THE MAYERS LIFE-STYLE QUESTIONNAIRE (2) Please answer all relevant questions, whatever the nature of your problem, by putting a

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1 Nm: THE MAYERS LIFE-STYLE QUESTIONNAIRE (2) Dt: Pls nswr ll rlvnt qustions, whtvr th ntur of your prolm, y putting in th pproprit olumn/ox. 1. LOOKING AFTER YOURSELF f g h i j k l m n o Ar you l to: Inpnntly With iffiulty With xtrm iffiulty - gt up in th morning t n pproprit tim - slp qutly - mintin prsonl hygin to your stisftion - wsh your loths - shop for foo - prpr n ook foo - mng your hlth prolms inluing mition - ht your hous qutly - ln your hous to your stisftion - o your grning to your stisftion (if you hv grn n njoy grning) - us tlphon - r wht you wnt / n to r - writ wht you wnt / n to writ / us intrnt - us puli trnsport lon - riv r if you r r rivr Dr Chris Myrs 2004 Upt My 2015 Profssor Chris Myrs

2 2. LIVING SITUATION Do you: Ys No - lik whr you liv (your hous / flt / shr ommotion) - hv th lvl of privy tht you woul lik - fl sf in your hom - fl sf within th town / villg in whih you liv 3. LOOKING AFTER OTHERS - if you hv rsponsiility for othr popl / nothr prson, is thr ny wy in whih you n hlp - if you hv pt, is thr ny wy in whih you n hlp Ys No 4. BEING WITH OTHERS f g h Do you: Ys Osionlly No - njoy th ompny of othr popl - gt lonly - njoy your own ompny - mk frins sily - visit / tlk to your fmily or frins rgulrly - hv frins to support you, if you fl you n it - hv prtnr / girlfrin / oyfrin / spous - fl h /sh givs you qut support Dr Chris Myrs 2004 Upt My 2015 Profssor Chris Myrs

3 5. BEING IN OR OUT OF WORK / ATTENDING COLLEGE - r you in pi mploymnt - r you in shltr mploymnt - o you o ny voluntry work - woul you lik to in pi mploymnt/shltr mploymnt/voluntry work - if you r stunt, r you l to ttn Collg rgulrly Ys No f - if t work or Collg, r you l to work/stuy Inpnntly With iffiulty With xtrm iffiulty 6. YOUR BELIEFS AND VALUES - o you hv rligious / spiritul lifs tht r importnt to you - o you lik to with othrs who hv similr lifs / vlus - r you l to join othrs with similr lifs Ys No 7. FINANCES Do you: Ys No - riv nfits - hv qut mony for your ns n thos of your fmily - hv iffiulty ugting/mnging your mony - hv iffiulty ollting pnsion or nfits Dr Chris Myrs 2004 Upt My 2015 Profssor Chris Myrs

4 8. CHOICES Ar you l to: Ys Osionlly No - liv fling you r in ontrol of your lif - hoos wht you wnt to o in y / wk - o som tivitis y yourslf, kping your inpnn - prtiipt in som tivitis tht giv you stisftion - fl goo out yourslf s prson 9. ACTIVITIES YOU ENJOY DOING Ar you l to o th lisur tivitis you njoy oing / wnt to o: (list up to 5 tivitis) Inpnntly With iffiulty With xtrm iffiulty Hving fill in this form, pls go k ovr it n put x ginst th rs whih r of most onrn to you Dr Chris Myrs Upt My 2015 Profssor Chris Myrs

5 Guilins for th us of th ontt lttr n Myrs Lifstyl Qustionnir (2) Th ontt lttr n Myrs Lifstyl Qustionnir (2) r instrumnts us to monstrt prson-ntr pproh within ouptionl thrpy prti for popl with nuring mntl hlth prolms. Th Lifstyl Qustionnir (2) givs usrs of th srvi n opportunity to intify thir priority ns in rltion to thir qulity of lif for intrvntion gins. Popl with nuring mntl hlth prolms wr intrviw out thir qulity of lif (Myrs, 2000) n following nlysis of ths intrviws, th Myrs Lifstyl Qustionnir (2) ws wor. It inlus ll rs tht th intrviws onsir importnt n follow full litrtur rviw on qulity of lif. A pilot stuy n min stuy hv n omplt to vlut th us of th ontt lttr n Myrs Lifstyl Qustionnir (2). Th ovrll rspons ws positiv. An vlution of th min stuy ws pulish in th British Journl of Ouptionl Thrpy (Myrs, 2003). Th Myrs Lifstyl Qustionnir (2) n us in on of two wys: snt out to th lint with th ontt lttr on rfrrl hs n riv. Th lint is nourg to omplt th Lifstyl Qustionnir (2) for you mk your first visit. givn to th lint to omplt, possily with your hlp, whn you mk your first visit. Th pilot stuy n min stuy init tht this ws th mtho prfrr y most lints. It n omplt whilst you r thr or lft with th lint to omplt for you mk th son visit. H/sh my n som tim to think out th positioning of th tiks. >>>>> Dr Chris Myrs 2004 Upt My 2015 Profssor Chris Myrs 1.

6 Do nourg th lint to us strisks to init thir ky priority rs, s rqust t th n of th Lifstyl Qustionnir (2). On th Lifstyl Qustionnir (2) hs n omplt, tim is rquir for you n th lint to isuss th positioning of th tiks n strisks in orr for intifi prolms to lt with ppropritly uring th intrvntion. I m intrst to know your viws, n thos of your lints, out th us of th ontt lttr n Myrs Lifstyl Qustionnir (2), so pls o lt m know. Clints somtims sy tht not ll th qustions r rlvnt to thir prolm. Pls sy tht th Lifstyl Qustionnir is sign to ovr th ns of mny lints with grt vrity of prolms n vryon is iffrnt! Th ontt lttr os sy tht lint only ns to omplt th rs tht r rlvnt to him/hr. Thr is opyright nottion on th ontt lttr n Myrs Lifstyl Qustionnir (2) so pls o not hng th woring or formt. Do fl fr to photoopy. Us of th Myrs Lifstyl Qustionnir (2) s n outom msur It is suggst tht th Myrs Lifstyl Qustionnir (2) givn to th lint to omplt gin, for intrvntion ss. A omprison n thn m of th positioning of th tiks for intrvntion n towrs th n of intrvntion. Rfrns Myrs CA (2000) Qulity of Lif: Prioritis for Popl with Enuring Mntl Hlth Prolms. British Journl of Ouptionl Thrpy, 63 (12), Myrs CA (2003) Th Dvlopmnt n Evlution of th Myrs Lifstyl Qustionnir (2). British Journl of Ouptionl Thrpy, 66 (9), Dr Chris Myrs 2004 Upt My 2015 Profssor Chris Myrs 2.

7 How th Ouptionl Thrpist n hlp you.. As you hv n rfrr to n ouptionl thrpist, it is hop tht sh/h will l to hlp you to hv mor positiv qulity of lif. Th ouptionl thrpist is onrn out ll th tivitis you unrtk throughout th y. If you hv ny iffiulty oping with vryy tivitis n hv ny prolms oing tivitis tht r importnt to you, your ouptionl thrpist will try to hlp. If th ouptionl thrpist is unl to hlp, sh/h will try to put you in ontt with somon who n. Exmpls of tivitis with whih you my n our hlp: Ruing nxity out going out lon, or to th shops, n/or using puli trnsport. Offring is/informtion to hlp you xtn your soil/lisur tivitis if you wish to o so. Hlping you orgnis your tim mor fftivly. * * * * * * * * * * * * * Th ommunity ouptionl thrpist who will visiting you is: Th ontt rss n tlphon numr r: If you r l to omplt th tth Lifstyl Qustionnir for th visit, pls o so. Thn w n look togthr t th rs whr you n hlp. If you fl prts of th qustionnir r irrlvnt to you, pls o not fl you hv to omplt th whol form. Dr Chris Myrs 2004 Upt My 2015 Profssor Chris Myrs