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Participant's Age

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Maslach' Burnout Inventory - Human Services Survey
The purpose of this survey is to discover how various persons in the human services, or helping professionals view their job and the people with whom they work closely.

1. I feel emotionally drained from my work.

2. I feel used up at the end of the workday.

3. I feel fatigued when I get up in the morning and have to face another day on the job.

4. I can easily understand how my patients feel about things.

5. I feel I treat some patients as if they were impersonal objects.

6. Working with people all day is really a strain for me.

7. I deal very effectively with the problems of my patients.

8. I feel burned out from my work.

9. I feel I'm positively influencing other people's lives through my work.

10. I've become more callous toward people since I took this job.

11. I worry that this job is hardening me emotionally.

12. I feel very energetic.

13. I feel frustrated by my job.

14. I feel I'm working too hard on my job.

15. I don't really care what happens to some patients.

16. Working with people directly puts too much stress on me.

17. I can easily create a relaxed atmosphere with my patients.

18. I feel exhilarated after working closely with my patients.

19. I have accomplished many worthwhile things in this job.

20. I feel like I'm at the end of my rope.

21. In my work, I deal with emotional problems very calmly.

22. I feel patients blame me for some of their problems.

Non-proprietary single-item burnout measure:
I enjoy my work. I have no symptoms of burnout.

The General Self-Efficacy Scale
The General Self-Efficacy Scale is a 10-item psychometric scale that is designed to assess optimistic self-beliefs to cope with a variety of difficult demands in life.

1. I can always manage to solve difficult problems if I try hard enough.

2. If someone opposes me, I can find the means and ways to get what I want.

3. It is easy for me to stick to my aims and accomplish my goals.

4. I am confident that I could deal efficiently with unexpected events.

5. Thanks to my resourcefulness, I know how to handle unforeseen situations.

6. I can solve most problems if I invest the necessary effort.

7. I can remain calm when facing difficulties because I can rely on my coping abilities.

8. When I am confronted with a problem, I can usually find several solutions.

9. If I am in trouble, I can usually think of a solution.

10. I can usually handle whatever comes my way.

The Life Satisfaction Scale
The insights we gain from this Life Satisfaction Survey will provide an indication how happy you feel on your current life's path, and should take a maximum of 5 minutes to complete.

1. I know what my purpose in life is.

2. I am excited about learning new things and developing my skills and talents.

3. My life is in balance physically.

4. My life is in balance emotionally.

5. My life is in balance spiritually.

6. When life feels "out of control," I choose healthy behaviors to help me re-center and renew. (i.e. I do not use shopping, eating, sleeping, television / internet, or other substances to escape and cope).

7. I am aware and enjoy living in the moment (I don't dwell on future or past events).

8. I have fulfilling relationships with family and friends.

9. I have fulfilling intimate relationships in my life.

10. Humor, laughter, and playfulness are a big part of my daily life.

11. My partnerships are fairly and equally balanced (work and personal).

12. I find positive ways to deal with stress. (i.e. exercise, talking, meditating, etc).

13. I exercise appropriate control over the things that I can in my life.

14. I live life with an attitude of gratitude.

15. I live my life with passion and joy.

16. I have exciting dreams and aspirations to look forward to.

17. I am an optimistic person.

18. I enjoy hearing other people's insights and points of view, even when they are different from my own.

19. I find it easy to forgive others when I have been hurt.

20. I apologize and make amends quickly when I have hurt someone else.

21. I am good at keeping events in my life in perspective.

22. I live my life with integrity and honesty in all of my dealings.

23. Kindness and compassion are virtues that I practice daily.

24. I perform acts of service daily.

25. I have a strong faith which sustains me throughout my life.

The Workplace Stress Scale
Copyright © The Marlin Company, North Haven, CT, and the American Institute of Stress, Yonkers, NY

Directions: Thinking about your current job, how often does each of the following statements describe how you feel?

1. Conditions at work are unpleasant or sometimes even unsafe.

2. I feel that my job is negatively affecting my physical or emotional well being.

3. I have too much work to do and/or too many unreasonable deadlines.

4. I find it difficult to express my opinions or feelings about my job conditions to my colleagues.

5. I feel that job pressures interfere with my family or personal life.

6. I have adequate control or input over my work duties.

7. I receive appropriate recognition or rewards for good performance.

8. I am able to utilize my skills and talents to the fullest extent at work.

Please list hobbies/activities and past times in which you participate to balance your life:

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