Appendix A - Questionnaire

Please rate the following items according to your own personal feelings.  Use the scale below to determine the appropriate response for you.  Circle the number in the column to the right that most accurately reflects your reaction to each specific question posed.  There is no right or wrong answer.

1. I believe I could comfortably deal with an adult victim of emotional abuse.   1     2     3     4     5  
2. I believe I could comfortably deal with an emotionally abused child aged birth to 1 yr.   1     2     3     4     5  
3. I believe I could comfortably deal with an emotionally abused child aged 1 yr. to 12 yrs.   1     2     3     4     5  
4. I believe I could comfortably deal with an emotionally abused child aged 13 yrs. to 18 yrs.   1     2     3     4     5  
5. I believe I could comfortably deal with the person who caused emotional abuse of a child.   1     2     3     4     5  
6. I believe I could comfortably deal with the person who caused emotional abuse if the abuser were the child's mother.   1     2     3     4     5  
7. I believe I could comfortably deal with the person who caused emotional abuse if the abuser were the child's father.   1     2     3     4     5  
8. I believe I could comfortably deal with an adult victim of physical abuse.   1     2     3     4     5  
9. I believe I could comfortably deal with a physically abused child aged birth to 1 yr.   1     2     3     4     5  
10. I believe I could comfortably deal with a physically abused child aged 1 yr. to 12 yrs.   1     2     3     4     5  
11. I believe I could comfortably deal with a physically abused child aged 13 yrs. to 18 yrs.   1     2     3     4     5  
12. I believe I could comfortably deal with the person who caused physical abuse of a child.   1     2     3     4     5  
13. I believe I could comfortably deal with the person who caused physical abuse if the abuser were the child's mother.   1     2     3     4     5  
14. I believe I could comfortably deal with the person who caused physical abuse if the abuser were the child's father.   1     2     3     4     5  
15. I believe I could comfortably deal with an adult victim of sexual abuse.   1     2     3     4     5  
16. I believe I could comfortably deal with a sexually abused child aged birth to 1 yr.   1     2     3     4     5  
17. I believe I could comfortably deal with a sexually abused child aged 1 yr. to 12 yrs.   1     2     3     4     5  
18. I believe I could comfortably deal with a sexually abused child aged 13 yrs. to 18 yrs.   1     2     3     4     5  
19. I believe I could comfortably deal with the person who caused sexual abuse of a child.   1     2     3     4     5  
20. I believe I could comfortably deal with the person who caused sexual abuse if the abuser were the child's mother.   1     2     3     4     5  
21. I believe I could comfortably deal with the person who caused sexual abuse if the abuser were the child's father.   1     2     3     4     5  

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