Core Belief Form Test #1

Rate each statement on a scale of 1 (strongly disagree) to 7 (strongly agree). Answer honestly based on your current feelings, not what you think the “right” answer should be.

| # | Statement | 1 | 2 | 3 | 4 | 5 | 6 | 7 | |—-|—————| | 1 | Spending money is not something I derive pleasure from. | | | 2 | Being the center of attention is uncomfortable for me. | | | 3 | I feel uneasy and unhappy when away from civilization or urban environments. | | | 4 | Being around happy people when I’m feeling sad is something I dislike. | | | 5 | Looking at myself in the mirror is something I find displeasing. | | | 6 | I am not fond of competing with others. | | | 7 | Kissing is not an act I enjoy or appreciate. | | | 8 | Getting involved in other people’s problems is not something I prefer. | | | 9 | I dislike pondering or dwelling on things excessively. | | | 10 | Concerts are events I do not enjoy attending. | | | 11 | Learning new things is not something I find enjoyable. | | | 12 | Disliking the process of acquiring new knowledge is common for me. | | | 13 | Trying new foods is something I generally dislike or avoid. | | | 14 | Multitasking or juggling multiple tasks simultaneously is something I dislike. | | | 15 | Running errands for others is not a task I find pleasurable. | |

Bring the completed form to your next session. We will review your responses together.