
13.
Thank you for sharing your contact information in case I want to do follow-up by phone or e-mail.
Name
Company
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Country
Email Address
Phone Number
*
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.)
(Required.)
Yes
No
*
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
(Required.)
You may use my quotes anonymously.
If you wish to use my quotes, I prefer to have my first and last name used and for you to share with me any quotes that you wish to include.
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?
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?
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.
Addiction
Adoption and foster care
Aging
Animal Rights
Arts
Business
Children including Child abuse and neglect
Citizen Action and Politics
Criminal justice system
Crime, crime victims, and crime prevention
Developmental disabilities
Counseling and mental health
Dying, Death, and Grief
Education
Emergencies and Disasters
Employment
Financial Assistance
Food, Hunger, Nutrition, and Eating Disorders
Gambling
LGBT
Health and Wellness
Housing and Homelessness
Immigration
Information Rights, Resources, and Technology
Legal Services
Offenders and Ex-Offenders
Parenting
Pregnancy and Childbearing
Relationships
Safety
Sex Education, Therapy, and Family Planning
Suicidal ideation, suicide, and suicide prevention
Transportation, Travel, and Recreation
Veterans
Volunteerism
Other (please specify)
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.
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?
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.
Addiction
Adoption and foster care
Aging
Animal Rights
Arts
Business
Children including Child abuse and neglect
Citizen Action and Politics
Criminal justice system
Crime, crime victims, and crime prevention
Developmental disabilities
Counseling and mental health
Dying, Death, and Grief
Education
Emergencies and Disasters
Employment
Financial Assistance
Food, Hunger, Nutrition, and Eating Disorders
Gambling
LGBT
Health and Wellness
Housing and Homelessness
Immigration
Information Rights, Resources, and Technology
Legal Services
Offenders and Ex-Offenders
Parenting
Pregnancy and Childbearing
Relationships
Safety
Sex Education, Therapy, and Family Planning
Suicidal ideation, suicide, and suicide prevention
Transportation, Travel, and Recreation
Veterans
Volunteerism
Other (please specify)
22.
What is your age?
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
23.
Please describe your race/ethnicity.
24.
What is your current religion, if any?
Christian/Protestant/Methodist/Lutheran/Baptist
Catholic
Mormon
Greek or Russian Orthodox
Jewish
Muslim
Buddhist
Hindu
Atheist or agnostic
Nothing in particular
Other
25.
If you are affiliated with an organization, association, company, or agency that OFFERS help, what year were you founded or started?
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.
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.
Current Progress,
0 of 27 answered