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Miscellaneous
Fill in the Blanks
Recovery
Family Life
Friends
100
What three words describe you best?
The three words that describe me best are...
100
I like to _______________ on the weekend.
I like to _____________ on the weekend.
100

What is your least favorite part about the recovery process?

My least favorite part about the recovery process is...

100
Who do you live with?
I live with...
100
Who is your best friend? What makes them your best friend?
My best friend is....He/She is my best friend because...
200

Have you traveled outside of Connecticut before? If so, where?

I have/have not traveled outside of Connecticut...

200
My favorite band is __________.
My favorite band is ____________.
200

What are your plans once you step down from IOP?

After I step down from IOP, I would like to...

200
Do you have any pets? If you could have any pet in the world, what would it be?
I do/ do not have any pets. If I could have any pet in the world, I would like to have...
200
Do you consider yourself a good friend? Why?
I consider myself a ______ friend, I feel this way because...
300
Do you consider yourself an optimist or a pessimist?
I consider myself...
300
If I could be any animal, I would want to be a ___________.
If I could be any animal, I would want to be a ___________.
300

If you could be a clinician for a day what would you do?

If I could be a clinician for the day, I would...

300
Which family member are you closest to?
The family member I am closest to is...
300
If you could be friends with any celebrity, who would it be?
If I could be friends with any celebrity, I would like to be friends with ...
400
What are you really good at?
I am really good at...
400
My least favorite thing to do is ___________.
My least favorite thing to do is _____________.
400

What do you do during your 15 minute IOP break?

During break I like to...

400
How do you help out around the house?
I help out around the house by...
400
What are some qualities in a friend you feel are important?
I feel the important qualities of a friend are...
500
*Group Question!* What was your favorite thing about this summer?
My favorite thing about this summer was...
500
My two most favorite things to do are _______________.
My two most favorite things to do are _______ & ________.
500

*Group Question! EVERYONE answers!* What are your goals for the weeks you are here?

My goals for while I am here are...

500
What are the interests of your family members?
My mom/dad/sister/brother, etc. are interested in...
500
*Reverse Order! Ms. Kelly answers first!!* Is it easy for you to make friends? Why/why not?
I do not make friends very easily. I tend to be quite shy when I first meet people, I usually do more listening than talking. People can't really get to know me that way so I just blend in with the crowd. When I get more comfortable with others and start sharing stories or things I have in common with them, it gets much easier to make friends.